Objective. To study the frequency of the presence of Helicobacter pylori (HP), the effectiveness of eradication treatment, the factors that determine the failure of treatment among doctors in Chita. Material and methods. The study involved 164 people aged 19 to 73 years (average age 45.34 ± 13.15 years), including 93 doctors and 71 patients not related to medical activities. The presence of HP infection in 112 people was investigated by determining the antigen (AH) in the feces. 98 people were examined for the presence of HP DNA in gastric biopsies and A2142G, A2143G, and T2717C mutations in the bacterial genome, providing its resistance to clarithromycin by PCR. 59 doctors performed eradication treatment for HP with different schemes. Control of eradication was carried out 6-8 weeks after the end of therapy by determining AH HP in feces. Genetic testing was carried out in 30 doctors for the carriage of polymorphic genes CYP2C19 * 2: G681A (P227P), CYP2C19 * 3: G636A (W212X), CYP2C19 * 17: C-806T, MDR1 (ABCB1: C3435T) by PCR and the effect of the revealed genetic characteristics on the results of treatment. Statistical processing was carried out using descriptive statistics, x2 test and Fisher’s test for small samples (Biostatistics software). Results. A positive AH of HP in feces was registered in 62.5% of the examined: 66.3% of doctors and 50% in the compared population (p = 0.187). HP DNA in the gastric mucosa was detected in 49 people, which was 50% of the examined people. HP DNA was detected in 73.8% of doctors and in 32.1% of non-medical workers (p 0.05). In the CT and TT MDR1 mutant alleles, the effectiveness of all eradication schemes was 69.2% - 70%, of the clarithromycin scheme - 37.5% (p> 0.05). Conclusion. Doctors are at risk for Helicobacter pylori infection. In doctors, the infection is determined 1.3-2.3 times more often (when examined by different methods) than in patients not associated with medical activities. The effectiveness of all eradication schemes was 72.5%. The worst results were demonstrated by the scheme with tetracycline and metronidazole (43%). In case of non-adherence to the therapy regimen, the probability of successful treatment was reduced by 5.8 times. There is a tendency to a decrease in the level of eradication with genotypic resistance to clarithromycin in the genome of Helicobacter pylori, in carriers of mutant alleles with UM and RM of CYP2C19 and in the TT MDR1 genotype. The revealed reasons for the ineffectiveness of HP eradication in the doctors of Chita did not differ from the general population. The exception was the genotypic resistance of Helicobacter pylori to clarithromycin, which tended to develop more frequently in doctors.

Aims. To study the CYP2C19(681A/G) polymorphism among the population of the Trans-Baikal Territory in comparison with data in other regions of Russia and the world. Materials and methods. The study involved 132 people (81 women and 53 men). The median age was 47 (18; 72) years. Genotyping of the 681G/A polymorphic locus of the CYP2C19 gene was performed by polymerase chain reaction. Results. The prevalence of CYP2C19(681G/G) was 105 people (79.6%), CYP2C19(681G/A) — 25 people (18.9%) and CYP2C19(681A/A) — 2 participants (1.5%). Allele A of the CYP2C19 gene in position 681 was found in 14.2%. Allele A is less common in the population of the Trans-Baikal Territory, compared with Asians (China, p <0.001; Japan, p = 0.015) and did not differ in prevalence from Native Americans, Hispanics, African Americans, residents of Moscow, Voronezh, Irkutsk regions and Sakha-Yakutia. CYP2C19(681A/A) was more common in the Asian population than among the Transbaikalians, p = 0.003. The prevalence of the CYP2C19(681A/A) genotype did not differ between the population of the Trans-Baikal Territory, African Americans, Caucasians, and the population of the Moscow and Voronezh regions. Conclusions. The prevalence of the allele A in the population of the Trans-Baikal Territory was 14.2% and was comparable to the Caucasians, but less common than in the Asian population. The prevalence of the CYP2C19(681A/A) was 1.5%, which was consistent with world data among Caucasoid populations and was less common than in Asians.

Th e aim of the research. To study the frequency of genetic polymorphism of genes IL-1β 31T/C and IL-1β 511T/C in patients with gastroesophageal reflux disease (GERD) living in the Trans-Baikal Territory. Material and methods. A total of 139 people residing in the Trans-Baikal Territory for at least three generations were surveyed. Group 1 included 79 patients with GERD (30 male, 49 female), Group 2 (control) included 60 subjects (28 male and 32 female) without clinical and instrumental signs of the disease. The median age was 43 [33; 57] and 44 [37; 54] years, respectively, p = 0.754. Th e groups were matched by the gender, p = 0.16. Th e diagnosis of GERD was established using the GerdQ questionnaire and/or the presence of reflux esophagitis in endoscopic examination and the presence of pathological reflux in impedance pH measurements. Genotyping of interleukin 1 beta (IL-1β) polymorphic genes at positions 31T/C and 511 T/C was performed via the method of polymerase chain reaction. Results. The IL-1β 31C/C genotype was more common in the control group than in GERD patients (OR = 0.302 CI 95 % 0.088-1.034), p = 0.046. The study of the IL-1β 511T/C genotype did not show statistically significant differences in the studied groups. Heartburn one or more times a week was more oft en observed in patients with the IL-1β 511T/T genotype (OR = 11.143 CI 95 % 1.357-91.523), p = 0.0076. Conclusion. Among the population of the Trans-Baikal Territory, the prevalence of the IL-1β 31C/C genotype is higher in persons without clinical and instrumental signs of gastroesophageal refl ux disease. Th e genotypes IL-1β 31T/T and IL-1β 511T/T are more common in GERD patients with the symptomatic course of the disease.

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.

Justification The participants of the round table on diagnosis and treatment of acid - and Helicobacter-dependent diseases, held on November 20, 2020 at the XXIII congress of the Scientific Society of Gastroenterologists of Russia within the framework of the XV National Congress of Therapists (Authors) having discussed the status of the issue, decided on the need to harmonize measures and pool efforts to reduce the incidence of H. pylori infection by approaching the medical community with this Memorandum.

Objective.To determine the prevalence ofHelicobacter 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%.Conclusion1. 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. To study the prevalence of gastroesophageal reflux disease (GERD) symptoms and lesions of the esophageal mucosa in residents of Zabaikalsky krai, taking into account ethnicity. Methods. The first stage: 371 residents of Zabaikalsky krai over 18 years old, were door-to-door interviewed by using the GERD questionnaire (GerdQ). The respondents with 8 or more points were classified as having GERD symptoms. Additionally, we collected passport data, smoking status, alcohol and coffee consumption, anthropometric data and social status. The second stage: we analyzed 2130 upper gastrointestinal (GI) endoscopy reports from Regional Clinical Hospital in Chita. Results. 48 (12.9%) of 371 respondents had GERD symptoms. 135 (36.4%) respondents were Buryats, and 236 (63.6%) were non-Buryats, with the latter more often had GerdQ total score of 8 or more [38 (16.1%) non-Buryats and 10 (7.4%) Buryats, p=0.009]. The average age of non-Buryats respondents with GERD symptoms was 53.417.47 years and exceeded that in the group without symptoms (46.219.2 years), p=0.035. The age of Buryats with and without GERD symptoms did not differ (42.6711.52 and 37.8915.54 years, respectively, р=0.087). The prevalence of obesity, smoking, alcohol and coffee consumption of respondents with and without GERD symptoms, both among Buryats and non-Buryats was the same. Of the 2130 patients who underwent endoscopy, 164 (7.8%) had morphological changes in the esophagus, 105 (4.9%) had erosive esophagitis (EE). Catarrhal and erosive changes in the esophagus were detected in 156 non-Buryats (91 men and 66 women) (7.7%), while EE was diagnosed in 97 (4.8%) patients. 6.5% (5 women and 3 men) Buryats had the esophagus pathology, which caused by erosion. It was found that in non-Buryats group EE develop more often in male respondents (p=0.0019). Only non-Buryats had catarrhal changes in the esophagus (37.8%, 59 people), p=0.0312. At the same time, the incidence of complicated disease course in groups with EE was the same (p=0.8934). Conclusion. About 13% of residents of Zabaikalsky krai have weekly symptoms of GERD, male of a non-Buryat ethnic group are more likely to develop erosive esophagitis than women; the incidence of complications of esophagitis is the same in Buryats and non-Buryats respondents groups.

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 x 2 (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.

The portal vein thrombosis (PVT) is a partial or complete occlusion of blood flow through the portal vein that occurs due to the presence of a blood clot in its lumen. Currently, PVT has become more common in the clinic of internal diseases. PVT can be caused by many factors, among which local and systemic. Systemic factors include congenital and acquired thrombophilia. Local factors include inflammatory, infectious, and oncological diseases of the abdominal organs. One of the most likely causes of PVT is currently being considered liver cirrhosis. The article presents the literature data, clinical guidelines for managing patients with PVT in the discussion of three own clinical cases of patients with PVT, which were caused by various diseases.

The mechanisms of the gastroesophageal reflux disease (GERD) development and its complications are analyzed on the tissue and cell levels. That’s why studying polymorphism of interleukin (IL) genes is important. Genotypes IL1β-511Т/Т, IL1β31С/С and IL1RN2/2 (receptor antagonist IL1) associate with high risk of complicated course of GERD disease. Researching genes polymorphism of the pro-inflammatory cytokines of the patients having gastroesophageal reflux disease and changes in gastric mucosa it was determined that genotype IL1β-511Т/Т is associated with the deeper local level of IL1β. Meanwhile the patients having erosive esophagitis had lover level of IL1β. It was determined that genotype IL1RN2/2 and haplotype IL1RN*2 /IL1В-31*Т are connected with the high risk of esophagus cancer of patients having Helicobacter pylori. Genotype IL1β-511Т/Т and haplotype IL1β-511Т/Т /IL1RN1/1 of the patients having GERD are associated with the low risk of the esophagus cancer. So, the allele IL1RN*2 and genotype IL1RN2/2 can combine by independent predictors of GERD progression. The study of this field should be continued taking into account not only changes in gastric mucosa, presence of helicobacteriosis, but also the nature of gastroesophageal reflux.

Abstract Purpose To asses the level of oxidative stress in postmenopausal women in dependence of LV structural and functional changes and its filling parameters. Methods 203 postmenopausal women were included in the investigation: 142 women with surgical menopause (average age 44,3±5,4 years, menopause duration 3,8±2,4 years); and 61 women with natural menopause (average age 46,2±4,7 years, menopause duration 4,3±2,1 years). All patients underwent general clinical examination, menopausal index evaluation, ambulatory blood pressure (BP) monitoring (Cardiotens-01, Meditech, Hungary), echocardiographic examination with systolic and diastolic left ventricular (LV) function assessment. We also measured erythrocyte thiobarbituric acid reactive substances (TBARs), ultimate products of lipid peroxidation (Shiff bases), catalase activity and plasma general antioxidant activity. Control group consisted of 35 healthy menstruating women (mean age 39,2±4,2). Statistical methods such as Cruskell-Walles criteria and χ2 test were used. Results Only 39 postmenopausal women (19,2%) had normal LV geometry; 89 pts (43,8%) demonstrated LV concentric hypertrophy, 57 pts (28,1%) – concentric remodeling and 18 women (8,9%) –eccentric hypertrophy. All postmenopausal women showed signs of activation of oxidative stress while reducing the power of antioxidant protection systems, however, these changes were most pronounced in groups of patients with eccentric and especially concentric LV hypertrophy Nobody of included postmenopausal women had LV systolic function failure. Presence of LV diastolic function disturbance was the same in the patients with surgical and natural menopause (54,1% (33 pts) and 59,1% (84 pts), respectively, p=0,231) and did not depend on BP level: 59,1% (52 pts) in hypertensive and 56,5% (65 pts) in normotensive women, p=0,118. We detected that Shiff bases level in postmenopausal women with diastolic dysfunction was increased in 1,5 times in comparison with healthy menstruating women and in 1,3 times in comparison with those postmenopausal women who had no diastolic function disturbance (p<0,01). The level of erythrocyte TBARs in this group was increased in 1,3 and 1,2 times respectively (p<0,05). Erythrocyte catalase activity and plasma general antioxidant activity were decreased in all postmenopausal women in comparison with healthy ones (p<0,01). The presence of LV diastolic dysfunction correlated positively with erythrocyte Shiff bases level (τ=0,47, p<0,01) and negatively – with erythrocyte catalase activity and plasma general antioxidant activity (τ=−0,35 and τ=−0,35, p<0,01 respectively) Conclusions Thus, oxidative stress may play important role in left ventricular remodeling and diastolic dysfunction formation in postmenopausal women.