Aim. Study of the prevalence of gastroesophageal refl ux disease among residents of the Trans- Baikal Territory, taking into account its ethnic composition.

Materials and methods. By the method of random household walk, the study included persons over 18 years of age. The GerdQ questionnaire was applied. Additionally, passport data, information on smoking, alcohol use, coff ee, anthropometric data, social status, membership in a particular ethnic group (Buryats, Europoids) are collected. Four groups were analyzed: the 1st Caucasians, who scored 8 or more points on the GerdQ questionnaire and the 2nd — Caucasians, who scored less than 8 points, the 3rd group—the Buryats, who scored 8 or more points, and the 4th—Buryats, not scored 8 points. For statistical processing used the program Statistica 10.0, the diff erences were considered signifi cant when p< 0.05.

Results. 371 profi les were selected for analysis. 8 or more points on the GerdQ questionnaire scored 48 people (12.9%). 236 people—Caucasians (63.6%) and 135 Buryat people (36.4%), while the latter had more rare manifestations of GERD (38 Caucasians (16.1%) and 10 Buryats (7.4%) p = 0.009). The average age of persons of the 1st group was 53.4 ± 17.47 years and exceeded that of the 2nd group (46.2 ± 19.2 years), p = 0.035. Manifestations of GERD in Buryats were observed at a younger age and did not diff er between the 3rd and 4th groups. There was no correlation between GERD symptoms and bad habits (smoking, alcohol). The dependence of GERD symptoms with coff ee consumption and obesity has not been established.

Conclusion. The prevalence of symptoms of gastroesophageal reflux disease in the territory of the Trans- Baikal Territory is below the national indicators, which is probably related to the ethnic composition of the population. Age-related features of the identification of symptoms of GERD are characteristic only for Caucasians.

An analysis of the data available in the scientifi c literature on the modern understanding of the infl uence of harmful production factors on the state of the gastrointestinal tract in workers has been carried out. The results of the analysis made it possible to systematize the data of long-term study of the infl uence of production factors on the formation of diseases of the digestive system. The data on the prevalence of diseases of the digestive system in various professional groups are presented. An in-depth analysis of the relative risk indicators showed that the pathology of the digestive system in workers in hazardous industries can be attributed to production- related.

Objective. To assess the level of potential adherence to treatment in patients with gastrointestinal syndromes.

Material and Methods. The open-label, cross- sectional study included 264 respondents who underwent preventive examinations. To identify gastroenterological syndromes we used Gastrointestinal Simptom Rating Scale (GSRS) questionnaire, which allows assessing the presence and the intensity of diarrheal, dyspeptic, constipation, refl ux syndrome and abdominal pain syndrome. The study group includes respondents who, according to the results of the GSRS questionnaire, have at least one syndrome (from 2 or more points) (N = 140). The comparison group included participants without gastrointestinal syndromes (N = 124). The level of adherence was assessed using the Quantitative Adherence Assessment Questionnaire (QAA-25). A score of less than 50% corresponds to a low level of adherence; a score between 50% and 75% corresponds to a medium level of adherence. Of 75% and above is considered to be a high and suffi cient level of adherence in the respondent.

Results. Absolutely all respondents demonstrated an insuffi cient level of adherence to both drug therapy and medical support and lifestyle modifi cations. One in ten study participants had an medium level of adherence. The other 90% of patients from all groups had a low level of compliance (less than 50%) in all three areas of treatment adherence.

Conclusions. Participants in our study were potentially unprepared for adherence to treatment that is consistent with optimal protocols. This demonstrates the need to work with adherence, both using ways to increase adherence and using patientcentered approaches that take into account the individual level of adherence.

Aim of the study: Optimization of medical care to patients with liver cirrhosis (LC) based on using of patient- oriented approach in real clinic practice

Materials and methods: The reviews of 734 medical histories of patients treated in polyclinics and in-patient facilities of general specialization (surgery, therapy) and died from HL in 2015–2019 years in Krasnodar region were analyzed. The experience of regular medical check-up of 85 patients with LC who underwent mini-invasive surgeries was summarized.

Results: The number of mistakes in treatment tactics of patients with LC was revealed. The experience of regular medical check-up and schools for patients with LC was summarized.

Conclusion: Regular medical check-up of patients with LC in multi- disciplinary clinic with practice in mini-invasive surgeries and liver transplantation, attendance of schools for patients improves stabilization and in some cases treatment course of disease.

Objective: to determine the specifi c number and expression intensity of gelatinase B-positive cells in the gastric surface epithelium and lamina propria (cell component) in the area of the ulcerous defect in rats with experimental acetate ulcer of the stomach.

Materials and methods: 18 white Wistar rats were divided into three groups: initial (intact), experimental (modeling of an acetate ulcer) and control (falsely operated) in the experiment. Tissues were obtained from the ulceration zone or the presumed ulceration zone (in the initial and control groups) to asses morphological changes and also indicators, characterizing the activity of gelatinase B 7 days after the simulation of the experiment.

Results and Discussion. It was revealed some increase in the specifi c number of gelatinase B-positive cells against the background of moderate accumulation of lymphocytes in the integument epithelium of the gastric mucosa. A signifi cant increase in the specifi c number of gelatinase B-positive cells at the maximum intensity of its expression and a moderate accumulation of eff ector cells of tissue alterations was determined in the cellular component of the lamina propria of the gastric mucosa at the same time.

Gastric and duodenal peptic ulcer disease is a multifactorial pathology, in the etiopathogenesis of which the general and local reactions of the body to external and internal risk factors play a role. Psychoemotional stress is the main cause of the pathology of nervous and humoral regulation (general reaction), and the local reaction is expressed in a violation of the ratio between the factors of aggression and protection factors in the mucous membrane of the stomach and / or duodenum. The combined action of these components leads to the formation of an ulcerative defect.

The review presents an analysis of the literature on the etiology and pathophysiology of gastric ulcer and duodenal ulcer
in women. Data on the prevalence of these diseases in the world and in Russia are presented. The main points in the formation
of the doctrine of peptic ulcer disease are described and the article discusses in detail the theory of sexual diff erentiation -
the infl uence of age, menstruation, pregnancy, lactation, menopause on ulceration. Views on the key mechanisms of the eff ect of sex hormones on the gastrointestinal tract are revealed.

Nonalcoholic fatty liver disease (NAFLD) is a disease which etiology is related to various metabolic, ethnic, genetic and even ecologic factors. Complexity of etiology and multiply pathogenesis ways, leading eventually to the lipid droplets appearance in hepatocytes, infl ammation process and parenchyma fi brosis in liver, and also frequent cardiometabolic comorbidities, together make diffi cult risks stratifi cation and prognosis evaluation in NAFLD patients. Another matter is a question of NAFLD therapy, since unifi ed pharmacotherapy approaches are not yet adopted worldwide, and lifestyle modifi cation being accepted as an eff ective therapeutic approach, is not followed by patients in real world setting. Current review is dedicated to the consideration of NAFLD diagnostics, its risk of progression and existing therapeutical capabilities.

The article presents a clinical case of the fatal Mallory- Weiss syndrome, which suddenly developed in an 86-year-old patient with a new coronavirus infection COVID-19, complicated by bilateral polysegmental pneumonia. The patient had no history of gastroesophageal refl ux disease, gastric ulcer or duodenal ulcer. The level of D-dimer on admission was elevated, but the patient was prescribed a reduced dose of anticoagulants (heparin). Despite the initial positive dynamics of the condition, the patient had a wave-like course of COVID-19, followed by the development of Mallory- Weiss syndrome, extremely severe post-hemorrhagic anemia and multiple organ failure, which became the cause of death.

Introduction. Chilaiditi syndrome—hepatodiaphragmatic interposition—is a rare condition in which bowel loops are compressed in the space between the liver and the dome of the diaphragm, which can lead to the development of a wide range of complications. In the available literature data on the clinical manifestations of this condition in children with omphalocele are not described.

Materials and methods. The article describes rare clinical cases of patients 1 year 1 month, 2 years 11 month and 12 years old, previously operated on in the neonatal period for omphalocele, in whom, in the long term after surgery, signs of hepatodiaphragmatic interposition persisted, which led to the development of chronic duodenal obstruction.

Conclusion: It has been proven that the leading role in restoring the normal topography of the abdominal organs in children with omphalocele is played by the complete mobilization of the liver and the great vessels (IVC) fi xing it, which provide the possibility of its subphrenic localization. Chronic duodenal obstruction in children with a similar pathology has not been previously described. The proposed original method of surgical treatment seems to be pathogenetically justifi ed.