Perm City is the large industrial, scientific, educational and cultural center in Volga Federal District. Also it is one of the oldest and the most attractive Ural cities. Higher medical education on the West Ural was founded in 1916. The main stages of the development of Perm State Medical University are lightened in the article. Perm State Medical University is the peculiar school of experts of different medical specialties, scientific and educational personnel, specialists of the middle range of the health care system. The history of the university is full of historical, professional and creative traditions. 2016 year is the century of the higher medical education on the West Ural and the anniversary year for Perm State Medical University by E. A. Wagner.

Aim of the study. To investigate the effect of generation of tumor necrosis factor-alpha (TNFα) and the importance of TNFα(rs1800629) gene polymorphism in the progression of chronic hepatitis С (CHC) and ulcerative colitis (UC). Material and methods. The study involved 90 patients with chronic hepatitis C, 50 patients with UC and 50 healthy donors. The blood concentrations TNFα and TNFα gene polymorphism (rs1800629) were evaluated. Results. TNFα levels in the blood in patients with chronic hepatitis C were increased compared with the control group and correlated with the severity of cytolysis and fibrosis (r=0,34, р=0,02). At slow speed the formation of liver fibrosis TNFα amounted to 1.5(0.9-2.8) pg/ml, with a fast speed - 2.3(1.4-8.2) pg/ml (p=0.006). Patients with UC at 3-4 degrees endoscopic activity production of TNFα reached 6.5(7-9) pg/ml, which was significantly higher than the value obtained at 1-2 degrees endoscopic activity - 0.25(0-0.8) pg/ml (p=0.001). The allelic variations of TNFα in groups of patients with CHC at different rates forming LF statistically differences were not found. The allele, associated with severe progressive course of UC and increased production of TNFα - A risk allele and genotype GA TNFα, associated with a slow progression of UC - “protective” G allele and genotype GG TNFα gene were determined. Conclusion. Determining the level of TNFα allows to evaluate the severity of liver disease, heaviness and progression of liver fibrosis speed in CHC, and the severity of inflammation in the intestinal mucosa in UC. The presence of the allele A of TNFα(rs1800629) is a predictor of severe and progression of UC. Determining genetic polymorphism TNFα in patients with UC may be an additional factor to assess the prognosis of the disease.

Purpose. The aim of the investigation was to study the characteristics of endothelial function in patients with IBD. Materials and methods. 61 patients with ulcerative colitis (UC) and Crohn’s disease (CD) in the acute phase or with newly diagnosed forms of the disease were examined. CD group included 16 people (8 women and 8 men) mean age 35.63 ± 5.51 years. UC group included 45 patients (18 women and 27 men), their average age was 36.76 ± 3.17 years. To assess the endothelial dysfunction the level of microalbuminuria (MAU) was examined with Micral-Test strips. Serum concentration levels of CRP, TNF - α, alpha1 and alpha 2-globulins, fibrinogen as well as ESR were evaluated as the markers of systemic inflammation. Results: In CD patients a significant increase of MAU in severe forms of the disease 32 ±10.95 mg/l (р<0.05). was revealed. Furthermore, MAU was significantly higher in individuals with extraintestinal manifestations and complications of CD (28.01±17.89 mg/l and 20.00±14.14 mg/l, respectively). A significant relationship of the MAU levels and severity of CD (r=0.797, p=0.0002) as well as the presence of extraintestinal symptoms (r=0.625, p=0.0096) were identified. The evaluation of the systemic inflammation markers showed a significant increase of CRP levels and ESR in severe forms of IBD. A positive correlation of CD with the ESR (r=0.802, p=0.0021), CRP (r=0.773, p=0.0004), alpha-2 globulin (r=0.534, p=0.0298) and fibrinogen (r=0.647, p=0.0067) was identified. Conclusions: The evidence of endothelial dysfunction in patients with IBD was revealed that was expressed in the MAU levels elevation. The MAU level can be regarded as the criterion of the CD severity as well as the sign of its unfavorable course.

The composition and technology of complex probiotic in hard gelatin capsules was developed in Perm Branch «Biomed» of «Microgen» State Company. The preparation contains three production strains: Lactobacillus plantarum 8P-A3, L. acidophilus K3Ш24 and Bifidobacterium bifidum 1. Laboratory and experimental (preclinical) study of the probiotic included investigation of the antagonistic activity, “acute” and “chronic” toxicity, the effect of the preparation on histology and hematology of laboratory animals. The results of these studies suggested of the probiotic had high inhibitory activity against pathogenic microflora when compared with probiotic monopreparations and had no toxic effects on laboratory animals.

The objective. To determine the value of intestinal failure and translocation of bacteria Y. pseudotuberculosis, and normal intestinal microbiota in the initiation and generalization of infection in experimental pseudotuberculosis in conventional white mice, as well as pathological manifestation of it as a response to the adhesion and colonization of the mucosus membrane by pathogenic bacteria Y. pseudotuberculosis. Materials and methods. Experimental models of pseudotuberculosis in conventional white mice used the pathogenic Y. pseudotuberculosis 147 serotype I strain, containing a calcium-dependence plasmid with a molecular weight of 47 MDa. Cultivation of the pseudotuberculosis pathogen given its psychrophilic was performed on Hottinger agar at a temperature of (4-5) °C. The lactobacilli strain L. plantarum 8P-A3 was isolated from a lyophilized commercial probiotic Lactobacterin (manufactured by «NPO Microgen», Russia) and used to obtain native culture supernatant fluid of lactobacilli, the composition of which was detected by gas-liquid chromatography with mass-selective detection. Gentamicin for parenteral administration was manufactured by JSC «Biochemist», Russia. Pathomorphological examination was performed on the 4-6th day of the experiment. Fragments of the small intestine, liver, kidneys, and lungs from dead animals were chosen for examination. Tissues were fixed in 10% neutral formalin, dehydrated in isopropanol and embedded in paraffin. Preparations were stained with Ehrlich hematoxylin and eosin, examined on the microscope «Mikmed-2» (JSC «LOMO», Russia) under magnification ×200 - ×1000. Statistical processing of the experimental results was carried out according to the method of Kerber in modification of I. P. Ashmarin and A. A. Vorobyov. Results. The role of intestinal failure and translocation of bacteria Y. pseudotuberculosis, and normal intestinal microbiota in the initiation and generalization of infection in animals has been found. It has been proved that the oral administration of supernatant fluid containing microbial metabolites to animals as intramuscular administration of gentamicin equally prevent the development of generalized pseudotuberculosis and intensity of pathomorphological changes in the intestine and other organs of animals. Conclusion. Metabolites of the probiotic lactobacilli strain L. plantarum 8P-A3 jugulate the development of pseudotuberculosis at an early stage of the pathological process in experimental animals infected with pathogen Y. pseudotuberculosis, not only causing the preservation of the colonization resistance of the intestinal mucosa that prevents the adhesion and colonization of the pathogen, but also through their antimicrobial impact on the dissiminated pseudotuberculosis pathogen bacteria in animals.

The review describes the influence of serotonin (5-HT) and its receptor, transporter SERT and nuclear factor Nf-kB on the immune function of the body, particularly in the digestive tract. The mechanisms of the synthesis, metabolism and catabolism of 5-HT are characterized. The targets for serotonin on cell level are immunoactive cells - neutrophils, eosinophils, leukocytes, monocytes and dendritic cells. Receptor and non-receptor described mechanisms of action of peripheral serotonin are described. Immunoactive cells express on their membrane 5 HT1A- 5-HT1E- 5-HT2A- 5-HT3-, 5-HT4- and 5-HT7- serotonin receptor subtypes. Activation of these receptors modulate the release of TNF-α, secretion of interleukins IL-1β, IL-6, IL-8 / CXCL8, IL-12p40. Mediators of the non-receptor mechanisms are transporter SERT, tryptophan hydroxylase-1 and nuclear factor Nf-kB. Target-genes for Nf-kB are genes encoding cytokines. The cooperation of non/receptory pathways involved 5-HT1A- and 5-HT3 receptors. It is concluded that the diversity of ways of peripheral serotonin on the immune function of the body are existed.

This review covers the epidemiology, pathogenesis, risk factors, classification, clinical manifestations of candidiasis gastrointestinal, diagnosis and therapies.

The aim. To present a clinical case of serrated colon adenocarcinoma. To demonstrate morphological and genetic features of these tumors and to determine their clinical management. Key points. Described case shows diagnostics of serrated colon adenocarcinoma. A 67-year-old woman presented for colonoscopy because of long constipation besides abdominal pain and distention have appeared recently. Colonoscopy was performed and she was found to have a 3.0x3.0-cm tumor next to hepatic flexure and pedunculated 1.2х0.7 cm polyp in sigmoid colon (type Ip according to Paris classification). Endoscopic biopsies of these lesions were consistent with serrated adenocarcinoma and tubulovillous adenoma with foci of severe dysplasia. Additional diagnostic methods revealed no distant metastases. Patient was underwent right hemicolectomy with D3 lymphodissection, lesion in sigmoid colon was removed using snare with electrocautery. Final pathology revealed no residual tissue in margins and no malignant cells in removed lymph nodes. Genetic diagnostics by PCR found high level of microsatellite instability and positive CpG island methylator phenotype (CIMP+) in tumor tissue. Conclusions. According to WHO classification serrated lesion are considered to have malignant potential. They serve as the precursors for approximately 10% to 15% of sporadic colorectal cancer developed through the serrated pathway. These tumors were named serrated adenocarcinoma and had special morphological criteria that allow us to differentiate them with colorectal adenocarcinomas developed through the traditional pathway. Serrated adenocarcinoma has high level of microsatellite instability and positive CpG island methylator phenotype (CIMP+). Presence of microsatellite instability in tumor determines its more favorable prognosis because of tumor immunogenicity. Besides this type of canсer is more often responding to therapy with fluoropyrimidines.

The article presents the biography of one wonderful doctors, who have high human, civil and professional qualities, Fyodor Ch.. Gral