The aim of the paper — is to present the results of the consensus on the terminology used to describe data of high-resolution anorectal manometry.

Methods: Online survey was conducted with the help of the public platform “Google forms” with the aim to harmonize the terms, which are used to conduct high-resolution anorectal manometry (HRAM), to agree the conformity of the proposed Russian-language terms to those used in English-language literature, and their abbreviations.

Results: According to the aim, 56 specialists of different medical specialties who perform and use the results of HRAM in clinical practice and research were invited to participate in the survey. We received 45 answers from the respondents (42.2% coloproctologists, 22.2% gastroenterologists, 15.6% surgeons, 20% — representatives of other specialties). The response rate was 80.3%. According to the survey, 95.6% of respondents supported the need for harmonization of terms. Ten out of the 11 terms reached consensus level C1 (excellent), 1 term level of consistency was C2 (moderate). 90.9% of respondents (consensus level C1) were in favor of the appropriateness of using common abbreviations. However, the proposed abbreviations of the terms used in the conduct and description of the results of the HRAM can be accepted with reservations (in 10 cases out of 11 consensus level was C2).

Conclusions: The agreed in interdisciplinary consensus terms can be approved and recommended for the use in clinical practice and when research data are published in Russian-language scientific literature.

The Irritable Bowel Syndrom (IBS) is one of the most widespread functional disorders of digestive tract (FD GIT). According to biopsychosocial model the anxiety concerning feelings from digestive tract plays a key role in maintenance and, perhaps, in development of IBS. J. Labus proposed the new questionnaire — VSI — the Visceral Sensitivity Index or the index of gastrointestinal symptom-specifi c anxiety, later validated only for patients with IBS.

Aim: to estimate the value of VSI in patients with IBS depending on a sex, age and clinical subtype of IBS and its correlation with a depression, anxiety and alexihymia.

Methods: 245 patients with IBS were examined (women — 183, men — 62), middle age 45.31 ± 6.9 years (19–81). Initially, 10 patients from 245 selected patients with IBS did not answer to the questionnaire. 7 patients did not fill out the questionnaire. So, data from 228 patients with IBS which completely fill out the questionnaire was analyzed. According to the research objective the initial group of patients with IBS was divided into two subgroups: up to 45 years (the 1st group) and 45 years and older (the 2nd group). The 1st group included 120 patients; the 2nd group — 108 patients. IBS was confirmed by the diagnostic criteria of IBS according to Rome III (2006). Depression was assessed by the Beck’s Depression Inventori (BDI), anxiety — by the Stait-Trait Anxiety Inventory (STAI) (by Spielberger-Hanin), alexithymia — by the Toronto Alexithymia Scale (TAS).

Results: The VSI was higher in the senior age group of IBS patients (2nd group), at the same time there were no gender differences in both groups. The greatest values of VSI were observed at patients with IBS-D subtype in both age groups. VSI was an independent indicator in the 1st subgroup of patients with IBS (age up to 45 years) while in the 2nd subgroup (senior age group) weak correlation with a depression and personal anxiety (r ≥0.4) was observed.

Conclusion: The VSI can be used as the independent test refl ecting a psychoemotional condition of patients with IBS at a diagnostic stage.

Background. Despite the progress made in the treatment of chronic hepatitis C (CHC), there remain many unsolved problems in the treatment of patients infected with the 3rd virus genotype. This fact is mainly associated with the presence of hepatocyte steatosis due to the formation of local insulin resistance. Another important medical and social problem is polycystic ovary syndrome (PCOS), patogenetically associated with insulin resistance. Application of metformin in females to reduce insulin resistance can improve the results of antiviral therapy.

Material and methods. Overall 81 females with CHC and PCOS were included in original study. The 1st group (35 patients) received metformin in dose of 20 mg/kg of body weight per day as preliminary and concomitant treatment in addition to antiviral therapy. In 14 patients of this group steatosis was revealed. In another subgroup (21 patients) steatosis was not revealed. The 2nd group (46 patients) received antiviral therapy only. Patients of this group were divided into two subgroups by presence (17 patients) or absence (29 patients) of hepatic steatosis. Interferon-α2b in a standard dose of 3 million IU3 times per week in combination to ribavirin 13 mg/kg/day for 24 wks was applied as antiviral therapy. The period of the subsequent follow-up was 24 wks.

Results. Patients with hepatic steatosis had higher biochemical and histological scores of activities. In the groups of patients receiving metformin a higher incidence of a sustained virological response was observed. Additional application of metformin did not aff ect the safety profile of antiviral therapy.

Conclusions. Women with CHC with the 3rd genotype and PCOS, who took metformin, had a significantly higher frequency of sustained virological response with an equal safety profile.

The aim of this study was to study the eff ects of using the infusion drug Remaxol in young patients with alcoholic liver disease.

Materials and methods: the clinical and laboratory data of 80 young patients with alcoholic liver disease were analyzed, divided depending on the treatment regimen into 2 groups: the main (n = 44) who received Remaxol according to the scheme: 400 ml iv, drip, at a rate 40–60 drops per minute daily, course No. 5–10, and control (n = 36) — received basic therapy. In all patients, the dynamics in blood serum was studied: lipid peroxidation indices (malondialdehyde, diene conjugates), antioxidant protection enzymes (catalase, SOD, glutathione peroxidase), markers of cytolysis, cholestasis and lipid metabolism.

Results: initially there was a significant increase in lipid peroxidation processes, accompanied by slight stimulation of the antioxidant system of the liver and pronounced signs of cytolysis and cholestasis. The inclusion of Remaxol in treatment regimens leads to a significant decrease in the level of malondialdehyde and diene conjugates, and the restoration of the antioxidant system (increase in catalase, SOD, and glutathione peroxidase). At the same time, a marked decrease in the syndromes of cytolysis and cholestasis was noted, which was accompanied by an improvement in the condition of the patients: cessation of nausea, restoration of appetite and sleep, and improvement of well-being.

Currently, the pathogenesis of the formation and development of cysts has not been fully studied. This creates the need to analyze existing and fi nd new ways to model pancreatic cysts.

The aim: create a new way of modeling the true pancreatic cyst

Materials and methods: in an experiment on 7 mongrel dogs, a new method of forming a model of a true cyst of the head of the pancreas was developed, by creating a reservoir from the 12-type intestine with the pancreas, with suturing to the posterior wall of the pyloric part of the stomach.

Results: the model of the pancreas cyst proposed by the authors meets the criteria of the true pancreatic cyst and can be used in experimental studies of various methods of cyst treatment.

Conclusions: this method is technically simple in execution and allows one-step, in less time to perform the operation.

Objective: to assess the activity of р38 МАРК in serosal injury.

Material and methods. We modelled adhesive process in abdomen in 40 Wistar rats. Adhesion zone was immunohistochemically stained for p38 MAPK and p38 MAPK Phospho. Expression of р38 МАР-coding genes was studied the in the injured zone using RT PCR. The control group consisted of 5 intact Wistar rats.

Results. As a result of immunohistochemical staining of adhesion zone we determined that peak of p38 expression is registered on the 14th day after surgery, but phosphorylated p38 MAPK activity peak — on the 3rd day. Assessment of p38 MAPK genes expression showed that Mapk12 genes was expression peaks on the 3rd и 14th day, Mapk13 — in 12 hours and on the 7th day, Mapk11 and Mapk14 — on the 14th day. Statistical significance in comparison with data obtained in intact animals (р < 0,05) for MAPK12 was registered on the 3rd day, for MAPK13 — in 12 hours, on the 3rd and 7th day.

Conclusion. Our research allowed us to determine р38 МАРК cascade expression in non-changed reparative process. It was found that p38 MAPK cascade activation starts from the 6thhour after the surgery and lasts up to 30th day with its maximum on the 14th day.

Formation of abdominal abscesses with perforated ulcers of the stomach and duodenum with conservative treatment ranges from 3% to 14%. The main strategy for their treatment is a minimally invasive puncture treatment. A case of a patient’s late treatment of 56 years with a perforated giant gastric ulcer, the formation of a subhepatic abscess and its drainage into the lumen of the stomach is presented. Used methods of drainage of an abscess through a mini-access under the control of gastroscopy. A complex of therapeutic measures has been described, which allowed for the obliteration of an abscess cavity and the healing of a giant stomach ulcer within a month. It is concluded that the need for early use of gastroscopy in the differential diagnosis of perforated ulcers.

The article presents a clinical case of successful hybrid minimally invasive treatment of acute severe biliary necrotizing pancreatitis complicated by acute infected necrotic and fluid collections, abdominal sepsis. Endoscopic transgastric sequestrectomy in combination with polypositional percutaneous drainage and staged sanitation and drainage interventions allowed to avoid the traditional surgical treatment.

An article provides author’s translation from Latin of Niels Stensen’s letter to his teacher Thomas Bartholin, describing circumstances of Stensen’s discovery of parotid duct as well as vicissitudes of recognition of his priority but not Gerard Blaes’ one, who credited himself discovery of ductus parotideus. Brief data on Niels Stensen’s life is given, his contribution to medicine and geology is described.