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In 62 children with gastroesophageal reflux disease (GERD) and 32 with gastroduodenitis (DG) aged 9-17 years, the peculiarities of metabolism of collagen were studied. High levels of fractions of sialic acids were set, that was associated with the protein fructose, fractions of hydroxyproline in children with GERD compared with the patients with DG, which testify to the process of degradation of collagen and may be one of the factors contributing to the local inflammation of the esophagus and gastroduodenal zone of the digestive tract. The prevalence of Helicobacter pylori, as well as violations of diet, play an important role in maintaining the inflammatory process.

Unlabelled: THE AIM OF OUR INVESTIGATION: To study the dynamic of morbidity level of pancreas in Udmurt Republic (UR) and to prognose it for nearest years., Materials and Methods: We used the official statistic materials of Republic medical information-analytic center for 2001-2011 yy. In analyses of received data we used trend models and statistic method., The Results: We found that during analyzing period (2001-2011) common morbidity of pancreas in UR increased as well as primary--on 246% and 92% correspondently, especially in rural population. Morbidity of adult urban population is significantly higher than. By trend model method we can prognose raising of pancreas for nearest 5 years till the level of Russian one and higher., Conclusion: The tendency to increasing of pancreas diseases morbidity in UR was revealed for last 10 years. Prognosing rise of morbidity, more in rural population, requires to organize active prophylactic measures.

Unlabelled: The aim of this work is to study the level of some hormones and their role in the pathogenesis of gastroesophagal reflux disease (GERD) in children., Materials and Methods: 40 children with GERD at the age 9 till 17 years of them 17 boys (42.5%) and 23 girls (57.5%) were examined. Content of somatostatin, gastrin, insulin, cortisol in the blood was studied by immunofermental method. Motor function of the sthomach was studied using the apparatus EGC-4M., Results: The investigations which were performed revealed the fact that children with GERD have different concentration of somatostatin and gastrin depending on their age. In disturbances of interrelations of somatostatin and gastrin impairment of the stomach motility occurs. High level of insulin and cortisol is found in children with GERD. High level of insulin indicates of stimulation of protective and adaptative mechanisms. High level of cortisol intensifies catabolic processes, leads to disturbances of dynamic equilibration of aggressive-protective factors in the gastroduodenal zone., Conclusion: The results of our study revealed vital role of hormonal factors in the pathogenesis of GERD in children.

Unlabelled: THE AIM OF INVESTIGATION: To explore the possibilities of use of conservative therapy in the early stage of cholelithiasis., Materials and Methods: In the treatment of patients with early stage of gallstone disease in 103 patients was used mineral water Uvinskaya, in 96--Ursosan and in 118--Ursosan combined with mineral water Uvinskaya., Results: The comparative evaluation of different variants of therapy showed that combined use of Ursosan and mineral water Uvinsky was the most effective to eliminate the clinical symptoms of the disease and reduce the lithogenic properties of bile.

Purpose: The aim of the work was to improve the organization and conduct of clinical examination of patients with gallstone disease (GSD)., Materials and Methods: An integrated study of 396 patients with different pathologies of the hepatobiliary system and the medical check-up for three years for 101 patients., Results: Built logistic model to predict the likelihood of developing gallstone disease and developed a predictive scoring table it possible to distinguish patients at risk of developing gall stones. The result of follow-up of the proposed method was prevented economic losses due to the lack of need for a cholecystectomy, which is made up of one patient 6766.22 rubles., The entire group of 1,004,966.63 rubles., Conclusion: Obtained to diagnose cholelithiasis at an early stage dokamennoy. Developed a screening questionnaire, predictive scoring table, the scheme of follow-up also improves clinical examination of patients with cholelithiasis dokamennoy stage.

The Aim: The studying of physical-chemical qualities of liver bile and lipid exchange before and after cholecystectomy., Materials and Methods: We spent the complex investigation of physical-chemical qualities of bile and lipid levels in 210 patients with cholelithiasis stage I (pre-stone) and in 90 patients with cholelithiasis stage II and III (with gallstones) after cholecystectomy., The Results: In all examined patients we revealed disturbances of physical-chemical qualities of bile and lipid exchange. With correlation analysis it was found that bile lithogenity increases in high bile density, in progressing of inflammation process in bile ducts, in increasing of aterogene fractions of blood cholesterol., Conclusion: After cholecystectomy in liver-cells dyscholia the ability to stones formation preserves. It means that patients after cholecystectomy need in following-up with using of prophylactic measures to restoring of bile-formation.

Aim: To comprehensively investigate the function of the small intestine (SI) in metabolic syndrome (MS)., Subjects and Methods: Seventy-eight patients with MS were examined using, in addition to clinical studies, comprehensive ones of the function of SI: evaluation of its motor, digestive, and absorptive functions. The specific features of the hormonal and autonomic status were studied in the patients with MS., Results: Clinical local and common signs of SI lesion were seen in 82.9% of the patients. Examination of SI function revealed its impairments at all stages of hydrolysis and resorption in the presence of hypomotor dyskinesia in the postprandial period and hypersympaticotonia in the patients with MS. New pathogenic patterns were found in relation to the role of hormones in intestinal digestive and absorptive dysfunctions in MS., Conclusion: The findings may suggest that SI functional changes found in MS are an important component of its complex pathogenetic circle.

Aim: To assess therapeutic efficacy of mineral water Uvinskaya at a prestone stage of cholelithiasis., Material and Methods: A total of 135 cholelithiasis patients entered the trial. Of them 57 patients had a prestone stage and 78--stone stage of the disease. The stages were verified by clinical data, findings of dynamic hepatobiliscintigraphy, biochemical bile tests, anatomoemission spectroscopy with induction-bound plasma., Results: 57 patients at prestone stage of cholelithiasis received balneotherapy with mineral water Uvinskaya. The treatment relieved pain syndrome, dyspeptic symptoms, enhanced absorption-excretion function of the liver, prolonged the time of maximal gall-bladder filling, shortened radiopharmaceutical half-life in the gall-bladder, raised the level of trace elements (magnesium, iron, potassium) in the bile, improved gall-bladder contraction, lithogenic bile characteristics., Conclusion: Mineral water Uvinskaya has a positive effect in a physical-chemical stage of cholelithiasis.

The Aim: Complex investigation of the small intestine functional condition in metabolic syndrome., Materials and Methods: The 65 patients with metabolic syndrome were examined. We used clinical data and complex examination of the small intestine function by tests with mono-, di- and polycarboanhydrates., Results: In mojoriti of patients (82.9%) the clinical local and common signs of small intestine lesion were reviled. In study intestine function the disturbances in all stages of hydrolysis and resorbtion were found., Conclusion: Exchangings of the small intestine functional condition in metabolic syndrome are not only secondary, but lead to its progressing.

Aim: study and evaluation of clinical efficacy of combined use of Creon and Tricor in chronic pancreatitis (CP) accompanied by metabolic syndrome (MS)., Materials and Methods: We observed 60 patients with CP accompanied by MS, of whom 30 patients received standard therapy complex CPs (comparison group), 30--received Creon (microspheres of pancreatin) and Tricor (fenofibrate) in the combined treatment (observation group). In assessing the effectiveness of therapies used in clinical and advanced laboratory and instrumental studies., Results: In the course of treatment in patients with the observation group occurred faster clinical improvement, improved lipid, carbohydrate and purine exchange and decreased insulin resistance., Conclusion: The combined use of Creon and Tricor is pathogenetically substantiated and clinically effective in the CP accompanied by MS.

The aim of our investigation was to study the changes of bile morphology and possibilities of its using in early diagnostic stage of cholelithiasis. We spent the complex investigation of biochemical and crystal-optic qualities of bile in 207 patients with cholelithiasis stage I with different disease duration. The revealed crystal-optic morphotypes have selective morphology due to the bile lithogene level that allows to determine the disease duration and the bile instability to make in-time adequate profilactic.

162 patients with a stomach ulcer were examined, 98 people were with torpid course of a stomach ulcer, and 64 sick people were usual periods of cicatrizing ulcers. 56 sick people (the first group) with torpid course of a stomach ulcer received immunal as a part of complex irradical therapy and comparising group 42 sick people (the second group) with torpid course used only irradical therapy. In estimation of efficiency of therapy, in addition to clinical and endoscopies data, indicators of genotypes Helicobacter pylori and immune system were used. The pathogenetic role of virulent genotypes Helicobacter pylori in the formation of the torpid course of a stomach disease is shown. The information about the dependence of the immune defense from cytotoxic characteristics Helicobacter pylori was received. Inclusion of immunal in complex therapy improves the elimination of Helicobacter pylori and has good clinical effect.

Unlabelled: THE AIM OF OUR INVESTIGATION: siuay me level or moroiaity or cnolelimiasis and its dynamic in adult and children population of Udmurt Republic., Materials and Methods: We used the materials of state statistic registration documentation. We took into account the average population of Udmurt Republic, data of cholrlithiasis morbidity and the quantity of registrated cases of disease. To reveal tendency of cholelithiasis morbidity we spent the regressive analysis with using of trend models., The Results: We found that during analyzing period (2005-2009) common morbidity of cholelithiasis in Udmurt Republic exceeds the same data in Russian Federation. Morbidity of adult urban population is significantly higher than in rural population. The cholelithiasis morbidity increases at the age of 41-60 years. In children population we marked significant raising of primary cholelithiasis morbidity. CONCLUSION. It was revealed that cholelithiasis morbidity in Udmurt Republic remains high. Due to this information we have possibility to determine medical and prophylactic measures.

In the prevention of exacerbations of chronic pancreatitis 28 patients in the early period and one month after cholecystectomy were appointed by octreotide. In assessing the effectiveness of treatment, along with the general clinical data, used a number of modern laboratory instrumentation, ultrasound and biochemical studies. Comprehensive studies have shown that octreotide has a positive impact on the rehabilitation of patients after cholecystectomy, prevents the progression of inflammation and systemic complications.

We have studied the peculiarities of the heart lesions in 177 children with Gastroesophageal Reflux Disease (GERD), among them 73 children had accompanying residual organic lesion of the central nervous system (ROL CNS). While examining the patients general clinical findings, the results of the complex electrophysiological and endoscopic investigations were used. The disturbance of the heart rhythm and the conduction of the heart were revealed in most children with GERD and with accompanying ROL CNS. It was revealed that the role of disbalance of vegetative innervation is of great importance in the functional lesion of the heart.

Comparative evaluation of changing in functional conditions of the small intestine in using non-selective and selective non-steroidal anti-inflammatory drugs (NSAID) was estimated. The treatment of osteoarthrosis with NSAID lasted up to 3 years and longer then 3 years. As a result of integrated investigations of 92 patients it was revealed that NSAID damage the absorption primarily in proximal area of the small intestine, however the more prolonged period of using the drugs the more severe damage to intestinal digestion both of cavitary and membranous stages of hydrolysis occur. Enteropathy develops in a less extend of expression in comparison with non-selective NSAID in using selective NSAID. New pathogenic appropriateness concerning the role of hormones in functional disturbances of the small intestine in using NSAID was proved.

Aim: to provide a rationale for the use of immunal in intractable gastroduodenal peptic ulcers (PU), by studying Helicobacter pylori genotypes and immunological parameters., Subjects and Methods: Sixty-eight patients (37 men and 31 women) with torpid PU were examined. A study group comprised 35 patients who took immunal as a component of complex eradication therapy; a control group included 33 patients who received complex eradication therapy only. In addition to clinical and endoscopic data, the values of H. pylori genotypes were used to evaluate therapeutic efficiency., Results: The inclusion of immunal into the complex therapy in patients with torpid PU exerts a significant clinical effect in relieving the pain syndrome and dyspeptic symptoms and in accelerating ulcer cicatrization. The disappearance of virulent H. pylori strains was noted during treatment. Recovery of phagocytic, cellular, and humoral immunities is an important result of therapy., Conclusion: The use of immunal as a component of complex therapy for torpid PU is pathogenetically founded and clinically effective.

Aim: to study factors contributing to gallstone formation and to elucidate their relationship., Subjects and Methods: The examination of 230 patients with various hepatobiliary abnormalities used dynamic ultrasonic cholecystography, multifractional duodenal intubation, followed by a microscopic study and determination of the physicochemical properties of bile. Enzyme immunoassay was employed to measure the peripheral blood levels of gastrin, insulin, T3, T4, thyroid-stimulating hormone, cortisol, and growth hormone., Results: All the patients were found to have signs of an early (gallstone pre-formation) stage of cholelithiasis. Decreased emptying of the gallbladder and its hypotonia and altered bile physicochemical properties were ascertained to be poor predictors of possible gallstone formation., Conclusion: Correlation analysis has shown the important role of hormonal factors in the formation of lithogenic bile.

We spent the complex investigation of therapeutic efectiveness of ursosan and afobasol in 125 patients with gallstone disease on early stage (before stones). After the course of treatment we revealed positive changes of clinical symptoms and improvement of biochemical bile compound. Besides we found the positive changes in hormone levels correlated with decreasing of bile lithogenity.

It is shown, that in patients with erosive and ulcer defects of gastroduodenal zone at settling Helicobacter pylori (Hp) in an oral cavity in 100% of cases caries develops at intensity 13.6 +/- 1.4 teeth. Produced Hp protease and ammonia cause disintegration connected to protein silica acids and reduce activity lysocim, worsening, thus, fluid and protective properties of a saliva. In the subsequent infringement of autopurification of a teeth results in accumulation of a dental strike where protease activity conditionally pathogenic microflora conducts to depolymerization and demineralization enamels of a teeth.

Aim: To specify dysfunction of the stomach and duodenum in gastroesophageal reflux disease (GRD) to offer more effective pathogenetic pharmacotherapy of GRD., Material and Methods: Fibroesophagogastroduodenoscopy with further assessment of esophageal mucosa condition by Savary-Miller, intragastric pH-metry, dynamic gastroscintigraphy and electrogastrography were made in 150 GRD patients., Results: GRD patients were found to have significant disturbances of a motor-evacuatory function of the gastroduodenal complex. Addition of domperidon and mebeverin to routine combined treatment of GRD raises clinical efficacy of GRD treatment and promotes recovery of gastric and duodenal function though therapeutic efficacy of the above drugs depended on concomitant pathology., Conclusion: Domperidon and mebeverin addition to combined treatment of GRD makes this treatment more effective.

The clinical and pharmacoeconomic effectiveness of the third-generation cephalosporin Ceftriabol versus the original drug Claforan in the treatment of varying community-acquired pneumonia was studied in 60 and 58 patients, respectively. The Russian third-generation cephalosporin Ceftriabol was shown to be as effective as Claforan in treating patients with community-acquired pneumonia. However, in addition to the main--therapeutic effect, Ceftriabol produces a certain economic gain.

The aim of the study was to evaluate therapeutic efficiency of ceftriabol (Russia) and claforan (both 3d generation cefalosporins) used to manage severe extrahospital pneumonia. Ceftriabol (2 g) was administered one or twice daily, claforan intravenously (2 g b.i.d. or t.i.d). Results of the treatment were assessed from a combination of anamnestic and physical examination data, results of X-ray and laboratory studies. Normalization of major clinical, laboratory, and instrumental parameters in patients treated with ceftriabol and claforan was achieved roughly within the same time period. It means that ceftriabol is at least as efficacious as claforan when applied to the treatment of severe extrahospital pneumonia.

Aim: To determine clinical and cost-effect efficacy of staged (hospital-day hospital-outpatient clinic) treatment and rehabilitation of patients with ulcer disease (UD)., Material and Methods: Of 160 patients with duodenal ulcer 80 patients (controls) received treatment in hospital and 80 patients (the study group) were treated in hospital and day hospital. Efficacy of the treatment was assessed by clinical data, results of device and cost-effect investigations., Results: Clinical and endoscopic remission of duodenal ulcer was achieved for the same time in both the groups. The cost of the treatment of 1 patient was 23,393 and 21,163 rub in the controls and in the study group, respectively. Therefore, treatment in a day hospital reduced cost of the treatment. Later, the remission was consolidated by active follow-up in an outpatient clinic., Conclusion: Staged treatment of UD provides good therapeutic and economic effects compared to hospital treatment.

In the treatment of 78 elderly patients with the gallstone disease were used chophytol and vasilip. To estimate the efficiency of treatment we used modern laboratory-instrumental, ultrasonic and biochemical methods of examinations. The examinations of indexs of fat exchange in bile and blood showed the communication of theirs disturbances. The application of chophytol and vasilip in the treatment of the first stage of gallstone disease is prove the positive changes of clinical symptoms of illness and lead to improvement of liver functional condition and biochemical composition of bile. These changes are cause to decrease of risk of formation the gallstones.

In treatment 60 patients with duodenal and stomach peptic ulcer in composition standard eradication therapy was used de-nol. Thus, along with the positive dynamics of clinical symptoms of disease, there is renewal of motor activity of stomach, improvement of microcirculation and renewal of protective properties of gastric mucus. There is a decline of frequency of relapses of disease from data of remote supervisions on a background high-quality reparation of ulcerous defect at the used of de-nol.

Aim: To make prognosis of ulcer morbidity and lethality from its complications for the near future basing on the trends in ulcer morbidity and lethality for the last 10 years; to assess ulcer patients' followup quality and coverage., Material and Methods: Time series statistics of general, primary ulcer morbidity and lethality from ulcer complications in the Udmurt republic for the last 10 years have been analysed as well as expert evaluation of the treatment quality and follow-up of ulcer patients by 156 outpatients' cards and 118 disease histories., Results: General and primary gastrointestinal ulcer incidence in Udmurt republic in 1992-2001 decreased significantly but ulcer morbidity did not change. Lethality from ulcer complications rose 1.8-fold. The predicted lethality rise in 2003-2006 proved valid., Conclusion: If social and economic conditions in the republic do not change and public health service reforms remain low effective, further deterioration of the above lethality is predicted.

We spent the comparative studying of treatment effectiveness of patients with duodenal ulcer disease at the all-day hospital, all-day hospital with following treatment at the day-staying hospital and at the day-staying hospital. It was received equal clinical effectiveness at the different stages of treatment, but at the day-staying hospital economical effect was achieved, besides medical one.

Aim: To study function of the liver, sphincter system and the gall bladder (GB) in patients with biliary dyskinesia (BD)., Material and Methods: Thirty-four patients with BD have undergone clinical, fibrogastroduodenoscopic examinations, fractional duodenal intubation with examination of the bile, ultrasonography, dynamic scintigraphy of the hepatobiliary system., Results: The examination of the patients has detected GB hypotonia (65%), GB hypertension (35%), Oddi's sphincter hypertention (28%), Oddi's sphincter hypotonia (44%), Lutkens' sphincter hypertonicity (19%), Lutkens' sphincter hypotonia (13%), impairment of intrahepatic biliary tracts (65%), lithogenic bile (100%), duodenogastric reflux (41%)., Conclusion: Consecutive use of duodenal tubing, ultrasonography and hepatobiliscintigraphy provide assessment of defects in the function of the liver, biliary tract and sphincter system in patients with BD.

A complex study of 147 patients who were taking non-steroid anti-inflammatory drugs (NSAIDs) revealed gastric lesions in 120 patients (81.6%). H2 blocker (ranitidine) was used for treating 40 patients with NSAID-induced gastropathy, proton pump inhibitor (omeprazole) was used for 40 patients, and Gastrozepin combined with Misoprostol--for 40 patients. Pain syndrome and dyspepsia were eliminated in most of the patients as a result of the treatment. Using Gastrozepin and Misoprostol produced an active effect on the trophic processes in the gastric mucous coat and caused erosion and ulcer healing. As compared to ranitidine and omeprazole, Gastrozepin used in combination with Cytotec produces a lower effect on the reduction of the acid-producing stomach function, yet it has a considerably greater effect on the normalization of the gastric mucus structure and restoration of metabolism of the gastric mucous coat collagen.

Complex study of the components of the gastric mucus in 60 patients with gastric polyps was studied. The study found significant changes in the protein-hydrocarbonate composition of the gastric mucus, manifesting by an increased concentration of free, oligo-combined and protein-combined sialic acids and glycosaminoglycans. The degree of the changes in the gastric mucus was higher in patients with adenomatous polyps vs. hyperplastic ones. Hormonal factors play an important role in the disintegration of the gastric mucus.

The complex study of stomach and duodenal function was performed in 150 patients with GERD. It was revealed that 84,3% of patients had increased stomach acid-production. In GERD exacerbation we found the disturbance of gastric mucosa decreasing protective properties of esophageal, stomach and duodenal mucosa. The patients had increased intragastral and intraduodenal pressure leading to decreasing of closing function of pylorus. Due to dynamic gastroscintigraphy the slowing of stomach evacuation was revealed in 69,2% patients, the acceleration - in 7,7% patients. The prevalence of bradyperistalsis was found in elecrogastromyography. The role of hormones (gastrin, insulin, cortisol, thyrotrophin, thyroxin) in disorders of gastro-duodenal complex function was shown. The complex investigation of gastro-duodenal complex function opens the pathophysiologic base of GERD and these data may be used in the choice of adequate therapy.

The authors conducted a complex examination of functional condition of pancreas in 70 patients with chronic obstructive pulmonary disease (COPD). The defeat of pancreas was revealed in 44.3% patients with COPD. The rate and degree of pancreatic defeat depended of severity and long of basic disease. The pancreatic defeat often had subclinical character and was revealed after complex examination of patient. It was shown that secondary erythrocytosis, changes of microcyrculation and haemostas system to hypercoagulation have important role in disturbance of pancreatic function.

Aim: To reveal metabolic disturbances of connective tissue main substance in chronic obstructive pulmonary disease (COPD) and to assess their informative value in determination of treatment efficacy., Material and Methods: Peripheral blood of 130 COPD patients was studied for total glycosaminoglycanes, hyaluronidase activity, sialic acids fractions (free, oligobound and proteinbound), fucose fractions (oligobound and proteinbound) and activity of sialidase., Results: The levels of total glycosaminoglycanes, sialo- and fucose-containing compounds in the blood change with COPD severity and phase of the disease., Conclusion: The data obtained may be used to assess activity of respiratory inflammation and efficacy of the treatment.

Aim: To characterize actions of inhibitors of hydrochloric acid secretion on gastric function and to formulate indications to using different antisecretory drugs in ulcer disease (UD)., Material and Methods: Of 120 examinees with duodenal ulcer (DU), 40 received gastrocepin, 40--famotidin, 40--omeprasol. Follow-up study was made of motor, acid-, pepsin- and mucus-forming functions of the stomach., Results: By reducing production of acid and pepsin, gastrocepin is inferior to famotidin and omeprasol. Gastrocepin is more effective than famotidin and omeprasol in motor-evacuatory dysfunction. Gastrocepin improves defensive properties of gastric mucus better., Conclusion: The results expand indications for a differential administration of antisecretory drugs in UD.

Aim: To assess efficacy of essentiale in combination with cholagogum in prevention of cholelithogenesis in patients with fat hepatosis (FH) and concomitant cholecystitis (CC)., Material and Methods: 100 patients aged 31-60 years with FH and CC were examined using clinical, device and biochemical tests. The diagnosis was verified by the results of ultrasonography, computed and MR tomography. Fractionated duodenal tubing followed by biochemical examination of bile was conducted in all the patients., Results: Changes in physico-chemical properties of hepatic and vesical bile corresponding to stage I of cholelithiasis occurred in most of the examinees. Treatment with essentiale +cholagogum is clinically effective, improves functional condition of bile ducts and the liver, diminishes bile lithogenicity., Conclusion: In fat hepatosis and concomitant cholecystitis, essentiale and cholagogum improve biochemical composition of bile, resulting finally in decreased risk of cholelithogenesis.

There was a complex study of the functional condition of the liver and biliary system in 130 patients with peptic ulcer. Thus, 84.6% of the patients had some disorders of the hepatobiliary system. When antihelicobacterial therapy is used, the deterioration of some initially impaired functional parameters of the hepatobiliary system--reduction of the contractive function of the gallbladder, increased cholestasis and increased ALT and AST levels in the blood--are observed.

The therapeutic efficacy of tykveol was evaluated in 22 patients with chronic non-calculous cholecystitis and/or dyskinesia of the biliary tract (BT) concurrent with gallbladder deformity (GD). Supplementation of tykveol to the combined therapy in the patients with chronic non-calculous cholecystitis concurrent with GD was shown to exert a pronounced therapeutic effect. This caused positive changes in clinical symptoms and BT function, diminished the lithogenic propertes of bile. With the use of tykveol, recovery of neurohumoral regulation is an important factor that improves biliary tract function, as evidenced by decreased gastrin secretion.

The purpose of our research was to learn the efficacy of the Dirol chewing gum upon the condition of the oral cavity and the stomach acidity in patients with hyperchlorhydratic type of secretion. It has been estimated that correct usage of chewing gum by patients with hyperacidity of the stomach in a month after its administration decreases the level of gastric acidity to a normal one. Thus, it has been proved that the Dirol chewing gum favorably changes the condition of oral cavity both from hygienic point of view, acido-alkaline balance and saliva condition.

Aim: To study pathogenetic factors underlying development of ulcer disease and its course in different age periods., Material and Methods: Clinical, psychoemotional, endoscopic device, biochemical and radioimmunological examinations were used in the study of 283 patients with gastroduodenal ulcer. By age, the patients were divided into four groups: 15-18, 19-35, 36-60 and 61 and older., Results: Some age-specific clinical and endoscopic characteristics were found in the examinees. Risk factors (hereditary predisposition, high gastric juice acidity, the presence of Helicobacter pylori, etc.) occurred almost with the same frequency at different ages. Older patients had deficient defense-protection properties of gastric mucus. Most of the examinees's psycho-emotional state was characterized by moderate reactive and high personality anxiety. In all the age groups reactions of the hormonal system were of the same type--hypophyseo-adrenal hyperfunction and hypophyseo-thyroid hypofunction., Conclusion: The above findings may help in design of differentiated by age therapeutic and diagnostic measures for ulcer patients of different age.

We studied the dynamics of morbidity of the digestive apparatus including peptic ulcer, gastritis, duodenitis and mortality in the Udmurt Republic from 1992 to 2002. We revealed the decrease of morbidity of the digestive apparatus and stable data for peptic ulcer but the increase of mortality from the digestive apparatus pathologies on the whole and from complications of peptic ulcer. The mortality from the digestive apparatus diseases and peptic ulcer is forecasted to increase in the next years if the same social and economic conditions are preserved and there are no changes in the health-care system.

It was discovered that patients with stomach ulcers take anti-ulcer drugs while standing, sitting, lying, or moving in the space. The overwhelming majority of them take drugs while sitting and keep the same position almost without any motion during one hour.

We examined 215 patients, 98 of them being with gastric and duodenal erosions, 52 being with erosions of the gastroduodenal zone combined with duodenal ulcers, and 65 being with duodenal ulcers. Endoscopic, radiological, biochemical, pH measurement studies and abdominal gastroduodenal manometry were used for the evaluation of the functional state of the gastroduodenal system. It was established that impaired pyloric and cardiac functions, duodenogastric reflux, dyskinesia of the stomach and duodenum, stomach deformation and gastroduodenoptosis are observed more frequently in cases of erosive lesions as compared to ulcers. The obtained data allow us to assume that gastric and duodenal erosions are an independent nosological form with their own pathogenic mechanisms, clinical presentation and complications including ulcers.

Aim: To validate use of intravenous laser blood irradiation (ILBI) combined with actovegin administration in indolent gastroduodenal ulcers., Material and Methods: Modern endoscopic, morphological, device, biochemical techniques and radioimmunoassay were used in examination of 92 patients with indolent gastroduodenal ulcers aged 24 to 69 years. ILBI plus actovegin was given in failure of standard medicinal therapy., Results: ILBI plus actovegin combination produced marked analgetic, anti-inflammatory and detoxication effects. Favourable trends were observed in the composition of gastric mucus, detoxication, reparative and metabolic processes in the gastroduodenal mucosa, neurohumoral regulation., Conclusion: Combination of ILBI with actovegin proved highly effective in indolent gastroduodenal ulcers.