The aim of the study was to determine the relationship between the presence of disorders of carbohydrate and lipid metabolism with the structural changes of the liver in patients with ischemic chronic heart failure and non-alcoholic fatty liver disease. Materials and methods. The study included 120 patients aged 45 to 65 years old with I-III functional class chronic heart failure, myocardial infarction from 6 to 12 months. All patients had symptoms of metabolic syndrome and diabetes mellitus type 2. Patients analyzed anthropometric data, blood pressure measurement, evaluation of the content of visceral fat, level of liver markers damage, carbohydrate and lipid metabolism by conventional laboratory techniques; HOMA insulin resistance index was calculated by Mattews D. and metabolic index by Roitberg G. E.; perform calculations steatosis index (FLI) and liver fibrosis (NFS), liver ultrasonography. Results: In patients with chronic heart failure and non-alcoholic fatty liver disease FLI - index and NFS - index significantly correlated with higher levels of LDL cholesterol and triglyceride levels, decrease of HDL cholesterol and high metabolic index. Increasing FLI-index significantly correlated with the percentage of visceral fat. The level of glycated hemoglobin was significantly higher in the group with initial ultrasonographic evidence of NAFLD. FLI - index significantly correlated with level of GGT, whereas the NFS - index correlated with level of alkaline phosphatase in the group IB - IC ultrasonic classes of hepatic steatosis. Conclusion: we have identified a relationship between disorders of carbohydrate and lipid metabolism with the structural changes of the liver in patients with ishemic chronic heart failure and non-alcoholic fatty liver disease.

Aim of the work was to study relationship of molecules of immunoglobulins superfamily with histological variants of nonalcoholic fatty liver disease. Material and methods. Blood levels of parameters of immunoglobulins superfamily (ICAM-1, VCAM-1, PECAM-1) were studied in 40 patients (23 men, 17 women) with histologically proven nonalcoholic fatty liver disease in relationship with morphological changes in liver. Severe liver steatosis was revealed in 47.5 % of patients, nonalcoholic steatohepatitis was observed in 57.5 % of cases, moderate and severe liver fibrosis was present in 70 % of patients. The control group included 60 healthy volunteers. Results. The blood concentration of all adhesion molecules was increased in nonalcoholic fatty liver disease. The levels of ICAM-1 and VCAM-1 in blood increased and levels of PECAM-1 decreased with intensifying of fatty liver infiltration, reaching extreme values in cases of severe steatosis. Positive correlation between ICAM-1 and degree of steatosis was determined. In patients with parameters of nonalcoholic steatohepatitis score (NAS-II) of 5 and more points levels of ICAM-1 and VCAM-1 in blood were higher, than in group of patients with the minimal values of scale. Positive correlation of ICAM-1 and VCAM-1 with values of nonalcoholic steatohepatitis score was detected. Levels of ICAM-1, VCAM-1 and PECAM-1 in blood increased with intensifying of hepatic fibrotic changes and were maximal in severe fibrosis. Positive correlation of ICAM-1, VCAM-1 and PECAM-1 with fibrosis score was registered. Conclusion. Definition of adhesion molecules profile in nonalcoholic fatty liver disease allows to ascertain expressiveness of morphological changes and to stratify patients on groups with various morphological activity and liver fibrosis.

The features of the application of pegylated interferon - Сepeginterferon alfa2b (cepeg-IFN) on the results of treatment of 20 patients with chronic hepatitis C in outpatient practice. The analysis of the clinical, biochemical, virological data and transient liver elastometry on the background of antiviral therapy with cepeg-IFN. Based on these data is justified is not the worst in comparison with foreign analogues the efficacy and safety of the original domestic product for the treatment of patients with chronic hepatitis C, not previously treated with antiviral therapy, without a high degree of fibrosis or cirrhosis. Demonstrated clinical example of treatment failure associated with infection with a recombinant virus 2k1b and proposes an approach to the diagnosis of this variant infection

Chronic hepatitis is a common socially significant pathology in the world. One of the manifestations of chronic hepatitis B is a violation of lipid metabolism, affecting the course and progression of the underlying disease. Despite holding a large number of studies on the correction of lipid status in patients with chronic hepatitis, treatment of lipid disorders problem remains urgent. In this regard, the aim of our study was to evaluate the effect of combination therapy with the mononuclear fraction of blood compared with standard therapy on the dynamics of lipid metabolism in patients with chronic hepatitis.

The Aim was to investigate of clinical and diagnostic value of change of concentration of tumor necrosis factor (TNF) and also soluble receptors II type of tumor necrosis factor (sTNF-RII) in chronic hepatitis (CH) and liver cirrhosis (LC). Material and methods. 65 CH and 64 LC patients and 25 healthy volunteers were included in the investigation. TNF and sTNF-RII concentrations were assessed by the ELISA method. Results. The average TNF level in CH and LC was authentically (p<0,05) increased in comparison with the donors (84.12±10.92 IU/ml and 138.14±19.98 IU/ml cons 23.54±6.02 IU/ml). The sTNF-RII concentration in CH and LC was significantly (p<0,05) increased in comparison with the norm (in CH 7.33±0.32 IU/ml, in LC 13.15±2.19 IU/ml and in control 3.54±0.39 IU/ml). The TNF and sTNF-RII levels were significantly (p<0,05) increased in viral CH and LC in comparison with the alcoholic etiology and norm. The TNF and sTNF-RII increasing associated with the activity of inflammation and severity of LC class on the Child-Pugh score.

Revealed clinical and psycho-physical manifestations, especially the pathogenesis, endoscopic and morphological pattern of mucosal pathology Gastroesophageal Zone in elderly patients with erosive and non-erosive form of gastroesophageal reflux disease. A total of 226 patients studied nosology. Applied clinical, endoscopic, morphological, immunohistochemical methods. Increasing the number and functional activity of the stomach and esophagus APUD cell producing nitric oxide synthase and endothelin-1 in patients in comparison with comparison groups, suggests their main pathogenic factor of the disease. Cell hyperplasia cells secreting nitric oxide synthase and endothelin-1, more than twice, there is the formation of refractory form of the disease.

Chemotherapy, used in patients with oncological diseases, leads to damage of a mucous membrane of gastrointestinal tract. 60 % of patients treated by chemotherapy have stools disorders. The article presents the data of the study of the severity of gastrointestinal complaints in patients with lung cancer, chemotherapy, the nature of the influence appointed in the schemes of the treatment of lung cancer anticancer drugs, shows the possibilities of correction of the revealed violations. Using of probiotics in these patients leads to decrease of gastrointestinal complains.

The aim of the research: the study of features of clinical course of acute intestinal infections (AII) on the background of coronary heart disease (CHD), diabetes (D), mental and behavioral disorders on the background of alcohol consumption (AC); development of pathogenetic therapy for these comorbid conditions by means of using succinate-containing drugs. Materials and Methods: 197 patients with AII (without associated diseases, and with CHD, D, AC) were examined in dynamics. The patients received conventional infusion therapy or 1,5 % solution of Reamberin at 10 mg per 1 kg of body weight. Pharmacoeconomic efficiency of using Reamberin was calculated. Results: Associated pathology determines more severe course of AII and possibility of complications, including decompensation of chronic disease. Introduction of Reamberin in the infusion therapy for patients with AII enabled proved decrease in the number of existing symptoms in all groups by the second day of treatment, as well as decrease in the persistence of the main symptoms of AII. The absence of cases of decompensation of chronic disease in patients receiving Reamberin was noted, in cases of their presence on the background of traditional therapy. Specific economy as a result of using Reamberin in the complex therapy of AII was 23383,5 rubles mainly due to the reduction of the duration of the disease and more rapid vocational rehabilitation. Conclusion: The presence of comorbid pathology affects the typical manifestations of AII, which requires optimization of therapy. The findings show the ability of Reamberin to influence the clinical course of AII, including in cases with associated diseases, by reducing the persistence of the main symptoms of the disease as well as the number of complications associated with decompensation of chronic conditions. High cost-effectiveness of using Reamberin in the treatment of AII, along with a proven positive clinical effect, is an important argument in favor of the widespread use of the succinate-containing drugs in clinical practice.

The review presents modern data on epidemiology, risk factors, mechanisms of nonalcoholic fatty liver disease, role of intestine and colon microbiome in the development of nonalcoholic fatty liver disease.

The urgency of the problems caused by the high frequency of its occurrence. The role of the liver microsomal system and the gastrointestinal tract, where there is a cytochrome P450 biotransformation processes required for xenobiotics and endobiotics that will optimize the diagnosis of peritonitis, the development of methods of prevention and treatment. This review is an attempt to synthesize and analyze accumulated information about the pathogenesis of peritonitis, which dictates the need to revise the overall treatment strategy and the search for new effective methods of detoxification. It studies the processes of microsomal oxidation, will provide additional information relevant to the prediction of the adaptive capacity of the organism in the syndrome of endogenous intoxication. Therefore, one of these areas is the problem of simulation (catalytic and electrochemical) processes in the liver and the gastrointestinal tract.

The aim of our research was to study the current and future trends in the treatment of nonalcoholic fatty liver disease. This review presents recommendations of leading hepatology Associations in the treatment of nonalcoholic fatty liver disease (NAFLD). The article describes the results of research at the development of new directions in the treatment of this disease and rates the of the most promising drugs. Conclusions. There are several new drugs for treatment of nonalcoholic fatty liver disease under clinical trials today, but further research is needed to assess their long-term efficacy and safety. One of the more pathogenetically grounded drugs for the treatment of NAFLD is ademetionine.

Pancreatic ductal adenocarcinoma (PDA) is one of the most dangerous and clinically difficult cancers. PDA is one of the diseases for which the mortality rate is almost equal to the level of morbidity. The absence of effective methods of screening, late detection are the main reasons for that. At the same surgical and therapeutic treatments are ineffective. Using different types of chemotherapy increases the life expectancy of patients with 5-7 months of gemcitabine in the treatment of one to 8,5-11 months with combination therapy. Therefore, the search for new targets for therapy is a main task in this pathology. In a review article presents the results of recent research in the field of genetics and molecular biology of PDA. Described mutations in key genes: KRAS, TP53, CDKN 2A, SMAD 4, ARID 1A and also often identify other gene defects: TGFBR 2, KDM6A, AXIN 1, ACVR 1B, PIK3CA, RNF43, GNAS, ATM, GLI3, ARID 1A and RBM10. Presents the analysis of the relationship of gene mutations with changes of their signaling pathways and the possibility of using the features of targeted therapy of PDA. The review reflects the problems of changes in immune status, participation mechanisms stromal cell component in the processes of tumor progression and metastasis, the possibility of using specific antibodies in combination chemotherapy regimens in PDA.

Idiopathic cystic expansion of the intrahepatic ducts (Caroli’s disease) is a congenital hereditary disease, inherited as an autosomal recessive trait. To improve the prognosis in case of cholangitis appointed antibiotics. When intrahepatic stones and / or the presence of biliary sludge successfully used ursodeoxycholic acid. Described clinical case management of the patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) and Caroli disease. Antibacterial COPD exacerbations correction contributed to the prevention of cholangitis with improved liver function due antiholestatic and hepatoprotective effect of ursodeoxycholic acid. Integrated approach to comorbidity status of the patient achieves the highest compliance.

The purpose of the study. To present the history of the life and work of one of the greatest surgeons of modern times - S. S. Yudin. To justify the assumption of the presence of chromosomal abnormalities - Marfan’s syndrome Materials and methods. The study used bibliographical, historical-genetic and analytical methods Results. We have summarised information on the fate and scientific work of academician Sergey Sergeyevich Yudin and suggested the presence of chromosomal abnormalities - Marfan’s syndrome, as evidenced by: high growth and dolichostenomelia; hypermobility of joints; severe myopia; insufficiency of the aortic valve, the result of which was myocardial infarction. High adrenaline background, characteristic of the disease contributed to the highest health, lightning-fast reactions to events and emotional techniques of operations.