Frequent damage to the digestive system with a new coronavirus infection, as well as its combination with gastroenterological pathology complicates the whole complex of therapeutic and diagnostic measures for such patients. Understanding the problem is complicated by a large number of conflicting scientifi c data of varying degrees of evidence.
The article describes the mechanisms of gastrointestinal tract (gastrointestinal tract) aff ection by coronavirus SARSCoV-2 — induction of infl ammation and violation of the permeability of the gastrointestinal mucosa, changes in the composition and function of the intestinal microbiota, impaired intestinal-lung axis interaction. features of the clinical picture aff ecting the prognosis of the disease, explains the features of the examination, and suggests treatment methods. The article shows the features of the clinical picture that aff ect the prognosis of the disease, explains the features of the examination, suggests methods of treatment and nutritional support.

The damage of gastrointestinal tract and liver is detected in more than half of patients with COVID-19. The disease can begin with gastroenterological manifestations, to which respiratory symptoms subsequently join. The presence of gastrointestinal and liver lesions in patients with COVID-19 worsens the disease prognosis and increases the risk of mortality. There are multiple mechanisms of digestive system damages: the direct cytolytic eff ect of the virus on the target cells with SARSCoV-2 receptors on their surface, the action of components of systemic infl ammation, immunological and drug damages. The research of the use of rebamipide and ursodeoxycholic acid is a promising area in the treatment of COVID-19 patients with gastroenterological and liver lesions.

Objective: to study some mechanisms of progression of chronic liver diseases in patients with initial stage of liver fi brosis and the possibility of their correction.

Materials and methods: a total of 69 young patients with chronic liver diseases with initial stage 0–2 fi brosis (26 patients with chronic viral hepatitis C, 43 patients with nonalcoholic steatohepatitis) were examined. Ammonia levels were determined in peripheral blood by the method of single photometry reveals on the analyzer PocketChem BA, ArcRay (Japan), for the integral evaluation of intrahepatic blood fl ow disorders was used polyhepatography (PHG) is a non — invasive method.The intensity of the activity of the stellate cells of the liver (HSCs) was determined according to the expression of SMA-alpha in a liver biopsy sample. In terms of correction of hyperammoniemia and portohepatic hemodynamics disorders in our study used hepatoprotector with hypoammoniemic eff ect ornithine (L-ornithine-L-aspartate).

Results: ammonia levels in HCV patients and NASH patients was signifi cantly higher than in the control group, the level of hyperammoniemia prevailed in patients with NASH than HCV patients. Portohepatic hemodynamics disorders were detected in all patients, while the peculiarities of these disorders, depending on the etiology of hepatitis. These hemodynamic disorders were accompanied by signs of activation of HSCs. In the liver tissue we revealed expression of SMA-alpha in HSCs, indicating that the signs of activation of these cells. Efficiencyanalysis of the eff ectiveness of Ornithine showed a signifi cant reduction of ammonia in the blood and improvement in intrahepatic blood fl ow in patients with diff erent types of portohepatic hemodynamics disorders on the background of treatment.

Conclusion: in HCV and NASH patients, already at the initial stage sofl iver fi brosis, hyperammoniemia was detected (with HCV it was signifi cantly higher), activation of HSCs, which leads to impaired portohepatic hemodynamics in these patients. The use of a hepatoprotector with the hypoammoniemic eff ect Ornithine leads to a decrease of blood ammonia and an improvement of hepatic microcirculation, which allows expanding the possibilities of the pathogenetic treatment of chronic hepatitis for decrease of fi brogenesis.

Objective. To evaluate the frequency and factors associated with the development of fatigue among students of a medical university.

Materials and methods. Fatigue Assessment Scale (FAS) was used to identify and quantify fatigue. To determine the level of active attention, the electronic number test was used. Assessment of students’ physical activity was carried out according to the degree of energy costs. Capillary blood ammonia levels were evaluated using a Pocket Chem BA PA 4140 handheld analyzer.

Results. The median severity of fatigue according to the FAS questionnaire for students of the 5–6 year medical university was 23,0 (21,0–29,0) points. All students were divided into two groups depending on the level of scores on the FAS questionnaire. Pathological fatigue syndrome was identifi ed in 26 (65%) students. In 14 (35%) students, the FAS value was less than 22 points. in men, the level of fatigue corresponded to 21,0 (14,0–29,0) points, in women 23,0 (21,0–29,0) points, without reaching statistical signifi cance (p = 0,321). Among students of the fi rst group (FAS <22 points), the level of physical activity of the middle level was signifi cantly more likely to occur (p = 0,015). In this case, students with low physical activity diff ered signifi cantly higher values of both physical (14,0 (12,0–18,0)) and mental (11,0 (9,00–14,0)) FAS coefficients (p = 0,001 and p = 0,007). A decrease in BMI of less than 18.8 kg / m2 is associated with an increase in the risk of pathological fatigue among medical students by 0,283 (95% CI 0,087–0,927), and a low level of physical activity by 0,179 (95% CI 0,042–0,753). Additionally, a correlation analysis revealed a negative relationship between the values of the FAS test and the
level of the average student achievement score. The median ammonia concentration was 74,0 (66,0–99,0) μmol/L. Among students with capillary blood ammonia levels of more than 100 μmol/L, students with pathological fatigue predominated according to the FAS questionnaire (in 83,3% of cases), and there were no people with average physical activity (p = 0,062).

Conclusions. 1. Students of the 5–6th year of a medical university in 65% of cases have a high level of fatigue, which inversely correlates with academic performance.
2. Factors associated with pathological fatigue in senior medical students are body mass index less than 18,8 kg/m2 (RR0,283 (95% CI 0,087–0,927)) and low level of physical activity (RR0,179 (95% CI) 0,042–0,753)).
3. For senior students of a medical university included in the study, the median concentration of ammonia of capillary blood was 74,0 (66,0–99,0) μmol / L; no signifi cant relationship was found between the concentration of ammonia of capillary blood and the level of fatigue.

Aim. To study characteristic features of nutritional status of patients with Wilson ’s disease depending on stage of liver damage and determine the impact of malnutrition on oxidative stress level.

Methods. The study included 73 subjects, 33 (15 men and 18 women) had a confi rmed diagnosis of Wilson’s disease. All patients with Wilson’s disease (the study group) had liver damage: non-cirrhotic stages — 12 (36.3%), cirrhosis — 21 (63.6%). The control group consisted of 40 healthy subjects (20 men and 20 women) with neither body weight defi ciency, nor obesity, nor liver disease. All patients were conducted standard blood tests (clinical and biochemical blood tests), measuring  malonodialdehyde (MDA) in blood serum by high-performance liquid chromatography, as well as assessment of height, weight and BMI (Body Mass Index) and analysis the body mass composition with bioelectricalimpedanceanalyzer “Diamant AIST”.

Results. 1. Malnutrition was more common among patients with liver cirrhosis (28.6%) than in patients with non-cirrhotic stages (8.3%).
2. The nutritional status of patients with liver cirrhosis was signifi cantly diff erent from the control group: BMI, total protein and albumin levels, lymphocytes and arm muscular circumference were signifi cantly lower in patients with liver cirrhosis compared to the control group. The decrease in fat and muscular mass was more pronounced among women than men with liver cirrhosis.
3. The group of patients with chronic hepatitis did not significantly statistically diff er from the control group in most nutritional status parameters, except for albumin level, which was signifi cantly lower in persons of both sexes with noncirrhotic stages; total protein level and body fat percent were signifi cantly higher in men with non-cirrhotic stages than in the control group.
4. The marker of oxidative stress level was signifi cantly higher in patients with liver cirrhosis, and was higher in patients with malnutrition.

The purpose of the research was to determine the frequency and characterize the course of non-alcoholic fatty liver disease in patients with systemic lupus erythematosus.

Materials and methods. The study included 313 patients with systemic lupus erythematosus, observed in the E. M. Tareev Clinic of Rheumatology, Internal Medicine and Occupational Diseases of I. M. Sechenov First Moscow State Medical University (Sechenov University) in the period from 2001 to 2019. The diagnosis of systemic lupus erythematosus was based on the criteria of the American College of Rheumatology (1997). Examination of all patients included complete blood count, biochemical and immunological blood tests and an abdominal ultrasonography with an assessment of the liver size
and the presence of signs of steatosis. In 5 cases a liver biopsy was performed. 

Results. In 33 (10,5%) cases a differential diagnosis was made between non-alcoholic fatty liver disease and lupus hepatitis. Non-alcoholic fatty liver disease was the cause of liver damage in 15 (4,8%) patients with ultrasound signs of liver steatosis. Patients with obesity and metabolic syndrome prevailed in this group, and a low immunological activity of lupus was observed. An increase in liver enzymes in patients with liver steatosis was associated with the use of higher minimum doses of prednisolone.

 

Conclusion. Ultrasound signs of liver steatosis are an important criterion that suggests non-alcoholic fatty liver disease in patients with systemic lupus erythematosus.

The questionnaire screening of patients with bronchial asthma showed that the majority of patients do not focus on existing complaints from the digestive organs and refer them to manifestations of their underlying disease. Esophagogastroduodenalfi broscopic examination of patients with asthma for the fi rst time refl ected the presence of Esophagogastroduodenal zone (EGDZ) pathology in 67.3% of patients, of which erosive-ulcerative lesions were detected in 21.3% of cases and catarrhal lesions — in 46% of cases. It is necessary to pay attention to the fact that the resolving factors for the development of the pathology of the  Esophagogastroduodenal zone in patients with bronchial asthma are behavioral factors — smoking, drinking alcohol, strongly cooled drinks and violation of the safe use of the inhaler, creating serious prerequisites for the development of this pathology. The high frequency of EGDZ lesions in patients with bronchial asthma correlates with the duration of administration and doses of glucocorticosteroid therapy, which emphasizes its role as a trigger for the development of the pathology of the Esophagogastroduodenal zone.

Objective of the study: to establish the features of large intestine microbiocenosis in children with functional gastrointestinal disorders (FGIDs) and to analyze the biofi lm ability of Klebsiella spp. strains isolated in the study.

Materials and methods: the coprological tests from 83 children, divided into two groups: The fi rst group (n=34) is children under one year, the second group (n=49) is children over one year. The ability of biofi lm formation has been studied in 53 strains of Klebsiella spp. identifi ed in this study.

Results: It has been identifi ed that signifi cant factors in pathogenesis of FGIR in children are defi ciency indices of bifi dobacterial content, appearance of modifi ed Escherichia coli strains and increase of microbial density of dominant species of opportunistic bacteria — Klebsiella spp. and Staphylococcus aureus. Klebsiella was shown to have the ability to form biofi lm communities (48.1% in children under one year old and 50.0% in children over one year old). It is revealed that the presence of Klebsiella in the intestine is a signifi cant risk factor for the development of dysbiosis 2–3 degrees, and in the absence of Klebsiella spp. as part of the intestinal microbiocenosis in children, regardless of age, dysbiotic disorders of 1 degree (p<0,05) were recorded.

Conclusion: Persistence Klebsiella spp. with biofi lm formation ability has implications for the conservation and continued existence of associative pathological microbiocenosis that exacerbate bowel dysfunction.

The aim of the research: Examination of the prevalence, bending, age and sex structure of fatty liver lesions (FL) of diff erent etiology in rural therapeutic area.

Materials and methods: 1152 person (73.5%) from 1568 the population of the rural therapeutic area, came to the examination.

Results: Free fatty liver disease (NAFLD) was revealed at 21.4%, alcoholic liver disease (ALD)-24.0% of the rural population (p>0.05). FL associated with viral hepatitis B and/or C, detected at 1.7%; toxic hepatitis — 1 man — 0,09% among the surveyed. Prevalence of NAFLD was 220.1; FLD — 246.0; FL associated with viral hepatitis B and/or C — 17.4; FL amid toxic hepatitis — 0.9 on 1000 population rural therapeutic plot. In NAFLD, the ratio between men and women was 1 : 4.3 (p <0.001). Liver steatosis signifi cantly prevailed in the nosological structure of NAFLD (p <0.001), it was in 225  (91.1%), steatohepatitis in 20 (8.1%), cirrhosis in 2 (0.8%) people, no gender diff erences were revealed (p>0.05). Almost half the patients accounted for working age (48.2%): men — 51.1%, women — 47.5%; diff erences are not signifi cant (p> 0.05). In ALD the ratio between men and women was 1 : 1.4 (p>0.05). The nosological structure of ALD: liver steatosis in 167 (60.5%), steatohepatitis in 62 (22.5%), cirrhosis in 47 (17.0%) people. Most patients with ALD, both men (73.0%) and women (75.2%), were of working age (p <0.001). FL among persons with positive markers of viral hepatitis B and/or C20 have been identifi ed (1.7% of the total number surveyed) people: men — 9 (45.0%), female — 11 (55.0%) (p>0.05). Nosological structure of FL: liver steatosis — 10 (50.0%), steatohepatitis — 2 (10.0%), liver cirrhosis — 7 (35.0%), liver cancer — 1 (5.0%).

The aim. To study the epidemiology of fatty liver disease among the population of the Irkutsk region.

Materials and methods. The study was conducted on the basis of “Irkutsk Regional Bureau of Forensic Medical Examination». The object of the study was medical documentation — “The act of autopsy”.

Results. The analysis of the results of 7809 autopsies performed in 2012. A total of 7246 acts of autopsy were examined. Morphological signs of fatty liver disease were detected in 1602 (22.1%) cases.

Conclusion. 1. Fatty liver disease among residents of the Irkutsk region is 22.1%, and does not depend on gender: for women, 21.8% and for men, 22.3%;
2. Fatty liver disease is signifi cantly more common in women in the age group from 25 to 59 years, in other age groups there is no diff erence between men and women. People of young, old age and long-livers are least susceptible to fatty liver disease;
3. The median life expectancy of those who died of cardiovascular diseases with steatohepatitis is 2.5 years less than with steatosis, while the DALY index with steatosis is 13.6 years, and with steatohepatitis is 13.5 years, which has no significant diff erence.

Aim of investigation: to study the prevalence, characteristics, therapy and outcomes of diverticular disease (DD) according to the data of a multidisciplinary hospital.

Material and methods: the retrospective survey included 50 patients treated in the Voronezh Region Clinical Hospital № 1 in the period from 2016 to 2018 according to the following characteristics: age and gender, number of previous hospitalizations associated with DD and complications of diverticulosis,  the results of clinical diagnostic and instrumental examination data, conservative treatment and surgical interventions.

Results: Within the discovered data there were 38 (79.1%) emergency and 12 (20.9%) planned admissions. Gender diff erences were established with the predominance of female patients: 28 women (56%) and 22 men (44%) respectively. According to age diff erences 4 patients were under 30 years (8%), 7 — from 31 to 40 years (14%), 13 — from 41 to 50 years (26%), 17 — from 51 to 60 years (34%), 9 people were older than 61 years (18%). The average age was 39.2 ± 2.1 years.
The majority of patients were of working age. Acute diverticulitis was the predominant form of DB — 28 (56%) cases. Bleeding was detected in 2 (4%) cases, peridiverticular infi ltrate — in 4 (8%) cases, peridiverticular abscess — in 3 (6%) cases, and recurrent chronic diverticulitis — in 13
(26%) cases. Repeated development of DD complications over a three-year follow — up period was found in 40 (80%) patients. Of the 28 (56%) patients with acute diverticulitis who did not receive anti-relapse treatment, 21 (42%) were subsequently operated on for DD complications.

Conclusion: 1. The results of the performed analysis showed that every second patient with DD was of working age (up to 68 years). In the period from 2016 to 2018, there was a tendency of increase in the incidence of DD in patients of all age groups. 

2. Acute diverticulitis was the predominant form of DB (56%). Peridiverticular infi ltrate and peridiverticular abscess were detected in 8% and 6% of cases respectively.

3. Within three years, repeated development of DD complications was observed in 40 (80%) patients of the studied sample. Of the 28 patients (56%) with acute diverticulitis treated conservatively and not receiving anti-relapse therapy, 21 people (42%) were subsequently operated on for complications of DD.

The purpose is to study the dynamics of morbidity, mortality and case fatality ratefrom liver cirrhosis in the age aspect from 2010–2017 in Kyrgyzstan.

Materials and methods: Analyzed state reporting forms No. 12 “Report on morbidity and preventive work (family medicine center, dispensary)” and “C51 — Distribution of deaths by sex, age groups and causes of death” from 2010–2017. Data processed by Microsoft Office Excel.

Results: The average cumulative prevalence of liver cirrhosis (K 74) in persons older than 15 years for the period 2010–2017 was 50.9 0/0000, the average incidence is 12.3 0/0000, the mortality is 45.2 0/0000. Persons over 75 years old had the highest mortality rate — 160, 7 0/0000, the age group “45–59 years old” occupied the third position (92.8 0/0000) after the persons “60–74 years old” (140.9 0/0000). It is necessary to emphasize the presence of mortality among children and individuals 15–24 years old, although the incidence rates (0.2 0/0000 and 2.5 0/0000, respectively) and the  proportion (0.2 % and 1.6 %, respectively) were low. In the period 2015–2017 were registered 47 children with “K 74”, of which 15 were fi rst identifi ed, and for 2011–2017 yy. 32 children with a fatal outcome. Over the past 3 years there has been a tendency for the growth of all three indicators in children. For 2010–2017 yy. the average cumulative case fatality ratein persons over 15 years of age prevailed over children in 2,069.9 cases per 10,000 patients (8878.4 0/000 and 6808.5 0/000, respectively). The case fatality rateamong adults decreased 1.6 times (11176.8 0/000 and 6815.2 0/000, 2010 and 2017, respectively), and among children 1.5 times(4285.7 0/000 and 2857.1 0/000, 2015 and 2017, respectively).

Conclusion: On the basis of the obtained data, in order to improve the K 74 accounting system, an emergency notifi cation (Form No. 58u) was introduced in the country for newly detected and lethal cases of cirrhosis and liver cancer in the outcome of hepatitis B and C. To develop specifi c prevention measures and control strategies in general, the country needs a register of patients with cirrhosis and liver cancer with etiological interpretation.

Purpose of the study. Analysis of the results of recent studies of BC with the aim of understanding the possibility of changing or modifying the natural course of BC with therapeutic or surgical methods, the possibility of a complete cure of BC with therapeutic methods.

Materials and methods. This review examines the results of recent studies aimed at studying the eff ect of modern therapeutic methods for treating CD for the course of this disease and the possibility of reducing the number of surgical interventions.

Results. The concept of competent therapeutic treatment of BC in the long term (more than 7 years) has not been confi rmed. The accumulating experience of repeated bowel resections in patients with CD, suggests that the phenotype of the disease in the re-operated patients with CD remains the same, regardless of the nature of the treatment. However, the risk of surgical interventions in patients with CD in recent years has decreased.

Conclusion. Early diagnosis (CT, MRI) and the earlier treatment of complications instead of prescribing therapeutic treatment, eff ective prevention of relapses with modern drugs in the postoperative period leads to the fact that recently there has been a decrease in the risk of surgical interventions in patients with CD. Surgical strategy is aimed at the use of “economical” resections with the formation of the primary small-intestinal or small-colonic anastomosis in an open way.

Purpose: to estimate the expression of a molecule of vascular adhesion of PECAM-1 (CD31) at patients with acute pancreatitis of varying severity in ΙА phase diseasedevelopment.

Materials and methods. Work has clinical character and is based on the prospective analysis of observation and treatment of 135 patients with acute pancreatitis of various degrees of severity. Patients were divided into three groups, depending on severity of a disease: 1 group — 45 patients with slight acute pancreatitis, the 2nd group — 45 patients with medium-weight acute pancreatitis, the 3rd group — 45 patients with heavy acute pancreatitis. Blood sampling for a research was carried out at receipt prior to therapy. Phenotyping of lymphocytes was carried out by method of an indirect  immunofl uorescence by means of mouse monoclonal antibodies to the molecules CD31 receptors of lymphocytes.

Results. The obtained data demonstrate that the percent of CD31-expressing of lymphocytes depends on weight of acute pancreatitis. At initially severe form of a disease, there was strengthening of process of transendothelial migration of lymphocytes in the center of forming of a necrosis in pancreas tissue. In our research signifi cantly (p <0.001, p1 <0.001, p2 <0.001) the percent of the CD31-expressing lymphocytes to 13.21 increased [12.50; 5.76].

Conclusion. The obtained data demonstrate that there is an interrelation between PECAM1 expression as a marker of intercellular interactions and severity of acute pancreatitis.

Relevance. The problem of the diff erential diagnosis of pancreatic cancer (PCa) and acute pancreatitis remains relevant throughout the world. The available clinical, laboratory, instrumental preoperative, and often intraoperative, including morphological, data do not always allow us to accurately determine the nature of the focal lesion of the pancreas.

Purpose of the study. To develop a method for the early diagnosis of pancreatic cancer by the method of infrared spectroscopy of blood serum.

Materials and methods. By the method of infrared spectroscopy of blood serum, 30 patients with pancreatic disease were examined: 20 patients with acute pancreatitis, 10 patients with prostate cancer. The control group consisted of healthy volunteers (20 people) without diseases of the pancreas.
The study was carried out by infrared (IR) spectroscopy of a patient’s blood sample in the region of absorption spectra of 1200–1000 cm –1 [31]. As diagnostic parameters, we chose the ratio of the heights of the peaks of the absorption bands on each other: 1165/1150 (Parameter 1), 1165/1090 (Parameter 2), 1165/1080 (Parameter 3), 1165/1070 (Parameter 4), 1165/1050 (Parameter 5).

Results. The values of the parameters of the IR spectra of the blood serum of patients with PCa are signifi cantly lower than the values of the corresponding parameters in acute pancreatitis by 42% (P1), 54% (P2), 53% (P3), 59% (P4), 57% (P5), respectively (p≤0.05). Such a sharp diff erence in IR spectroscopic parameters allowed us to visualize the method and create diff erential diagnostic profi les of pancreatic diseases.

Conclusions. A change in the content of phosphorus-containing compounds (ATP, ADP, AMP) in the blood during acute pancreatitis and PCa causes changes in spectroscopic characteristics. The method of IR spectroscopy allows us to diff erentiate these diseases of the pancreas. IR spectroscopic parameters allow the formation of diff erential diagnostic images of pancreatic cancer and acute pancreatitis and visualize mathematical calculations. The proposed method is non-invasive, that is, it allows without internal intervention in the patient's body to diagnose acute pancreatitis and pancreatic cancer.

Aim. Analysis of the results of our own experience of EUS-guided fi ne-needle aspiration (EUS-FNA) of digestive tract lesions, depending on the technical and methodological aspects.

Materials and methods. From 2007 to July 2019, the EUS-FNA was performed in 86 patients. Aspirating and ProCore needles of various calibers were used. Punctures were performed once (54), two- (20), three- (8) and four times (4) both with and without aspiration.

Results and discussion. Material suitable for histological examination was obtained in 86% of patients: with a single puncture — in 83.3% of cases, double — in 91.3%, triple — in 100%, four times — not obtained. Using 19G needles, the material was obtained in 80.5%, 22G in 93%, 25G in 100% of cases. Punctures were successful in 90.5% of patients with pancreatic lesions, in 75% of patients with subepithelial lesions, in 80% of cases with abdominal and retroperitoneal lesions, in all patients with lymphadenopathy, mediastinal and liver lesions. With aspiration, punctures were successful in 85.5% of cases, without aspiration in 100% (3/3). With the combined method (with and without aspiration), the material obtained in diff erent modes in 11 patients was equally sufficient for histological examination. It was also noted that one of the Fujifi lm echoendoscopes used for performing the EUS-FNA has an inconvenient design of the biopsy channel distal part. A surgery was performed on 50 out of 86 patients; in 42 (84%) of them, the EUS-FNA material was suitable for performing a morphological examination. The histological examination results conformity of the material obtained by fi ne-needle aspiration and surgical material was 88.1% (37/42).

Conclusion. It is necessary to consider many factors to obtain the most eff ective results in the EUS-FNA, since none of them is prevailing.

Objective: to conduct a comparative assessment of the use of the hepatoprotector and the prebiotic in NSAIDs-hepatopathy, induced by prolonged use of nimesulide using histological and immunohistochemical methods.

Materials and methods: The experiment was conducted on laboratory animals (rats), which were used to model NSAID-hepatopathy by administering nimesulide by the oral route for 21 days. Animals from the two experimental groups received a hepatoprotector and a prebiotic (simultaneously with nimesulide). The eff ect of the drugs was assessed by the results of histological examination of the liver tissue and the manifestation of the immunohistochemical expression of receptors of tumor necrosis factor α (TNFαR1) on hepatocytes. To detect receptor expression, labeled TNFR1 (polyclone) antibodies, species-specifi c to rat tissue antigens, were used.

Results: histological examination of animals from experimental groups revealed the preservation of liver tissue, which was manifested by a decrease in pathological disorders. The study of immune responses in the pathogenesis of NSAIDs-hepatopathy demonstrated that the simultaneous use of both hepatoprotector and prebiotic signifi cantly reduced the eff ect of tumor necrosis factor α on liver tissue, which was confi rmed by a low level of TNFαR1 expression in animals of experimental groups compared to manifestations of TNFαR1 expression in animals with NSAID-hepatopathy. Hepatoprotector had a more pronounced protective eff ect compared to the prebiotic.

Conclusion: studies have shown that the simultaneous use of both hepatoprotector and prebiotic with nimesulide reduces histomorphological and immune disorders in the liver tissue. Drugs can be recommended for the correction of pathological disorders of the liver tissue with prolonged use of NSAIDs.

The aim of the study was to study the changes in the transcriptional activity of the GSTM, GSTP and GSTT genes in acute toxic hepatitis caused by paracetamol and against the background of preliminary administration of drugs (heptor, mexidol, oxymethyluracil).

Material and methods: Toxic hepatitis was modulated in male albino mongrel rats assigned to fi ve groups (control group, primed with paracetamol without subsequent administration of the drug, with the administration of heptor, mexidol and oxymethyluracil). After 24 and 72 hours of paracetamol administration, the rats were anesthetized and the mRNA levels of the GSTM, GSTP and GSTT genes in the liver homogenate were examined. Drugs were administered one hour before paracetamol administration.

Results: It has been shown that with 24-hour exposure to paracetamol, the expression ratio of the GSTM gene increased from –0.37 in the control group to 1.03 in the untreated group. After 72 hours of exposure to the toxicant, it was elevated compared with the control group in all groups (paracetamol without treatment — 0.77; heptor — 1.74; mexidol — 1.51; OMU — 1.62). An analysis of the representation of GSTT gene transcripts after 72 hours of exposure showed a stepwise increase and decrease in the expression level in the groups studied. The expression of the GSTP gene with the 24-hour experiment was reduced and ranged from –0.3 to –1.51. (F = 2.916; p = 0.038), and with 72 hours of exposure to paracetamol, the results were opposite. Statistically signifi cant values (p = 0.032) were obtained by comparing the group with paracetamol without treatment and when used as the OMU drug.

Conclusion: the results obtained may indicate the involvement of the given genes in paracetamol metabolism in liver cells. It was found that OMU is a hepatoprotector responsible for restoring the antioxidant defense system. 

Studies were performed on 84 rats in 12 series, 7 acute experiments in each series. Studied the change in gastric and pancreatic secretion with the introduction of the short-chain peptide CCK-8 and pentagastrin in the presence of trypsin and contrуcal. It was concluded that the short-chain peptide CCK-8 and pentagastrin are utilized by the liver to a large extent. Trypsin, when passing through the liver, reduces the ability of the liver to utilize CCK-8 and pentagastrin. The protease inhibitor contrуkal® when passing through the liver increases the ability of the liver to utilize these peptides. It is concluded that the liver is involved in the modifi cation of peptidergic mechanisms of regulation of the digestive glands.