Objective. To determine the prevalence of Helicobacter pylori (HP) in doctors in Chita, to identify clinical manifestations of infection, endoscopic, ultrasound and morphological changes in the stomach, to conduct eradication treatment with an assessment of its effectiveness, to determine the resistance of HP to clarithromycin and to develop treatment tactics for HP-associated diseases in the region.

Material and methods. 70 doctors of Chita were examined, including 55 women and 15 men, average age 47.04±12.76 years (20 persons were 39 years and younger, 33 persons were 40–59 years, 17 people were 60 years and older; 27 persons were gastroenterologists, 17 — therapists, 11 — pediatricians, 5 — surgeons and 10 persons were doctors of other specialties). All doctors underwent antigen (AH) of HP determination in feces, a survey on the original questionnaire to assess clinical manifestations. Ultrasound examination of the stomach was performed in 47 doctors. Endoscopy of the upper gastrointestinal tract (GI) was performed in 35 persons. During endoscopy, in 29 doctors biopsy material of the mucous membrane from 5 points of the stomach were taken. A histological examination of biopsy samples was performed with an assessment using the OLGA system. The resistance of HP to clarithromycin was determined by the molecular genetic method in biopsy samples of gastric biopsy. 44 doctors conducted eradication with different schemes. Adverse events (AE) and treatment tolerance were evaluated. Control of eradication was carried out 6–8 weeks after the end of therapy by determining AH of HP in the feces. Statistical processing was carried out using the method of descriptive statistics, criterion of Student and criterion x² (Biostatprogramm).

Results. A positive AH of HP in feces was registered in 71.4% of the doctors examined: 73.3% of men and 70.9% of women, 75% of people under the age of 39 years, 72.7% of those aged 40–59 years and 64.7% are over 60 years old. Gastroenterologists were infected in 63%, therapists in 70.6%, pediatricians in 72.7%, surgeons in 80%, another specialists in 90% of cases. In the presence of HP, 81.6% of the examined showed symptoms from the digestive organs, 3 times more often a hereditary history of stomach cancer was determined. The wall thickness of the stomach during ultrasound in the infected was recorded 0.21–0.18 mm more than in the group of HP-negative individuals. A histological examination of III–IV degree of activity of inflammation in the stomach was diagnosed in 86.1%, stage III atrophy and colonic metaplasia in 20.7% of the examined doctors. The desire to conduct eradication treatment was expressed by 78% of doctors, 44 people completed the therapy. Non-compliance with the eradication regimen was noted in 9 people. AE were registered in 76.6% of cases. The efficacy of all regimens was 71.4%: when using the regimen with clarithromycin — 73%, with josamycin — 100%, with tetracycline and metronidazole — 33%, with levofloxacin — 100%. HP DNA was detected in 27 samples of gastric. In 10 cases, mutations A2142G and A2143G in the HP genome were detected, providing resistance to clarithromycin, which amounted to 37%.

Conclusion

1. 71.4% of doctors in Chita are infected with HP, among which the bacterium is most often detected at a young age (39 years and younger).

2. Infected doctors are more likely to have gastrointestinal symptoms, a history of gastric damage, and hereditary gastric cancer.

3. In 20.7% of doctors, histological examination revealed colonic metaplasia and dysplasia, which confirms the need for treatment and requires further observation.

4. Only 78% of Chita doctors expressed their readiness to eradicate HP, and 20.4% of those who started treatment did not comply with the treatment regimen. This fact requires further educational activities.

5. The efficacy of eradication by all schemes was 71.4%. Genotypic resistance of HP to clarithromycin was found in 37% of doctors. Further studies are needed to identify the characteristics of the macro- and microorganism (genetic polymorphism of enzymes, HP mutations) in groups, both among doctors and other categories of patients who do not have professional contacts with microorganisms and antibiotics in order to develop recommendations on the use of HP eradication schemes in region.

Aim. The study of disorders of the motor-evacuation function of the stomach and duodenum (duodenum) in patients with duodenal ulcer and their use in choosing effective therapy.

Materials and methods. The study included 107 patients with ulcerous duodenal ulcer with the presence of motor-evacuation disorders of the gastroduodenal zone — group I and 99 patients with ulcerous duodenal ulcer without a violation of motor-evacuation function of the stomach and duodenum — group II. Anamnestic and physical data, results of X-ray and endoscopic examinations were used in verification of the ulcer. Assessment of the motor function of the stomach and duodenum was carried out using the gastroenteromonitor GEM-01 “Gastroskan-GEM”. Depending on the treatment method, patients with ulcerous duodenal ulcer of group I were divided into 2 groups: observation group — 52 patients with ulcerous duodenal ulcer of the duodenal ulcer received 50 mg 3 times a day prokinetic itopride hydrochloride as a part of complex anti-ulcer therapy and a comparison group — 55 patients with ulcerous duodenal ulcer underwent standard antiulcer therapy.

Results. In the observation group after treatment, pain disappeared in 90.0% of patients, decreased in 10.0%. In the comparison group, pain completely disappeared in 18.8% of patients, decreased in 76.6%, remained unchanged in 4.7%. Against the background of treatment in patients of the observation group, the frequency and amplitude of the stomach and duodenum corresponded to the normokinetic type of curve. When using itopride hydrochloride in the treatment of patients of the observation group, restoration of the closure function of the pylorus was revealed. After the treatment, the ulcer healed in the observation group in 97.8% of patients (in 88.2% of cases at the stage of a high-quality “white” scar); in the comparison group, ulcer healing occurred in 94.5% of cases, of which in 67.1% — in the stage of poor-quality “red” scar).

Conclusion. The use of the prokinetics of itopride hydrochloride as part of complex therapy increases the effectiveness of the treatment of ulcerative duodenal ulcer by restoring the motor-evacuation function of the stomach and duodenum.

The aim is study the association of CDX2, CK20, CK7 with morphological changes in the gastric mucosa at children of aboriginal and newcomer population of the Republic of Tuva with gastritis.

Materials and methods. We examined of children with gastroenterological complaints by 2 ethnic groups: 69 aboriginal and 34 immigrants. All underwent esophagogastroduodenoscopy with sampling of biopsies from the antral region and the body of the stomach. Diagnosis of gastritis was carried out according to the modified Sydney classification. H. pylori was determined of coloring the biopsies by Gimza. Expression of biomarkers was recorded by immunohistochemical method (CDX2, CK20, CK7). The analysis of the statistical significance of differences in qualitative characteristics was carried out using the criterion χ².

Results. We had determined the expression of CDX2 in 4 schoolchildren in the Republic of Tuva. This is can be examined as a marker for dynamic observation with a poor prognosis, because marker CDX2 tight connect with metaplasia and atrophy in gastric mucosa at adults. Association of the expression of CK20 and CK7 was established with the activity of gastritis, infection H. pylori, metaplasia of gastric mucosa, what more expressed by Tuva population. This has been testifying of the intensification proliferative processes in the gastric mucosa. This fact explaining the acceleration of progression the inflammatory process into the body of stomach. All it’s associated with an increased risk of dystrophy and atrophy at the gastric mucosa.

Conclusion. CDX2 CK20, CK7 can to act as biomarkers of development the precancerous damage of stomach in schoolchildren of Tuva, especially by Tuvans. The presence of atrophy, metaplasia or CDX2 protein is a prognostically unfavorable factor.

The aim of the study was to evaluate the expression features of cancer invasion markers in ductal pancreatic adenocarcinoma and determine their relationship with the frequency of lymph node metastasis.

Materials and methods: 84 cases of pancreatic ductal adenocarcinoma were studied with morphological and immunohistochemical studies using antibodies MMP2, Integrin β1 and β3, β-catenin, Twist and Snail, which associated with increased invasive properties of the tumor according to the literature.

Results: The study showed the presence of relationships between the expression indicators of the studied markers in different structures of the parenchymal component of the tumor with the frequency of lymph node metastasis in pancreatic cancer.

Conclusion: The results of the study show the possibility of using these markers as additional morphological parameters that allow us to assess and predict the risk of lymphogenous dissemination of pancreatic cancer.

Purpose and objectives:

1. To study the blood supply of Peyer’s patches in the norm.

2. To reveal the features of the blood supply of the Peyer’s patches in different sections of the small intestine.

The peculiarity of the blood supply to the wall of the small intestine is that it depends on the morphostructure of the wall of this intestine.

The distribution of arterial vessels in the submucosa is such that trey are divided into ordinal vessels (1, 2, 3 and 4 orders), which branch into layers and zones of the intestine, end also localized in Peyer’s patches.

According to the results of the study, it was reveated that the features of the blood supply to the layers of the wall of the small intestine is that 4 zones of the wall of the intestine differ: mesenteric, antimesenteric (liber) and two lateral zones that differ in morphological and morphometric indicators.

The purpose of the research: morphofunctional estimation of the gastroprotective activity of the dry extract from the roots and rhizomes of Ferulopsis hystrix in neurogenic ulcer.

Materials and methods: The studies were carried out on white Wistar rats. The neurogenic ulcer was simulated by 24-hour immobilization of the animals. The gastroprotective effect of Ferulopsis hystrix was estimated taking into account the Pauls’ index which was calculated for bleedings, erosions and strip-like ulcers as well as taking into account the morphometric indices (the depth of erosions) of the stomach mucosa. The intensity of lipid free radical oxidation processes was estimated by malonic dialdehyde content (MDA); the state of the antioxidant system was estimated by the activity of catalase, superoxide dismutase and the reduced glutathione content.

Results. The Ferulopsis hystrix extract in the doses of 100 and 150 mg/kg reduces the depth of erosions by 43% and 80% respectively, thus promoting the diminishment of destructive processes in the stomach mucosa against the background of neurogenic ulcer. The Ferulopsis hystrix extract in the given doses decreased the MDA content by 37% on average; the catalase activity was twofold increased; the reduced glutathione increases 2.6 times and SOD activity — 3.8 and 2.8 times respectively.

Conclusion. Ferulopsis hystrix has the gastroprotective effect in neurogenic ulcer.

The aim of the present work was to estimate the choleretic effect of dry extracts derived from Carthamus tinctotius L., Calendula officinalis L. and Tagetes erecta L.

Materials and methods: The experiments were carried out on white male rats weighing 180–230 g. The extracts in a single dose were introduced into the duodenum of the rats at the doses of 50, 100 and 200 mg/kg in the form of water solution.

Results: The results of the experiments have shown that the extracts from Calendula officinalis and Carthamus tinctorius have the marked choleretic effect due to the presence of biologically active substances, predominantly fl avonoids.

The aim. To conduct a comparative analysis of the effect of turmeric extract and 5-aminosalicylic acid (5-ASA) in the composition of rectal suppositories in clinical symptoms and the content of lipid peroxidation products in the mucous membrane of the large intestine in experimental Crohn’s disease (CD).

Materials and methods. The experiment was performed on 70 non-linear white Wistar rats. CD was modeled by rectal administration of trinitrobenzenesulfonic acid, rectal suppositories were used each 12 hours: with 5-ASA in a dose of 50 mg, with 10% turmeric extract of original composition, weighing 0.3 g each. On the 3rd, 5th and 7th day of CD, the clinical status was determined by the modified Disease activity index scale and the content of lipid peroxidation products in the large intestine mucosa.

Results. In the dynamics of CD in the colon, the content of primary, secondary and final lipid peroxidative products in the heptane and isopropanol phases increases; the severity of clinical signs (weight loss, diarrhea, blood in the fecal masses) increases with increasing content of POL. The use of rectal suppositories with turmeric extract in case of CD reduces the severity of clinical symptoms, reduces the content of lipid peroxidation products mainly in the isopropanol phase of the colon lipid extract; an association was established between the index of clinical activity of CD and the content of lipid peroxidation products in the large intestine. The effectiveness of local application of turmeric extract in the composition of rectal suppositories is comparison with the effectiveness of the use of rectal suppositories with 5-ASA in terms of the clinical activity index and the content of lipid peroxidation products in the large intestine.

The appearance of hematohecia (blood in the bowel movement) is considered one of the most disturbing and serious symptoms of diseases of the gastrointestinal tract (GIT), signaling a violation of the integrity of the vessels of the intestine and mucous membrane. In the presented lecture the main diseases and conditions are considered, in the clinical picture of which the appearance of blood in the stool is noted, which must be considered in the course of differential diagnostics

Irritable bowel syndrome is a chronic functional disorder of the intestine, manifested by altered intestinal habits and recurrent abdominal pain in combination with two or more criteria: association with defecation, association with a change in the frequency of defecation, association with a change in the appearance of the stool. To date, IBS remains a diagnosis of exclusion that needs to be differentiated from a wide range of organic diseases. In recent years, a large number of publications have appeared on the research of etiopathogenesis, diagnosis and treatment of IBS. This literary review highlights the problems of searching for biomarkers of IBS as a way to solve the problem of diagnosis of this pathology and understanding the causes of its occurrence.

Barrett’s esophagus is one of the most serious complications of gastroesophageal reflux disease also known as GERD. Late diagnosis and treatment cause a high risk of developing adenocarcinoma of the esophagus with the background of Barrett’s esophagus. Today, this condition is one of the most controversial diseases of the gastrointestinal tract (GIT), requiring a careful approach to diagnosis and treatment by a group of specialists, including an endoscopist, gastroenterologist and pathologist. This article is a review of the literature on the history and current aspects of the diagnosis and treatment of Barrett’s esophagus.

The aim of the study is to demonstrate the possibilities of enteroscopy in diagnostics of rare source of small bowel bleeding in patient with blue rubber blue nevus syndrome.

A 31-years old patient with severe anemia from the early age applied to our Hospital to diagnose the source of gastrointestinal bleeding. Previously performed EGD and colonoscopy didn’t reveal any sources of bleeding. Scintigraphy detected the signs of ongoing intestinal bleeding. Endoscopic methods (videocapsule and balloon-assisted enteroscopy) revealed multiple venous malformations of small bowel, as the source of gastrointestinal bleeding of «unknown source». The patient was performed surgery — resection of segments of small bowel with malformations. The diagnosis was verified morphologically. Postoperative period was without complications. For the first time in several years the patient had a fully restored level of hemoglobin.

The urgency of inflammatory bowel diseases increases every year as the prevalence of pathology in the world increases. Unlike most diseases, inflammatory bowel diseases do not always debut classic intestinal symptoms, often in the debut of pathology — extraintestinal manifestations.

The article describes three clinical cases of patients with IBD and skin manifestations, different outcomes and management tactics.