Introduction. Russia is among the leaders in incidence and mortality from gastric cancer (GC). The incidence of gastric cancer in the Republic of Tyva is especially abnormally high. Currently, there is interest in studying genetic factors in various types of cancer. But for GC, such research is not enough.Aim. To study the polymorphism of the apoptosis marker genes CASP9 (rs1052576), TP53 (rs1042522), FAS/APO-1 (rs2234767) in the blood of indigenous people with GC in the Republic of Tyva.Materials and methods. 107 Tuvinians were examined (47 people with GC and 60 persons in the control group). The diagnosis of GC was established on the basis of a comprehensive laboratory, instrumental and morphological examination by oncologists at the Republican Oncology Dispensary. Genotyping of polymorphisms rs1052576 CASP9, rs2234767 FAS/APO-1 and rs1042522 TP53 was carried out in all 47 patients with GC and in 60 people in the control group using the polymerase chain reaction method from DNA samples isolated from venous blood.Results. In patients with GC, compared with healthy individuals, the mutant allele G (44.7% versus 27.5%; p = 0.01) and the homozygous genotype GG (23.4% versus 6.7%; p = 0.03) of polymorphism rs1042522 TP53, as well as mutant allele A (57.4% versus 32.5%; p < 0.001) and homozygous genotype AA (31.9% versus 15.0%; p = 0.05) of polymorphism rs2234767 FAS/ APO-1 were more often registered among indigenous inhabitants of the Republic of Tyva. The frequency of various genotypes and alleles of the polymorphism rs1052576 CASP9 did not differ significantly between patients with GC and healthy individuals.Conclusion. Based on these results, it can be assumed that the A allele of rs2234767 FAS/APO-1 and the disruption of the anti-oncogenic function of the p53 protein produced by the G allele of rs1042522 TP53 are associated with GC and can be used as markers to determine increased risk in the population of indigenous residents of the Republic of Tyva.

Aim. To study the functional activity of blood eosinophils in patients with Opisthorchis felineus (O. felineus) invasion.Material and methods. A total of 328 patients with O. felineus invasion (120 men and 208 women, mean age 40.3 years) and 34 practically healthy patients (14 men and 20 women, mean age 41.1 years) aged 18 to 70 years were examined. The main method for diagnosing opisthorchiasis was the determination of eggs or bodies of adult parasites in the duodenal contents and/or feces, which was used in all 328 patients with opisthorchiasis. All patients underwent a complete blood count and biochemical blood test, esophagogastroduodenoscopy and ultrasound examination of the abdominal organs. The study of the functional activity of blood eosinophils was carried out in 42 patients with opisthorchiasis and 34 healthy individuals from the control group by chemiluminescent analysis with the measurement of the intensity of production of reactive oxygen species in spontaneous and zymosan-induced reactions in lucigenin- and luminol-dependent processes.Results. The frequency of eosinophils in the complete blood count above 5% in the examined patients with opisthorchiasis was 19.5%. An increase in the content of eosinophils in the blood in patients with opisthorchiasis was associated with an increase in the frequency of complaints of pain in the right hypochondrium, pruritus, skin rashes, an increase in the proportion of leukopenia and neutropenia, an increase in the level of gamma-glutamyl transpeptidase in the blood, and an increase in the frequency of ultrasound signs of cholecystitis. At the same time, a pronounced increase in the functional activity of blood eosinophils, determined by the chemiluminescent method, was observed in patients with O. felineus invasion.Conclusions. Patients with O. felineus invasion with an increase in the content of eosinophils in the blood due to the likelihood of an aggressive course of the pathology deserve the close attention of practitioners with the need for a thorough comprehensive examination of patients, including immunological methods.

The problem of liver cancer is becoming increasingly important due to the epidemic of metabolic diseases and persistent high alcohol consumption. This determines great attention to the development and improvement of methods for early diagnosis and treatment of liver cancer. Huang et al presented a study in the World Journal of Gastroenterology, in which they showed that the use of the traditional Chinese medicine Calculus bovis (CB) can suppress tumor growth in mice by inhibiting M2 tumor-associated macrophages (TAM) through modulating the activity of the Wnt/β-catenin pathway. The interaction of CB components with the Wnt/β-catenin pathway, M2 TAM polarization, and tumor dynamics were studied using network pharmacology, transcriptomics, and molecular docking. It is now generally accepted that the polarization of TAM and the differentiation of the functions of M1 and M2 phagocytes are of great importance for the progression of neoplasms. It is assumed that M2 TAM promote proliferation and migration of tumor cells. Attempts to medicinally influence the Wnt/β-catenin pathway in order to modulate phagocyte polarization now belong to one of the most promising areas of immunotherapy of oncological diseases. Undoubtedly, the work of the Chinese authors deserves attention and further development.

Numerous studies suggest a negative impact of problematic internet use (PIU) not only on mental health but also on somatic components of adolescent health. The present study aimed to identify the associations between different types of PIU – generalized PIU (GPIU), problematic video game use (PVGU), and problematic social media use (PSMU) – and recurrent pain symptoms (headache, abdominal pain, and back pain), as well as to determine the role of psychosocial factors in these associations. In a cross-sectional school-based study, 4411 urban Siberian adolescents were asked about the presence, frequency, and intensity of pain symptoms in the past three months. Standardized psychometric scales were used to assess GPIU, PSMU and PVGU. Given the presence of psychosocial problems as a major confounder, direct associations of PSMU and GPIU with recurrent pain symptoms (headache, abdominal pain, and back pain) were found. PVGU was weakly associated only with abdominal pain. Further analysis indicated that the positive associations were largely mediated by comorbid psychosocial problems. These findings highlight the importance of addressing both problematic internet use and comorbid psychosocial problems to effectively reduce PIU-associated recurrent headaches, abdominal pain, and back pain among adolescents.

Aim. To study the activity of the inflammatory process in the gastric mucosa (GM) in gastroesophageal reflux disease (GERD) in schoolchildren living in a region with a high incidence of stomach and esophageal cancer. Material and methods. The transverse method in the Republic of Tyva collected data on the presence of gastroenterological complaints in 1535 schoolchildren aged 7-17 years. The main diagnostic criterion for GERD was the presence of weekly heartburn in the subjects. Subsequently, esophagogastroduodenoscopy was performed with the taking of biopsy material of the mucosa of the antrum and body of the stomach in 246 children. Morphological assessment of GM was carried out in accordance with the Sydney classification after staining biopsy sections with hematoxylin-eosin. Diagnosis of Helicobacter pylori was carried out after staining according to Giemsa. The studies were approved by the ethics committee and the consent of the examined was obtained. Results. Schoolchildren in Tyva have a high prevalence of GERD (9.5%). Associative relationship of GERD with gastritis activity, both in the body (p=0.7338) and in the antrum (p=0.2036) was not revealed. In the antrum, the activity of gastritis was higher than in the body of the stomach (p=0.0001). In children with GERD, when infected with Helicobacter pylori, there was an increase in activity, both in the antrum (p=0.0001) and in the body of the stomach (p=0.0159). At the same time, in children with GERD, the inflammatory process is associated with infection by a microorganism, regardless of its belonging to the Cag A strain. Conclusion. An association of GERD with highly active Helicobacter pylori associated gastritis has been established, regardless of whether the microorganism belongs to the Cag A strain.

Aim of the study was to investigate quality of life indicators in children and adolescents with gastroesophageal reflux disease (GERD) in the Mongoloid and Caucasian populations of the Republic of Tyva. Material and Methods. Schoolchildren aged 7–18 years of the indigenous (25 Mongoloids – Tuvans with GERD and 354 practically healthy) and newcomers population Republic of Tyva (5 Caucasians with GERD and 158 practically healthy) were examined using a cross-sectional method. Gastroenterological complaints and demographic information were recorded. To assess the quality of life of children, adapted Russian parent (CHQ-PF28) and child (CHQ-PF45) versions of the Child Health Questionnaire (CHQ) were used. The questionnaire allows you to assess various areas of a child’s life. Results and discussion. A decrease in the quality of life was established in schoolchildren of both ethnic populations in the presence of GERD on a number of scales as assessed by the children themselves and their parents. However, unlike parents, children’s assessments tended to decrease in the “family cohesion” section (p = 0.068), which, to a certain extent, may reflect the presence of intrafamily problems that can have a traumatic effect on the child. According to parents’ assessments, in schoolchildren with GERD in the Caucasian population, the decrease in indicators concerned only the “physical activity” scale (p = 0.039). In the Tuvan population, more extensive deviations were noted ‒ in sections “general health assessment” (p = 0.041), “physical activity” (p = 0.024), “changes in health status” (p = 0.006), “pain/ discomfort” (p = 0.037). According to the assessment of children, Caucasians with GERD did not show a decrease in indicators, and Tuvans with GERD had fewer deviations on the scales than, according to their parents. Conclusions. Tyva schoolchildren with GERD showed a decrease in quality of life indicators, which was more pronounced among Mongoloids - Tuvans, and there were differences in its assessment by the children themselves and their parents.

Introduction: The purpose was to study the indicators of physical development of primary-school-aged children with intellectual disability by observing the type of autonomic nervous regulation and their levels of catecholamines and serotonin. Methods: A total of 168 primary school age children were examined, of which 54 had intellectual disability. The autonomic nervous system was assessed using cardiointervalography; anthropometric parameters were applied in accordance with recommendations. The contents of serotonin and catecholamines in blood plasma and lymphocytes were assessed using enzyme immunoassay and luminescent histochemical methods. Results and conclusions: Delayed physical and mental development in children with intellectual disability were associated with low serotonin levels in this group of children. The optimal option for the physical development of children with intellectual disability is a sympathetic type of autonomic nervous regulation, while negative-type vagotonic nervous regulation was associated with the maximum delay in physical development. The hypersympathetic type of nervous regulation was accompanied by minimal changes in physical development, despite the hormonal imbalance in the ratio of catecholamines and serotonin. The level of the neurotransmitter serotonin is a prognostic marker of the physical development of children of primary school age. The total amount of catecholamines and serotonin in blood plasma has a direct relationship with the amount of these neurotransmitters in blood lymphocytes; the more hormones in plasma, the more of them in lymphocytes. Therefore, the determination of the contents of catecholamines and serotonin in lymphocytes can be used as a model for studying neurotransmitters in humans.

The aim of the study was to analyze the content of biogenic monoamines (catecholamins and serotonin) and metabolic parameters (activities of succinate dehydrogenase and acid phosphatase) of lymphocytes in normal children and in children with special health needs, depending on the type of autonomic regulation. The survey involved 168 children of primary school age, of these, 114 relatively healthy children and 54 children with intellectual disabilities (mild (F70) and moderate (F71) degree of mental retardation). The groups were comparable in terms of gender and age. In both studied groups, an increase in the parameters of succinate dehydrogenase and catecholamines from vagotonic to hypersympathicotonic types of the initial vegetative tone was recorded. Also, in the group of children with special health needs, a decrease in the activity of acid phosphatase was found as the activity of the sympathetic division of the autonomic nervous system (ANS) increased. In general, in healthy children, against the background of the prevailing eutonic type of autonomic regulation, the optimal regulatory and metabolic parameters of the cell are fixed, which determines sufficient adaptive responses in this group. In the group of children with disabilities, the dominant activity of the sympathetic division of the autonomic nervous system manifests itself at the cellular level as hypercatecholaminemia, reduced levels of serotonin, and acid phosphatase activity.

Purpose. Evaluation of the effectiveness of detoxification using enterosorbents in the immunorehabilitation of cancer patients. Materials and methods. 87 patients with metastatic forms of solid tumors of various localizations with metastatic lesions were examined. The patients were divided into 2 groups: study group (41 patients who received detoxification therapy in addition to standard therapy) and comparison group (46 patients who received only standard therapy). The effectiveness of therapy with these drugs was evaluated after one month by assessing clinical and immunological parameters. The assessment of the state of cellular immunity was carried out by flow cytometry. Results. Disturbances in the function of the immune system in the form of insufficiency of the cellular effector link of immunity were detected in all examined patients before the start of therapy. The state of the cellular link of immunity was characterized by an increase in the number of transitional and non-classical subsets of monocytes, an increase in the content of T-, B- and NKT-cells, but with a decrease in NK-cells. An increase in the ratio between the number of T-helpers (CD3+CD4+) and the number of cytotoxic T-cells (CD3+CD8+) was observed in the examined patients. Restoration of cell subsets to the level of control values was found in the examined patients after detoxification therapy as part of immunorehabilitation measures. Significant changes in the number of cells in the blood were absent in the comparison group after the therapy which indicated the absence of a complete relief of the systemic inflammatory response. Conclusion. Chronic toxicosis with the development of a systemic inflammatory reaction on the background of the immune system dysfunctions were found in cancer patients. The use of enterosorbents in complex immunorehabilitation therapy is substantiated and confirmed by the relief of asthenovegetative and dyspeptic syndromes, normalization of the immune system which makes it possible to recommend detoxification therapy during immunorehabilitation measures.

Data on the relationship of headaches with Internet addiction is rather inconsistent. Purpose: to establish common risk factors for the development of various types of Internet addiction and primary types of headache. Materials and methods. 5195 schoolchildren aged 11-18 in Siberia were examined. Internet addiction and its types were determined using the Chen questionnaire, Game Addiction Scale and The Social Media Disorder Scale; Type of headache (migraine or tension headache) – according to the questionnaire of S.Yu. Tereshchenko, based on The International Classification of Headache Disorders, 3rd edition (beta version), 2013; Mental disorders – in computerized testing in the program “The Development and Well-Being Assessment” (DAWBA, R. Goodman et al.) Results. It has been established that Internet addiction occurs 6 times more often in migraine and 3 times more often in tension headache. However, this relationship is only observed for Social Media Disorder. The connection of headaches with Game Addiction has not been revealed. At the same times headaches (especially migraine) and Internet addiction (predominantly social media disorder) have a common comorbid pathology and risk factors: recurrent abdomen pain, back pain, insomnia, daytime sleepiness, gastroesophageal reflux disease, asthenic syndrome, emotional problems, hyperactivity, high prognosis of mental pathology.

INTRODUCTION: In childhood, the immune system is actively formed, among other things, through the contact with viral and bacterial pathogens. Children over 5 years who suffer from acute respiratory diseases more than 4 times a year, are referred to the group of frequently ill children (FIC) requiring increased attention of doctors. AIM: To identify peculiarities of the autonomic regulation, metabolic, regulatory parameters of immune system cells in FIC of the primary school age. MATERIALS AND METHODS: The study involved 114 children aged 711 years. On the basis of the data of the card of childs individual development, a group of FIC was identified with recurrence rate of acute respiratory diseases more than 4 times a year (n = 28). A control group included episodically ill children (13 times a year, n = 86). The condition of the autonomic system of a child was evaluated by the data of heart rate variability using ORTO Valeo hardwaresoftware complex. The content of serotonin and catecholamines in blood lymphocytes was determined using luminescent histochemical method. Activity of succinate dehydrogenase and acid phosphatase were evaluated by cytochemical methods. RESULTS: The study of regulatory-metabolic parameters of immune cells in the group pf FIC showed reduced activity of succinate dehydrogenase (р 0.01) and reduced content of serotonin (р 0.01), and high activity of acid phosphatase (р 0.05) and catecholamines (р 0.001) in comparison with the control group. The analysis of parameters of autonomic regulation in FIC group showed predominance of parameters characterizing the sympathetic division of the autonomic nervous system and reduction of parameters characterizing the activity of the parasympathetic division (р 0.05). CONCLUSION: The results evidence a sharp imbalance between metabolic and catabolic processes in the immune system of FIC of the primary school age with the underlying predominant activity of the sympathetic nervous system. This gives the ground to study the reasonability of administration of medications and physiotherapeutic procedures for correction of the parameters of the autonomic regulation in the inter-recurrence period with the aim of improving the general adaptive capacities of FIC of the primary school age.

Aim: To research the relationship between laboratory and instrumental manifestations of pathology and polymorphisms of inflammatory cytokine genes in patients with Opisthorchis felineus invasion. Design. During 2022, we conducted a comparative study of patients who were hospitalized for etiotropic therapy of O. felineus invasion. Materials and methods. 139 patients with O. felineus invasion were examined. All patients underwent clinical and biochemical blood tests, ultrasound of the abdominal organs and liver elastometry with an assessment of liver fibrosis according to the METAVIR scale. Genotyping of single nucleotide polymorphisms of the IL28b, IL6, TNFA, and IFNG genes was performed using real-time PCR. Results. In patients with opisthorchiasis, liver fibrosis was associated with the presence of the minor allele A of the rs1800630 TNFA polymorphism and the TC genotype of rs2069705 IFNG. Polyps in the gallbladder were associated with the CC genotype of rs1800630 TNFA, while an increase in alkaline phosphatase and an increase in the proportion of eosinophils in the blood were associated with the CC genotype of rs2069705 IFNG. We did not find differences in the studied parameters depending on the genetic polymorphisms rs12979860 IL28b and rs1800795 IL6 in patients with O. felineus invasion. Conclusion. The obtained regularities should be used to increase the efficiency of dispensary observation in order to prevent the development of complications of parasitic invasion. Keywords: Opisthorchis felineus, single nucleotide polymorphism, cytokines, liver fibrosis.

Aim . To study the indicators of the quality of life in school-age children with abdominal pain in the assessment of children and their parents. Material and methods . The cross- sectional method collected data on the presence of gastroenterological complaints in 542 schoolchildren aged 7–17 years. To assess the quality of life of children, adapted Russian versions of the Child Health Questionnaire were used: parental (CHQ-PF28) and child (CHQ-PF45). The calculation of indicators was carried out according to the sections characterizing various areas of the child’s life, according to a 100-point system. The studies were approved by the ethics committee and the consent of the examined was obtained. Results . The indicators of the parent and child versions of the questionnaire indicated that schoolchildren with abdominal pain had a worse quality of life on many scales compared to children who had no complaints.However, the deterioration of life indicators in schoolchildren with abdominal pain, according to a survey of children, was noted on a signifi cantly larger number of scales, which may be a refl ection of their «social orphanhood». Conclusion . Thus, a signifi cant decrease in the quality of life in schoolchildren with abdominal pain was established. There are diff erences in the assessment of children and their parents in assessing the quality of life of this category of patients.

Introduction. The functioning of the autonomic nervous system (ANS) to some extent affects various aspects of human health and general well-being. One of the main ANS functions is to ensure adaptation to the factors of the external and internal environment, carried out by the coordinated activity of the sympathetic and parasympathetic links. Determining the predominant type of ANS reactivity according to the characteristics of the heart rhythm makes it possible to predict the adaptive capabilities of the child’s body in the learning process in a personalized way. The aim of the study was to study the trend in heart rate variability in children with special health conditions associated with disorders of the intellectual development, which characterizes the implementation of mechanisms for adapting the body to the conditions of schooling. Materials and methods. We examined one hundred sixty eight 7–11 years children of primary school age, including 54 children with special health abilities (SHA) (F70, F71), and 114 mentally healthy children. The study of heart rate variability was carried out using the hardware-software complex “ORTO Valeo”. There was analyzed TP, HF, LF, VLF, LF / HF; RMSSD, SDNN, Mo, AMo, ΔX, IN, AMo / Mo, Amo / ΔX; type of vegetative regulation. Results. In SHA children of primary school age, the LF, VLF, LF / HF indices are increased and HF is decreased relative to the control group, which indicates the predominance of the sympathetic link of the autonomic nervous system over the parasympathetic. When analyzing the spectral components in SHA children of primary school age, VLF (40.6%) and low HF (19.6%) dominate. According to the types of autonomic regulation in SHA children, the following ratio was found 50: 4: 33: 13, the central type of cardiac regulation dominates (type I). Limitations. The limitation of the study is due to the specifics of the individuals in the observation group – children of primary school age (7–11 years) with special health opportunities associated with mental retardation. Conclusion. SHA children of primary school age have high activity of sympathetic modulation, reduced resistance to stress, high tension of adaptive responses with the dominance of the central type of regulation of the cardiac activity. The revealed imbalance of the parameters of autonomic regulation in SHA children without corrective measures (including correction of physical status, psychoemotional and educational loads) threatens the development of a breakdown of adaptive responses to the effects of various internal and external factors, contributing to asthenization of regulatory systems.

Aim . To study anatomical variations of the intra–trunk pathways in the thoracodorsal nerve bundles and to develop a system for their coding. Materials and methods . After fixation in a 2% solution of acetic acid using the MBS-10 stereomicroscope, we performed macro- and microscopic intra-trunk dissection of thoracodorsal nerve bundles in 121 specimens obtained from 105 corpses of males and females who died at the age of 40–97 years. Using the obtained findings, we compiled a database in the MS Excel 12.0 software and determined the number of anatomical variations in absolute and relative (% from 121 specimens) units. Results . The study revealed that the thoracodorsal nerve is a mixed nerve, which consists of 1 motor and 1– 3 sensory bundles that variously pass through the spinal nerves, trunks, and the axillary nerve with the formation of 20 intra-trunk pathways. In 77% of cases, sensory bundles arising from the thoracodorsal nerve pass through the posterior bundle, the posterior division, the middle trunk, and the C7 spinal nerve or the inferior trunk and the C8 spinal nerve. In 22% of cases, the thoracodorsal nerve has one or, rarely, two duplicate sensory pathways besides the main one. In 93% of cases, the motor bundle to the thoracodorsal nerve passes through the C7 spinal nerve and the middle trunk, the posterior division, and the posterior bundle. Coding the anatomical variations of the intra-trunk pathways in the direction of sensory bundle «posterior bundle → posterior division → trunk → spinal nerve; motor bundle ← posterior bundle ← posterior division ← trunk ← spinal nerve allows to briefly yet clearly and fully display the morphological diversity of the nerve anatomy. Conclusion . The identified anatomical variations of the intra-trunk pathways can be useful in the diagnosis of injuries and diseases. They expand indications for the use of spinal nerves, trunks of the brachial plexus, and the thoracodorsal nerve in reconstructive surgery.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Introduction. An essential point in the prevention and risk assessment of these diseases is identifying their predictors predisposing to a progressive course of inflammation in the gastroduodenal zone, particularly gastroesophageal reflux disease (GERD) intersection syndrome and dyspepsia syndrome (DS). A more unfavourable situation is observed among the indigenous - Mongoloid populations. The aim of the study is to investigate the ethnic features of the prevalence and clinical manifestations of the intersection of GERD with DS in schoolchildren of Mongoloid and Caucasian populations of Tuva, Evenkia and Buryatia. Material and methods. A cross-sectional survey was carried out on the presence of gastroenterological complaints in schoolchildren aged 7-17 years, followed by random gastroscopy with a biopsy of the gastric mucosa. Six hundred forty one Caucasians, 894 Mongoloids were examined in the Republic of Tuva; in Buryatia, there are 168 Caucasians, 622 Mongoloids; in Evenkia, there are 993 Caucasians, 376 Mongoloids. Endoscopically examined: in Tuva, 122 Caucasians, 158 Mongoloids; in Buryatia - 28 Caucasians, 82 Mongoloids; in Evenkia, there are 133 Caucasians, 71 Mongoloid. Results. Among schoolchildren in the Siberian region, the prevalence of GERD overlap syndrome with DS was 4.7%. An increase in indices was noted among the Mongoloid populations: by 5.7% and 3.6% among Caucasians. Schoolchildren of Mongoloid populations with the overlapping syndrome often had a variant of dyspepsia with epigastric pain. At the same time, regardless of ethnicity, schoolchildren with intersection syndrome have an increased likelihood of forming erosive and ulcerative lesions of the mucous membrane of the gastroduodenal zone. Conclusion. The syndrome of overlapping in Siberian schoolchildren has a more unfavourable course with features in the ethnic populations of Mongoloids and Caucasians.