A long-term monitoring of the incidence of digestive cancers was carried out according to the population cancer register in Novosibirsk in 1988-2012. Different trends were established in the cancer incidence of individual localizations: from a two-fold decrease in indicators for stomach cancer to a one-third increase in colorectal cancer. Cancer risk factors of different localizations are discussed.

Purpose of the study. Assessment of the oncogene CA-125 as a laboratory parameter having non-gynecological genesis on the example of two clinical observations. Materials and methods. A literature review on the clinical significance of the CA-125 oncogene and a description of two clinical observations Results. Oncogene CA-125 is considered as a laboratory indicator of gynecological oncology. The article presents the results of studies of elevated levels of CA-125 in patients without gynecological diseases. The authors give two observations of patients with anasarca and ascites and elevated level of CA-125.

Aims: to investigate the effect of acidic night reflux and serum adiponectin level on the development of gastroesophageal reflux disease (GERD) among young patients. Objectives: to compare the clinical manifestations of GERD, the pH-metry data the frequency of pathological nocturnal acid reflux and serum adiponectin level in young people with normal and overweight. Materials and methods: the study included 62 patients with GERD at the age from 21-44 years. The study group (SG) included 31 patients with a BMI of> 25 kg / m² and the group of clinical comparison (CCG) included 31 patients with GERD with a BMI <25 kg / m². The anthropometric date and serum adiponectin level were determined. 24-hour pH-metry, upper endoscopy with polypositional biopsy were performed. Survey of patients on the severity of GERD symptoms was carried out on the basis the GerdQ questionnaire. The quality of life was assessed by the SF-36 questionnaire (The Short Form-36). To identify risk factors the case-control method was used to calculate the odds ratio (OR) and 95% confidence interval. Results: in young patients with GERD with overweight OR of developing pathological acidic night reflux were 3.4 (95% CI 1.1-10.2, p = 0.026), OR of developing pathological acid day refluxes 3.5 (95% CI 1.2-9.9, p = 0.023). In young patients with erosive form of GERD, the level of adiponectin (Me = 7.5 pg / ml) was significantly lower than in the NERB group (Me = 19.7 pg / ml) (p = 0.012). Conclusions: the article reveals that one of the risk factors for development GERD is overweight or obesity. In the pathogenesis of GERD humoral mechanisms (adipokines, in particular, adiponectin) as well as anatomical and functional factors (abdominal obesity, abnormal nocturnal acid refluxes) play role with young people which leads to development of erosive esophagitis and complications (Barrett’s esophagus).

Aim. To study 20-year trends in the prevalence of antibodies to Helicobacter pylori and CagA antigen in the Novosibirsk population. Methods. Within the framework of population-based studies over 1994-2015 random representative samples of adolescents and adults aged 25-69 years of both sexes including 1,438 citizens (754 adults and 684 schoolchildren) were studied. Results. In adults, the infection rates of Helicobacter pylori did not change significantly. In adolescents, the prevalence slightly decreased, but the dynamics of decline were much less pronounced than in Eastern and, especially, Western Europe. Cytotoxic strains (CagA) were identified approximately at the same frequency during this time. Conclusion. Interventions are needed to improve the sanitary and hygienic control of the quality of food and water.

The objective of this study was to determine whether feeding behavior and compliance with its modification are different between healthy respondents and those taking or potentially requiring of inhibitors of vitamin-K-epoxide reductase, considering the geographical specificity of diet. Material and methods. In open multicenter studies 196 respondents’ (88 men, 108 women) food preferences were assessed using questionnaires by NA Nikolaev (2015). Quantitative evaluation of compliance with lifestyle modification was studied with questionnaire. Results. There were no significant differences in consuming food either increasing (37,0 ± 19,5 points against 37,3 ± 17,98 points; Wald-Wolfowitz (Z), p = 0.16) or decreasing (62,2 ± 26,3 points against 63,4 ± 23,8 points; Wald-Wolfowitz (Z), p = 0.95) the efficiency of inhibitors of vitamin-K-epoxide reductase between the studied categories of respondents. The absence of differences persisted considering the geographical specificity of diet (104,9 ± 45,6 points vs. 100,7 ± 43,9 points; Wald-Wolfowitz (Z), p = 0.78). There was no connection between compliance with lifestyle modification and the actual diet modification in patients taking inhibitors of vitamin-K-epoxide reductase. Conclusions. Doctors’ recommendations of modifying feeding behavior are shown to be ineffective for patients taking inhibitors of vitamin-K-epoxide reductase. This may be an independent risk factor for complications either of proper treatment with these drugs or of underlying disease. Further clinical studies of patients’ compliance with feeding behavior modification are required.

Study of the conducted studies with the participation of children and adolescents during the 10-year observation of patients with cholelithiasis (CL). Materials and methods: The work is a fragment of a 10-year follow-up of patients with CL. Two groups were formed: the 1st group (1) (n = 113) patients with cholecystectomy who underwent cholecystectomy (CE) and were prospectively observed for 10 years; 2-nd- (2) (n = 92) - unoperated patients with SCI, a prescription of at least 10 years, the symptoms of which were retrospectively analyzed. Results: Heartburn frequency for the 10-year period increased in the 1st group by 47.8%, in the group (2) by 22.8% (p = 0.005). In the group (1), with the initially symptomatic course, the maximum increased - by 66.3% (p <0.001) and by 45.8% with the initially asymptomatic flow (p = 0.001). In the group (2), in patients with initially asymptomatic course increased by 40% (p = 0.003). The symptom of «bitterness in the mouth» began to be detected more often in the first group by 22.1% (p <0.001), almost independently of the original version of the flow. The frequency of the symptom of «fatty food intolerance» (NFI) increased in the 2 nd group by 15.2% (p = 0.006), mainly due to the group with the initially symptomatic course. The frequency of diarrhea in the 1st group increased by 37.3% (p = 0.046), especially significant in the group with baseline asymptomatic course 33.3% (p = 0.005).The frequency of constipation increased in the 1st group by 25.6% (p <0.001), predominantly in the symptomatic group with a 27% decrease (p <0.001).The incidence of bitter mouth symptoms, diarrhea, constipation in group (2) has changed statistically insignificantly. Conclusions: During the 10-year follow-up of patients with CL, the frequency of symptoms increased, especially significantly: heartburn, bitterness in the mouth, diarrhea, constipation in patients after CE. Symptoms of heartburn and constipation began to occur more often in groups with the initially symptomatic course. The symptom of NFI began to be detected more often in the group of unoperated patients with CL.

Purpose of the study. The study of the cytokine spectrum of blood serum and its relationship with the index of porphyrin metabolism. Materials and methods. 84 patients (22 women and 62 men) aged from 26 to 69 years (mean age 49.6 ± 1.3 years) were examined. The cytokine spectrum of TNF-α, IL-1β, IL-1Ra, IL-6, IL-8, IL-10 and excretory porphyrins: δ-aminolevulinic acid, porphobilinogen, uroporphyrin, and coproporphyrin were determined by special methods. Results. In 59 people (70.2%), elevated concentrations of cytokines in the serum were recorded. The deviations from the control values for IL-1Ra (39 people, 66.1%) and IL-6 (45 persons, 76.3%) were recorded more often. Violations in the exchange of porphyrins were found in 58 patients (69.0%). On the totality of the disturbances, biochemical syndromes have been identified: an increase in porphyrin precursors, uroporphyrinuria, coproporphyrinuria, urocoppororphyrinuria, combined disorders. A direct correlation was established between IL-6 (r = +0.409), IL-1Ra (r = + 0.478), IL-10 (r = + 0.456) with uroporphyrin fraction, as well as IL-1Ra and δ-pminolevulinic acid (r = + 0.501). The increase in porphyrin precursors and fractions is significantly more often detected with violations of the cytokine spectrum (χ2 = 5.6, at the critical value p = 3.8, p <0.05). Conclusion. Violations of the cytokine spectrum and porphyrin metabolism are recorded in most patients with NAFLD. The reason for their occurrence at the moment remains unclear, which requires additional research.

Objective: To increase the effectiveness of prediction and diagnosis of fibrosis in patients with non-alcoholic fatty liver disease. Materials and Methods: We conducted an open-type case-control study involving 149 patients with NAFLD and a different stage of fibrosis determined with elastometry and histological examination of the liver biopsy specimen (group 1 - without signs of liver fibrosis (n = 40), group 2 - fibrosis 1 (n = 43), group 3-2 (n = 34) and group 4-3 stages (n = 32)). General clinical and laboratory methods of examination were conducted. In addition, noninvasive markers of fibrosis in the blood serum were studied: the concentration of insulin, leptin, adiponectin, matrix metalloproteinase-9 (MMP-9) and its inhibitors - tissue inhibitor of matrix metalloproteinase-1 and 2 (TIMP-1, TIMP-2). The polymorphism PNPLA3 148M / I (rs738409) was studied by the PCR method as a potential marker of the progression of liver fibrosis in NAFLD. Results: We identified clinical and laboratory signs demonstrating informativeness in the formation of progressive stages of fibrosis. It was studied that patients with NAFLD have hyperleptiemia and hyperinsulinemia. Evaluation of various types of leptinresistance allows to differentiate patients of high risk group for the progression of fibrosis. The nature of fat tissue distribution (abdominal obesity) is a highly informative criteria of high-stage liver fibrosis. Polymorphism of the PNPLA3 gene 148M/I has prognostic significance in the formation and progression of liver fibrosis in patients with NAFLD. The level of leptin, its soluble receptor in the serum, the biochemical activity of the disease (NASH), the waist are clinical and laboratory markers for the formation and progression of liver fibrosis in patients with NAFLD. This markers were included in the mathematical model. Conclusion: Complex quantitative analysis of clinical, instrumental and laboratory indicators allows predicting the formation and progression of liver fibrosis in individuals with non-alcoholic fatty disease.

Difficulties are known in the process of differential diagnosis between non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD), since the data of the main objective, laboratory and instrumental methods give similar results, not allowing to reliably speak about the etiology of the process. The most sensitive, specific, accurate, minimally invasive and accessible method for diagnosing chronic diffuse liver diseases is the combined use of transient elastometry and shear wave elastography. The scientific novelty of the proposed work is the application of combined use of transient elastometry and shear wave elastography as a method of comparative evaluation of ALD (under conditions of abstinence more than 1 month) and NAFLD. The primary importance of abstinence in ALD therapy has been confirmed. The aim of the study was to make a comparative evaluation of elastometric parameters of liver stiffness in patients with NAFLD and in ALD under abstinence conditions. Materials and methods. The control group included 30 practically healthy persons with a body mass index (BMI) from 20-30 kg / m2, without pathological changes according to the general, biochemical blood tests, when evaluating the echostructure of the abdominal cavity according to ultrasound, without any diseases of the liver and other organs in the history, voluntarily agreed to the study (group N). Two equal subgroups of subjects were included in the experimental group: 30 patients with non-alcoholic fatty liver disease (F1), 60% of whom had a BMI> 25 kg / m2 and 40% <25 kg / m2. 30 patients with confirmed alcohol dependence according to the CAGE, AUDIT, CDT test, who had not consumed alcohol for more than a month and at the time of the study being treated in the rehabilitation department of the Republican Narcological Dispensary, Ministry of Health of the Chuvash Republic (F2). One-dimensional (transient) elastometry of the liver and two-dimensional shear wave elastography with elastometry (SWE) were performed in the liver research algorithm (along with standard laboratory methods). Results: the indicators of general laboratory analyzes do not allow differential diagnosis of NAFLD and ALD; a reliable difference in indicators was found when assessing the responses to CAGE, AUDIT, CDT, SWE; Relatively more pronounced pathological changes in the organ parenchyma were observed in the comparative evaluation of elastometric indices of liver stiffness in alcoholic and fatty liver lesions in NAFLD than in ALD under conditions of abstinence (from one month).

Purpose. To identify the factors associated with nonalcoholic steatohepatosis/steatohepatitis in patients with ulcerative colitis (UC) and Crohn’s disease (CD). Materials and methods. The study involved 47 patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) aged 24 to 64 years. The diagnosis of steatohepatosis/steatohepatitis was estimated according to the data of ultrasound diagnostic of liver. The study did not include alcohol abusers, as well as patients with viral and autoimmune hepatitis. Results. Patients with CD had a reliable association between platelet count and the presence of nonalcoholic steatohepatosis/steatohepatitis (median platelet count 287×10⁹/L, [192×10⁹/L; 420×10⁹/L] in patients with nonalcoholic steatohepatosis/steatohepatitis and 250×10⁹/L, [180×10⁹/L; 379×10⁹/L] in patients without nonalcoholic steatohepatosis/steatohepatitis, p = 0.01). There were no significant differences in the body mass index (BMI) and age between the groups with nonalcoholic steatohepatosis/steatohepatitis and without nonalcoholic steatohepatosis/steatohepatitis among the patients with CD. Between patients in the UC group with and without nonalcoholic steatohepatosis/steatohepatitis, significant differences were found in the BMI (median BMI 28,7 kg/m² [26,2 kg/m2; 32,7 kg/m²] and 20,9 kg/m² [18,4 kg/m²; 22,7 kg/m²], respectively, p=0.03), mean hospitalization rates (1,53 hospitalizations/year, [0,1 hospitalizations/year; 2,92 hospitalizations/year] and 0,83 hospitalizations/year, [0,36 hospitalizations/year; 1,46 hospitalizations/year] respectively, p=0,025) and age (median age 55,3 years [48 years; 62 years], and 30.4 years, [25 years; 35 years], respectively, р = 0,001). Conclusion. In patients with a CD factor associated with nonalcoholic steatohepatosis/steatohepatitis is the platelet count. In the case of the UC, steatohepatosis is associated with a high rate of hospitalization, BMI, and age.

The article outlines the basic principles of treatment of mild-to-moderate ulcerative colitis, according to Russian and international recommendations. Approaches to the treatment of ulcerative colitis resistant to mesalamine therapy are considered. A review of clinical trials for the evaluation of the effectiveness of topical steroids is presented. The algorithm of patient selection for budesonide multimatrix treatment is proposed.

Objectives of the study: determination of clinical and epidemiological features of astrovirus infection in adult residents of Novosibirsk hospitalized with acute gastroenteritis (AGE), and genetic characteristics of the identified isolates of astrovirus. Materials and methods: 1469 patients aged 15 to 91 years, hospitalized with a diagnosis of AGE in the period from January 2016 to February 2018 were examined. Along with the generally accepted methods of diagnosis, feces were examined by PCR for the presence of astroviruses, rotaviruses o and noroviruses of the second genogroup. Results: Viral etiology of AGE was established in 311(21.2%) people. Astrovirus infection was diagnosed in 27 (1.8%), inferior in frequency to noroviruses (13.5%) and rotaviruses (5.7%). Astroviruses were detected throughout the year, mostly in patients under the age of 30 (88.9%). Half of the cases of astrovirus AGE (48.1%) showed consumption of seafood on the eve disease. Astrovirus AGE proceeded in a moderate form, characterized by fever from the first day of the disease, in most patients with subfebrile (92.6%). In 81.4% of patients, watery diarrhea was observed, in the remaining 18.6% of patients the disease proceeded in the form of acute gastritis. Significant differences of clinical symptoms, indicators of a haemogram and coprogram in patients with astroviruses AGE from other viral OGE are not installed. Astroviruses of three genotypes, HAstV-4 (48%), HAstV-1 (44.5%) and HAstV-8 (7.5%) were circulating during the observation period. In 2016, HAstV-4 was dominant, and then HAstV-1 became dominant by the end of 2017. In two patients for the first time in Novosibirsk, HAstV-8 was determined. Conclusion: The absence of specific manifestations of viral AGE of various etiologies, including astrovirus AGE, determines the need to introduce into clinical practice test systems for the verification viral pathogens into clinical practice. The study of the genetic diversity of astroviruses reveals the change of the dominant genotype and is important for understanding the patterns of astrovirus circulation both in the Novosibirsk region and in Russia as a whole.

Standardized original silymarin has a number of therapeutic effects: membrane stabilizing; antioxidant; metabolic; antiinflammatory; detoxification; regenerative; antifibrotic; cytoprotective; reducing the severity of fatty liver disease; reduction of neutral fat in the liver; antiviral; immunomodulating; antifibrotic; antiproliferative; normalizing the level of cholesterol in the blood; antidepressant; diaphoretic; diuretic. The review provides data on clinical observations that testify to the efficacy and safety of standardized silymarin in order to recommend its use for the prevention and treatment of a number of diseases of the hepatobiliary system. The hepatoprotector Legalon (MEDA, Germany) has a high degree of purification according to Rottapharm | Madaus and meets the European standard for the content of silymarin in the preparation and is produced in accordance with GMP criteria. “Legalon” is a preparation, the quantitative determination of silymarin in which is carried out by a modern method of high-performance liquid chromatography. These factors allow us to treat Legalon as a “reference” preparation of silymarin.

Purpose of the study. To study the morphofunctional state of the stomach in patients with hemoblastosis in the period of clinical-hematologic remission (GSR). Materials and methods. 164 patients with lymphomas were examined. The average number of courses of polychemotherapy (PCT) is 9.4 + 0.9, the average duration of remission is 66.47 + 9.26 months. Comparison group - 72 patients with chronic HP-associated gastritis without hematologic disease. Results. During the period of GSR, the frequency of symptoms of gastric dyspepsia increased, with the pain syndrome being negligible, the frequency of pyloric Helicobacter (HP) detection decreased significantly. The relationship of HP and dysplasia of the epithelium of the gastric mucosa was noted, which was detected much more often than in patients with chronic HP-associated gastritis without hematological pathology (OR = 319, (95% CI- (20.06-5073.5, p <0.0001), which suggests more a high risk of developing gastric cancer in patients with hemoblastosis in the GSR period. Сonclusion. Morphological changes in the stomach, including ulcerogenic and procancerogenic (erosion, atrophy, dysplasia) in patients with hematological diseases in the period of clinical and hematological remission are more frequent and expressed more than before treatment.

The purpose of the work was to study the characteristics of clinic of dermatoses and registration frequency of “extrahepatic signs”, accompanying diseases of liver and biliary tract, a diagnosis which has already been verified before resorting to Dermatologists. Materials and methods: the work is based on the aggregated results of clinical, laboratory and instrumental examinations conducted during the 10 years of 368 patients with diseases of the liver and biliary tract. Results: in structure of nosological forms of dermatoses at 368 patients with various forms of the chronic diffuse diseases of a liver (CDDL) most often were registered: an itch of a skin - 86,4%, mycoses of feet - 77,1%, a seborrhea - 60,9%, a superficial candidiasis of a skin and mucous - 50,8%, a chromophytosis - 41,0%, a human papillomavirus infection - 40,8%, a xerodermia - 31,5%. The prevalence and intensity of clinical implications of dermatologic symptoms depend on the nature of pathological process in a liver and testify to its gravity and activity. Conclusion: considering the high frequency of registration at CDDL of onikhopatiya, teleangiectasias, trichopathies, Campbell de Morgan’s spots and high informational content of a symptom of “the become empty veins”, extension of the register of extrahepatic “signs”, and change of this term on more denotated - dermatologic symptoms of a dermal syndrome of CDDL is represented expedient. The submitted data can be used both by gastroenterologists, and dermatologists.

Purpose of the study. The study of the effectiveness of the domestic hepatoprotector “Remaxol” in the complex treatment of patients with pulmonary tuberculosis in combination with CHC on the background of drug and alcoholic liver damage. Materials and methods. 108 patient histories with diagnosis of pulmonary tuberculosis were analyzed, in which chronic hepatitis C (CHC) was defined as a concomitant pathology. The average age of the patients was 36.4 ± 10.5 years. Patients of the first group (n = 37) with a diagnosis of pulmonary tuberculosis in combination with CHC on the background of chronic alcohol intoxication received complex chemotherapy for tuberculosis, and as a pathogenetic therapy, Remaxol was intravenously dripped 400 ml once a day for 12 days. The comparison group (n = 23) with the same diagnosis were on complex antituberculous chemotherapy in combination with pathogenetic and symptomatic therapy. Patients of the second group (n = 25) with a diagnosis of pulmonary tuberculosis against the background of CHC in combination with drug damage to the liver received a complex chemotherapy for tuberculosis, as well as a Remaxol intravenous drip 400 ml once a day for 12 days in quality of pathogenetic therapy. Patients of the control group (n = 23) with the same diagnosis were on complex antituberculous chemotherapy in combination with pathogenetic and symptomatic therapy. Results. Infusion therapy with the drug “Remaxol” led to the rapid disappearance of dyspeptic disorders and pain syndrome, a significant decrease in cytolysis. The pronounced hepatotropic effect of the drug “Remaxol” was confirmed by the rates of decrease in the average indices of ALT and total bilirubin. The conclusion. The use of hepatoprotector “Remaxol” in the complex treatment of patients with pulmonary tuberculosis with concomitant pathology of HCV on the background of alcohol and drug damage contributes to the improvement of the functional state of the liver.

With the aim of highly sensitive chromatography- mass spectrometry (Agilent 7000B, USA) with triple quadrupole analyzer and electron ionization source). Followed by statistical processing of measurement results the fatty acid composition of erythrocyte membranes in patients with colorectal cancer (63,2+9,4 years; 57 men, 43 women) of different stages and localizations and persons of comparison group (61,7+7,5 years; 14 men, 10 women) was studied. The study revealed significant differences in fatty acid (FA) levels in erythrocyte membrane phospholipids in patients with colorectal cancer associated with the stage of disease and in control group. Patients with colorectal cancer (CRC) compared to the control group was set to increase level of polyunsaturated fatty acids, mainly due to the omega-3 (including docosapentaenoic, docosahexaenoic), since the early stages of CRC (p<0.001-0.05) and a decrease in the level of saturated C14:0, C15:0, C17:0 (p<0.01 to 0.02), monounsaturated (C16:1;7, C16:1;9, C18:1; t9 p<0,001-0,04) fatty acids, and the ratio of omega-6/omega-3 polyunsaturated fatty acids (p<0.001), correlating with the stage of CRC. The detected shifts indicate a change in the metabolism of fatty acids in the process of carcinogenesis. The peculiarities of the differences in the fatty acid composition of erythrocyte membranes in patients with CRR of different stages make it possible to conclude that they can be used in the diagnosis of the disease with an emphasis on the early stages of the disease. On the basis of the obtained results it is shown that further studies of individual fractions of LC and their role in the progression of the disease are necessary.

Purpose of the study. To investigate the frequency and some mechanisms of osteopenia in chronic pancreatitis. Materials and methods. In a study of 161 patients with chronic pancreatitis included. Bone-turnover markers was measured: osteocalcin, β-CrossLaps, dual-energy X-ray absorptiometry was performed. The analysis of the content cytokines IL-2, IL-6, IL-8 in colonic biopsies, composition of the gut microbiota. Results. Bone disorders is associated with an increase in cytokines in colon biopsy and the altered intestinal microbiota.

The aim. The study of morphology and composition of gallbladder stones in the search for the possibility of differentiation of cholesterol type stones by X-ray tomography technique. Materials and methods. In-vitro investigation of gallstones were performed by the X-ray microtomography, X-ray phase analysis and electron microscopy methods. Results. The phase and element composition of gallstones were determined in our experiments. Cholesterol monohydrate, cholesterol anhydrous and calcium carbonate were discovered in the gallstones composition. 3D-distributions of linear attenuation coefficients of gallstones were obtained from X-ray microtomography measurements. The agreement of experimentally measured linear attenuation coefficients with the calculation based on tabular data for pure cholesterol is demonstrated. The cavities of different morphological structure formed in the process of growth were found in the gallstones. On the basis of X-ray, electron microscopic and optical measurements the possibility of formation of thin layers of bilirubin on the surface of cholesterol stones is demonstrated.

The qualitative indicators of the neuromuscular block were compared and evaluated the heart rate variability, using a variety of the methods of dosing of rocuronium bromide in the female patients with BMI more than 40 kg∙m-2, who were operated by laparoscopic cholelithiasis. It has been determined that the dosage of rocuronium bromide 30 mg / m² on the body surface area has an advantage over dosing on the ideal body weight, reduces sympathotony, the temporary ranges of the block duration and the need for repeated administration of rocuronium bromide. There was an expressed correlation between the amount of the entered rocuronium and the stress index of heart rate in the calculation on the body surface area than on the body weight. It allows to suggest more security on the dosing on the surface area than on the weight.

Objective: to improve the diagnosis and treatment of diseases of the ileocecal section. To improve the diagnosis and possible operative and endoscopic treatment of the ileocecal section, knowledge of normal anatomy and clinical anatomy is necessary. Much attention is paid to the state of the valvular apparatus of the gastrointestinal tract in normal and with various pathologies, and in particular, the ileocecal section, both in adults and in children. The following intravital methods for diagnosing the condition of the ileocecal section are available: X-ray, endoscopic, functional - peripheral computer electrogastroenterography. Conclusions. The presented literature data testify to the great functional significance of the ileocecal section both for the gastrointestinal tract and for the entire human body as a whole. But the available endoscopic data is fragmentary, illuminates the individual elements of the transition, is not systematized. Thus, the information presented in the review of the literature indicates the relevance and expediency of studying the endoscopic anatomy of the ileocecal section both in normal and in some diseases.

The aim of the study was to evaluate the effectiveness and safety of sodium phosphate (NaP) for colon cleaning in clinical practice. Patients and methods: 63 patients were under observation. Of these, 32 took the tablet form of Na P. The control group consisted of 31 patients who were preparing for colonoscopy using the standard method using a two-regimen for preparation of polyethylene glycol 4000. Conditions for the use of the NaP-tablet form were evaluated using a scale of criteria for compliance with the recommended treatment regimen. Results. Adequate use of the tablet form of NaP was noted in 84% of patients. The main reasons for the inadequate training were non-compliance with the intake of 1 person (3.1%), non-compliance with the diet before preparation for the study - 3 people (9.4%). Evaluation of the quality of preparation for the study was carried out according to the Boston scale [1-3]. When esophagogastroduodenoscopy was carried out, 34.3% (11 patients) of patients showed changes in gastric mucosae of the stomach, of which possible association with the reception of the tablet form of NaP in 1 (3.1%). Drug withdrawal and preparation for study 1 (3.1%) were stopped. The compliance with the use of the tablet form of NaP was high, especially among patients who previously used other preparations for intestinal preparation. Conclusions: the use of the tablet form of NaP in preparing the colon for colonoscopy when compared with other methods of purification showed good results both in the quality of the patient’s preparation and in the continuity of the patients with this preparation in preparation and in the safety of its use, which coincides with the data of other randomized research.

Hyperemesis gravidarum - one of the common diseases in during I and II trimesters of pregnancy. The review presents data concerning the prevalence, clinical manifestations, methods of diagnostics and treatment, as prevention of hyperemesis gravidarum. The literature of 2015-2018 is analyzed.

A research objective was assessment of a current and the result of pregnancy at women with various types of dispepsia. 175 pregnant women are examined: 73 - with dyspepsia during pregnancy, but without that before a gestation, 46 pregnant women - with chronic gastrointestinal diseases before pregnancy and 56 pregnant women who had no dyspepsia as pregnancies in time, and in the anamnesis. The conducted research reflects negative impact of gastrointestinal disorders of functional and organic genesis on a current of a gestation: increase in frequency of an early gestoz, placentary insufficiency, infections of urinary tract, anemias, deterioration in indicators of health of newborns on a scale Apgar. Dyspepsia also lead to increase in complications of childbirth and the postnatal period - epiziotomiya, postnatal endometritis. Thus, dyspepsia during pregnancy should be considered as risk factor of the complicated course of pregnancy, childbirth and the postnatal period demanding adequate correction.

The aim was to investigate the thyroid status in children with chronic gastroduodenitis in combination with such atopic diseases as bronchial asthma and atopic dermatitis. Materials and мethods. 39 children of pre-pubertal age that have a morphologically confirmed diagnosis of chronic gastroduodenitis-CGD were examined with an ELISA. The children were divided into 2 groups: 1 - a group of 16 children with HGD only; the second is 23 children with CGD and atopy. Results. In both groups, the mean T3, T4, T4cb, TTG levels and the number of patients with normal levels of thyroid hormones in the blood serum were the same. A higher level of antibodies to thyroglobulin was found in patients with CGD and atopy and a higher level of antibodies to thyroid peroxidase in patients with CGD only. The mechanism of the revealed differences requires additional study.

Purpose of the study. Description of the case of the Klippel-Trenone syndrome. Materials and methods. A short review of the literature on the problem of the Klippel-Trenone syndrome and a description of the clinical observation is presented. Results. The abdominal form of the Klippel-Trenone syndrome is a rare variant of this type of pathology. This report describes the observation of a 65-year-old patient, with the abdominal form of the Klippel-Trenone syndrome, manifesting rectal bleeding Сonclusion. Thus, the study of literature and our observation shows that in the presence of typical manifestations of the Klippel-Trenone syndrome, bleeding from the organs of the gastrointestinal tract can have the same vascular-malformational nature.

A clinical case of a virologic breakthrough in a patient with a 1b genotype after a 12-week therapy with ombitasvir + paritrapeprivir / ritonavir + dasabuvir, due to significant mutations in the NS3, NS5a, and NS5b region of the virus is presented.

The study describes a case of a two-stage reconstructive surgical reconstruction in a patient with with damage of common bile duct and unformed bowel fistulas

Inflammatory bowel diseases (IBD) - ulcerative colitis (UC) and Crohn’s disease (CD) are characterized by a specific clinic: diarrhea, the presence of blood in the stool, abdominal pain, general weakness. However, IBD can be combined with other bowel diseases, for example, with the bacterial overgrowth syndrome (BOS). BOS may not be suspected due to the similarity of symptoms with manifestations of exacerbation of CD or UC, the symptoms of BOS can be regarded only as a manifestation of IBD, which leads to incorrect treatment tactics. In this article, we demonstrate the clinical case of such a combination.