Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology最新文献

The purpose of the study: To determine the prognostic significance of the expression of molecules of PCNA, Bcl-2, NF-Kb and tachykinins (substance P, neurokinin A) in patients with gastric ulcer (CU) receiving cytotoxic therapy.

Materials and methods: Total surveyed 90 patients divided into 3. equal groups. The first comparison group consisted of patients with chronic atrophic H. pylori-associated gastritis (CAG) (30 pers.). A second control group consisted of patients with gastric ulcer (30 pers.). Third, the study group consisted of 30 people. with CU suffering from hematological malignancies, in a period of complete clinical remission of the disease and receiving supportive polychemotherapy (PCT). Patients underwent endoscopy, morphological and immunohistochemical study of the mucous membrane of the antrum and body of the stomach to detect the expression of molecules of PCNA, Bcl-2, neurokinin A, substance P and factor Nf-Kb.

Results: The total level of dyspeptic syndrome on visual scale analogue in patients receiving chemotherapy and GU (GUpct) was significantly higher (p < 0.05) compared with patients with GU. It should be noted that patients with GUpct reducing clinical symptoms is much slower (p < 0.05). At the same time in 13 (43.3%) patients with GUpct determines the duration of ulcer healing, whereas in patients with GU in only 4 (13.3%) patients. Patients with GUpct more frequently (p < 0.05) were verified II and stage Ill chronic gastritis (CG), while Stage I--less (p < 0.05). Patients with GUpct significantly more often (p<0.05) was determined by the II degree of CG and significantly less (p < 0.05)--IV degree. Patients with GUpct determined significantly lower (p < 0.05), the expression performance PCNA, substance P and neurokinin A and higher (p < 0.05)--Bcl-2 and factor Nf-kB.

Conclusion: GU in patients receiving chemotherapy, dyspeptic syndrome is characterized by severe, advanced stage of CG on the background of relatively low severity of CG in accordance with the classification of OLGA (2008). Patients with GUpht have a significant level of violation of regeneration changes how is this atrophy, intestinal metaplasia, dysplasia of gastric mucosa association with gross violations of the processes of epithelial cell homeostasis of epithelial cells regulation after molecules PCNA, Bcl-2, NF-kB and tachykinins (substation P, neurokinin A).

Objectives of the investigation was to examine the dynamics of emotional and autonomic disorders in patients with peptic duodenal ulcer (DU) associated with arterial hypertension after acute gastrointestinal bleeding during training at School of Combined Pathology (SCP). Main group included 25 patients. The comparison group consisted of 26 patients with the matched pathology, sex and age, but not trained at SCP. Results. Both groups of patients demonstrated improvement in emotional sphere and autonomic regulation. However, in patients who had training at the SCP the indicators of emotional status improved earlier and got a greater extent. Optimization of autonomic regulation was identified in 3 months, not six months, like in untrained patients. Conclusion. Training hypertensive patients with peptic DU at the SCP improves the efficiency of emotional state and autonomic regulation.

Widespread in clinical practice, comorbid conditions and diseases, among which is the high prevalence of metabolic syndrome (MS), determine the need for selection of the optimal pharmacotherapy. The presence of certain liver diseases, including nonalcoholic fatty liver disease (NAFLD), may interfere with the processes of transformation of drugs, the metabolism of which occurs in the liver, which has been proved by experimental investigations. The article deals with the rational choice of antihypertensive drugs as a whole, and angiotensin-converting enzyme (ACE) in particular in patients with metabolic syndrome and NAFLD. Particular attention is paid to the possibilities of certain ACE inhibitors and their pharmacological properties.

Aim: Develop a differential management at the patients with suspected sphincter of Oddi dysfunction after cholecystectomy.

Materials and methods: 169 patients after cholecystectomy, divided into 2 groups. 1st group - 60 patients after repeated surgery formed as a comparison group. They multivariate analysis of clinical, laboratory and ultrasonic data revealed the most significant signs of organic causes of cholestasis, expressed in scores. 2nd group - 109 patients with a suspected sphincter of Oddi dysfunction, who did not have symptoms of organic pathology. Types of bile outflow were assessed by hepatobiliary scintigraphy (GBSG). In cases of doubtful diagnoses computer tomography, magnetic resonance cholangiopancreatography, and/or retrograde cholangiopancreatography are performed.

Results: According to the scoring system, patients 1st group scored 4 or more (8,7 ± 3,87) points. GBSG performed only in 7 (11.6%) patients, and in all cases the cholestatic type of bile outflow was detected. The amount of estimated points in the 2nd group was 2-3 points (2,43 ± 0,34; p < 0.05). GBSG performed in all patients and three types of bile outflow were revealed: normal - in 21 (19.2%) patients, cholestatic in 8 (7.3%), and accelerated - in 80 (73.3%) patients. When refining the diagnosis in 10 (9%) patients had hidden organic disorders of bile outflow, served as an indication for surgery.

Conclusion: Scoring system for the assessment of the suspected sphincter of Oddi dysfunction allows to differentiate of patients for invasive research and surgery. In our study group of 109 patients received less than 4 points, they have dominated the functional disorders, but the results of a detailed examination, 9% of patients had latent organic changes that have become indications for surgical treatment.

Aim: The aim was to improved results of treatment of patients with threatened or held bleeding from esophageal varices on the background of liver cirrhosis.

Materials and methods: The analysis of the survey results and endoscopic treatment of 40 patients with liver cirrhosis complicated by threatened or held bleeding from esophageal varices. The effectiveness of the treatment was assessed by the dynamics of recourse degree esophageal varices, presence and character of postoperative complications and mortality.

Results: Application of endoscopic ligation as primary and secondary prevention of bleeding from esophageal varices can improve the immediate and long-term results of treatment of patients with liver cirrhosis complicated by portal hypertension. Prevention of bleeding from esophageal varices is a dynamic endomonitoringe supplemented with repeated courses of endoscopic ligation.

Aim: Aim. To evaluate lung function in patients with liver cirrhosis of the liver with conservative therapy and surgery tunneling liver.

Materials and methods: The study involved 55 patients with liver cirrhosis with portal hypertension. Patients were randomized into 2 groups. In the first group (n = 40) patients received medication. Patients of the second group (n = 15) was performed tunneling liver shunt operation.

Results: In patients with liver cirrhosis observed clinical and functional remodeling of the lung appears shortness of breath, coughing, wheezing, and restrictive ventilatory disorders.

Conclusions: In patients with cirrhosis of the liver after tunneling is observed normalization of lung ventilation. After conservative treatment reliable normalization of lung function occurs.

Colorectal cancer (CRC) is an actual problem today And it occurs 6 times more frequently in patients with inflammatory bowel diseases (IBD) than in healthy population. CRC in IBD patients is more aggressive and needs total colectomy, which leads to permanent disability That is why canceroprevention is one of the key goals of IBD treatment. The aim of this review is to overview actual pathogenesis pathways of CRC in IBD and methods of chemoprevention. In this review we describe risk factors of CRC, which can be summarized as aggressive disease and chronic inflammation and are based on pathogenesis of CRC. That is the reason why methods of chemoprevention needs to influence on inflammation and other pathogenesis pathways. The role of such classes of medication as non-steroidal anti-inflammatory drugs, 5-aminosalicylic acid, immunomodulators, ursodeoxycholic acid in canceroprevention in RD patients are described in this review.

Aim: To assess normal measurements of pressure in anal canal during sphincterometry on S4402 MSM and WPM Solar GI devices.

Materials and methods: The study included 126 patients with colonic polyps. inclusion criteria were absence of anal incon- tinence and defecation disorders. Seventy-three patients were assessed with S4402 MSM device, Included were 28 males (mean age 56,2±10,2 years) and 45 females (mean age 54,9±13,7 years). Fifty-three subjects were assessed via WPM Solar GI device: 23 women (mean age 51,4±11,1 years) and 30 males (mean age 65,1±15,9 years).

Results: Sphincterometry results using S4402 MSM device in males were as follows: mean resting pressure - 52,1+198 mm Hg; maximal resting pressure - 60,3±21,9mm Hg; mean pressure at voluntary contraction - 118,2±41,5 mm Hg and maximal pressure at voluntary contraction - 174,2±56,8 mm Hg. Corresponding values in females were 37,1±15,3 mm Hg, 43,8±15,5 mm Hg; 75,1±29,5 mm Hg and 99,1±39,7 mm Hg, respectively. Using WPM Solar GI sphincterometry the following figures were obtained in males: resting pressure - 43-61 mm Hg; maximal voluntary contraction pressure - 121-227 mm Hg; mean pressure - 106-190 mm Hg; maximal pressure with coughing test - 45-175 mm Hg; at straining minimal pressure decreased to 19-43 mm Hg (20-60%). In females the results were as follows: resting pressure - 41-63 mm Hg; maximal pressure at voluntary contraction 110-178 mm Hg; mean pressure - 88-146 mm Hg; maximal pressure at coughing test - 76-126 mm Hg, pressure decrease at straining to 28-52 mm Hg, relaxation up to 19-40%.

Constipation is a common symptom during pregnancy. The majority of cases are simple constipation that occurs due to a combination of hormonal and mechanical factors affecting normal GI function. However, a number of women suffer from constipation prior to conception and find their symptoms worsen during pregnancy. Patients with simple constipation can usually be treated by diet recomendation, physical activity. Medications are best avoided but if necessary should be taken under supervision using best available evidence, It is important that all patients be evaluated by detailed history, physical examination and basic investigations to outrule GI pathology that may be present in a small number of cases.

The goal: to investigate a preventive activity for novel medication magnesium 2-aminoethansulfonate in experimental hepatitis in pregnant rats.

Material and methods: The study has been conducted in firs week pregnant rats with paracetamol and ethanol-induced liver injury.

Results: There has been found out that new domestic compound magnesium 2-aminoethansulfonate (laboratory name LBK-527) introduced daily at a dose of 28 mg/kg per os during 6 days, limits cytolysis and cholestasis caused by either paracetamol or ethanol intake in experiments in pregnant rats. Study shows that liver of the animals, that have been given LBK-527 simultaneously with either 500 mg/kg paracetamol or 10 ml/kg 40% ethanol, remains being structurally close to normal. The substance prevents acute toxic liver dystrophy and the organ's structure disintegration made by mentioned toxic agents. Having administered at a therapeutic dose LBK-527 isn't associated with faetotoxicity and embriototoxity in experiments in rats.