Method of treating patients with gastroesophageal reflux disease

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gastroenterology, laser therapy. The method involves administering the drugs: a proton pump inhibitor and a prokinetic accompanied by laser therapy. The proton pump inhibitor is presented by Controloc 20 mg 2 times a day. Gaviscon is administered in a dose of 2 tablets 3 times a day daily. Trimedat 200 mg is administered 3 times a day. The laser therapy is differentiated. That involves taking into account a severity of gastroesophageal reflux disease, a degree of manifestation of endothelial dysfunction and a severity of upper gastrointestinal motor dysfunction. The manifestation of endothelial dysfunction is shown by the contents of nitrogen oxide, pro-inflammatory, namely IL-1β, IL-6, TNF-α and anti-inflammatory, namely IL-4 cytokines. The degree of upper gastrointestinal motor dysfunction is shown by a stomach/duodenum ratio Pi/P(i+1). A mild degree of gastroesophageal reflux disease implying the levels of nitrogen oxide 35.2±2.7 mcmole/l and more, IL-1β 1.5±0.3 pg/ml or more, IL-6 1.8±0.8 pg/ml or more, TNF-α 2.78±0.35 pg/ml or more, IL-4 4.4±0.42 pg/ml or less, the ratio Pi/P(i+1) of 11.2±5.6% or less requires 6-7 daily procedures of the intravenous laser blood irradiation. The exposure length is 15 minutes at wave length 0.405 mcm, end face output density 1-1.5 mWt, pulse frequency 80 Hz, in a continuous mode. The moderate or severe gastroesophageal reflux disease with the levels of nitrogen oxide less than 35.2.2±2.7 mcmole/l, IL-1β 1.83±0.3 pg/ml or less, IL-6 1.98±0.8 pg/ml or less, TNF-α 10.04±2.84 pg/ml or less, IL-4 3.15±0.43 pg/ml or more, the ratio Pi/P(i+1) of 12.3±4.8% or more requires 9-10 daily procedures of the intravenous laser blood irradiation. The exposure length is 15 minutes at wave length 0.405 mcm, end face output density 1-1.5 mWt, pulse frequency 80 Hz, in a continuous mode.

EFFECT: method reduces the drug-induced load, reduces the length of treatment.

3 tbl, 3 ex

 

The invention relates to medicine, namely to "gastroenterology", and for the treatment of patients with gastroesophageal reflux disease.

In the last decade of gastroesophageal reflux disease (GERD) has attracted increased attention.

The importance of studying GERD is primarily due to its wide prevalence. In epidemiological studies has been a steady trend to increase the number of patients suffering from GERD, in several countries of Europe and North America, and Russia.

It is shown that in patients with GERD quality of life lower than in patients with untreated duodenal ulcer, angina pectoris, arterial hypertension.

It is established that, in turn, GERD is a trigger of the cascade complex mechanisms leading to the development and progression of coronary heart disease, hypertension, bronchial asthma is a cause of repeated pneumonia, cancer of the larynx, severe caries, which is an incentive for further study of this problem.

Improving treatments for patients with GERD continues to be one of the important aspects of gastroenterology. This lack of effectiveness of drug therapy causes professionals to develop new methods of treatment of GERD. Practice the last 10-12 years showed perspective is here used in the direction of low-intensity laser radiation (NEELY). In the literature there are data about anti-inflammatory, hypolipidemic and antioxidant effects of LLLT are marked rheological and microcirculatory effects, stimulation of the factors of specific and nonspecific immunity. But still there are no reliable estimates of the effects of LLLT on some links of the pathogenesis of GERD. There is a method of treatment of patients with GERD using laser therapy (Smorchkova O.S Use of combined UHF-laser therapy in patients with gastroesophageal reflux disease // Scientific Herald of medicine Central black earth region. No. 36. - The second quarter. - 2009).

Took the course percutaneous laser therapy using the "matrix" (NGO space device engineering, Moscow), head LO 1, symmetrically impacted acupuncture points (St44, CV15, St36). After 2 minutes after laser irradiation was carried out EHF-therapy radiating head LO-EHF-5,6 (wave length 5.6 mm, frequency 53,57 GHz) for the epigastric region, the projection of the duodenal bulb and the point of most severe pain lasting 2 minutes on each area.

The disadvantage of this method of treatment is that in the appointment of cutaneous laser therapy, the effect occurs only in the region of the contact zone and in contrast to intravenous laser irradiation of blood is not floor the positive effect on endothelial function, and there is no differentiated approach in the appointment of laser therapy.

The closest to the essential features of the claimed invention is a method for the treatment of patients with gastroesophageal reflux disease, using the contact laser therapy, taken as a prototype (Nikitin A.V., Smorchkova O.S "evaluating the effectiveness of laser therapy of gastroesophageal reflux disease based on data from follow-up observations". Laser medicine. - 2009. - Vol.13, issue 4, p.17-21), including the use of proton pump inhibitor gastrozol 20 mg 2 times a day, prokinetic under conditions of 10 mg 3 times a day, percutaneous laser wavelength of 0.89 μm, a pulse frequency of 80 Hz, the radiation power of 5 W, in the course of 10 sessions. Daily for one session worked on 3 areas - the lower third of the sternum, epigastric region and the area of most severe pain points, the exposure time of 2 minutes per area.

The prototype of the invention has the following essential features: the simultaneous use of drugs: proton pump inhibitor, prokinetics, and laser therapy.

However, the disadvantage of the prototype is that laser therapy is prescribed transdermal method, while in intravenous blood irradiation, the laser irradiation is s not directed at various private manifestation of the effects of low-intensity laser radiation, and comprehensive correction of changes in the system of homeostasis. The purpose of laser therapy is carried out without use of a method for increasing the level of inflammatory cytokines, stabilization of endothelial dysfunction, restoration of adequate motor function of the upper parts of the gastrointestinal tract and balanced type of the autonomic nervous system in patients with gastroesophageal reflux disease.

The claimed invention is directed to solution of the problem consisting in the creation of a method of differentiated approach to the treatment of patients with gastroesophageal reflux disease with intravenous laser irradiation of blood.

The solution to this problem provides a reduction in the frequency of clinical manifestations of gastroesophageal reflux disease, reduces the frequency of exacerbations, provides a positive impact on the pathological processes occurring in the upper sections of the gastrointestinal tract, reducing drug load, at the same time increases the effectiveness of medication therapy patient and provides the basis for the effectiveness of laser therapy in complex treatment of patients with gastroesophageal reflux disease taking into account the most important pathogenetic links of the disease (impaired motor function of upper sections of infection is a rule-intestinal tract, cytokine status, endothelial function).

To achieve this, the technical result of the claimed invention, a method for the treatment of patients with gastroesophageal reflux disease includes the following significant features: simultaneous integrated use of drugs: proton pump inhibitor, drug regulating motor function of the gastrointestinal tract, and laser therapy, advanced use of tablets antacids, laser therapy is prescribed differentially depending on the severity of gastroesophageal reflux, the degree of endothelial dysfunction (nitric oxide), the performance level of proinflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4) cytokines, disturbance of motor function of upper gastrointestinal-intestinal tract (coefficient comparison of stomach/duodenum Pi/P(i+1)), with mild gastroesophageal reflux, when the level of nitric oxide 35,2±2.7 µmol/l or more, at the level of IL-1β, equal to and more than 1.5 ą 0.3 PG/ml, IL-6, equal to and more than 1.8 ą 0.8 PG/ml, TNF-α, is equal to or more 2,78±0,35 PG/ml, IL-4, equal, and less of 4.4±0,42 PG/ml, with Pi/P(i+1), equal to and less of 11.2±5.6 per cent, held 6-7 daily procedures of intravenous laser irradiation of blood within 15 minutes wavelength 0,405 μm, output power at the end disposable intravenous St is the guide 1-1,5 mW, the pulse frequency of 80 Hz in CW mode, with moderate and severe severity level of nitrates/nitrites less 35,2±2.7 µmol/l, while levels of IL-1β, equal to and less than 1,83±0,4 PG/ml, IL-6, equal, and less 1,98±0,8 PG/ml, TNF-α, equal to and less 10,04±2,84 PG/ml, IL-4, equal, and more 3,15±0,43 PG/ml, with Pi/P(i+1)equal to or more 12,3±4,8%, held 9-10 daily procedures of intravenous laser irradiation of blood within 15 minutes wavelength 0,405 μm, output power at the end of the disposable optical fiber 1-1,5 mW, a pulse frequency of 80 Hz in CW mode.

In relation to the prototype of the claimed invention has the following distinguishing characteristics: as a proton pump inhibitor used controloc 20 mg 1 tablet 2 times a day, before meals, as a drug that regulates motor function of the gastrointestinal tract, trimedat 200 mg 1 tablet 3 times per day, additionally use antacids - gaviscon daily for 2 to so 3 times a day, at the same time appoint laser therapy differentially depending on the severity of gastroesophageal reflux, the degree of endothelial dysfunction (nitric oxide), the performance level of proinflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4) cytokines, disturbance of motor function of the upper parts of the gastrointestinal tract (coefficients the comparison of the stomach/duodenum Pi/P(i+1)), when mild gastroesophageal reflux, when the level of nitric oxide 35,2±2.7 µmol/l or more, at the level of IL-1β, equal to and more than 1.5 ą 0.3 PG/ml, IL-6, equal to and more than 1.8 ą 0.8 PG/ml, TNF-α, is equal to or more 2,78±0,35 PG/ml, IL-4, equal, and less of 4.4±0,42 PG/ml, with Pi/P(i+1), equal to and less of 11.2±5.6 per cent, held 6-7 daily intravenous procedures laser irradiation of blood within 15 minutes wavelength 0,405 μm, output power at the end disposable intravenous fiber 1-1,5 mW, a pulse frequency of 80 Hz in CW mode, with moderate and severe severity level of nitrates/nitrites less 35,2±2.7 µmol/l, while levels of IL-1β, equal to and less than 1,83±0,4 PG/ml, IL-6, equal, and less 1,98±0,8 PG/ml, TNF-α, equal to and less 10,04±2,84 PG/ml, IL-4 equal to or more 3,15±0,43 PG/ml, with Pi/P(i+1)equal to or more 12,3±4,8%, held 9-10 daily procedures of intravenous laser irradiation of blood within 15 minutes wavelength 0,405 μm, output power at the end of the disposable optical fiber 1-1,5 mW, a pulse frequency of 80 Hz in CW mode.

Between the features and the technical result is the following causal relationship: the use of the technique of intravenous laser irradiation of blood (ILIB-405 notes normalizing effect on the dynamics of motor functions of the stomach and duodenum, increases the level of inflammatory cytokines, stabilization of endothelial function and autonomic nervous system, increases the effectiveness of drug therapy, and earlier relief of symptoms, improved quality of care, reduces the treatment time.

According to the authors ' knowledge, the set of essential features that characterize the essence of the invention is not known, which allows to make a conclusion about conformity of the invention, the criterion of "novelty".

According to the authors, the essence of the claimed invention is not obvious from the prior art of medicine, because it has not detected above method of treatment vlok-405, which differ from the prototype of the claimed invention, which allows to make a conclusion on compliance with a criterion of "inventive step".

The set of essential features that characterize the invention, in principle, can be used repeatedly in medicine with the technical result consists in increasing the effectiveness of laser therapy in patients with gastroesophageal reflux disease, which allows to make a conclusion about conformity of the invention, the criterion of "industrial applicability".

This method is as follows.

All patients with gastroesophageal reflux disease is complex is Naya medication (proton pump inhibitors, drugs that regulate motor function of the gastrointestinal tract antacids) with simultaneous application of a course of intravenous laser therapy.

The proposed method of treatment of patients with gastroesophageal reflux disease were used in 100 patients, of whom 68 women and 32 men, mean age of 45.8±8,2. All patients gastroesophageal reflux disease were divided randomly into two groups: control (30 people) and the bulk (70 people). In the first (control) group were used for treatment, traditional drug therapy, the patients of the second group (the principal) along with drug therapy has received a course of intravenous laser therapy.

The diagnosis of gastroesophageal reflux disease was established on the basis of complaints, anamnesis, fibroesofagogastroduodenoscopia and daily pH monitoring of the esophagus. All patients were identified motor function of the stomach and duodenum method peripheral AGAG. For recording a signal used instrument gastroenterological "Astroscan-HEV" (NGO "Istok", Fryazino, Moscow region). When analyzing the signal power analyzed the ratio (Pi/P(i+1)) (%), which represents the ratio of the electrical activity of the overlying Department to the underlying.

A course of intravenous laser therapy was performed using AP is Arata laser therapy "matrix-ILIB" with wavelength 0,405 μm output power at the end of the disposable optical fiber 1-1,5 mW, the pulse frequency of 80 Hz, the duration of the procedure 15 minutes, the treatment course of 10 treatments. Procedures are performed daily with a break on Saturday and Sunday.

When endothelial function were identified various changes in the level of stable metabolites of NO - nitrates and nitrites (NOx). Patients were divided into groups with normal, low and high levels of metabolites (NOx) (table 1).

Table 1
Changes in the concentration of NOxin patients with GERD against laser therapy
The group surveyedThe high contentNormalReduced content
Before the treatmentAfter the treatmentBefore the treatmentAfter the treatmentBefore the treatmentAfter the treatment
HealthyNOx(35,2±2.7 µmol/l)
the main group49,56 is 1,52 ##36,45±1,35**35,78±0,5436,05±1,1428,38±1,53##35.32 per±2,16**
the control group52,32±2,97##45,32±1,4435,49±1,2235,63±0,7628,42±0,98##3151±2,84
HealthyNO2(7,4±1.5 µmol/l)
the main group12,93±0,24##8,4±0,41**6,38±0,298,71±0,52the 5.25±0,41#7,87±1,32**
the control group11,98±1,6##11,53±0,616,82±0,317,3±1,45,39±0,64#6,04±1,133
HealthyNO3=NOx-NO2(27,8±4.2 µmol/l)
the main group36,63±2.57 m# to 28.05±2,67**29,4±0,82#27,34±2,1723,13±0,95#27,45±2,46**
the control group40,34±3,22#33,79±2,4328,67±0,94#28,33±2,49to 23.03±1,24#25,47±1,98
*p<0,05; **p<0,01 - differences before and after treatment within the same group
#p<0,05;##p<0.01 to differences with the healthy group

In the main group level NOxas follows: to 48.6% (34 patients) with reduced content; 27,1% (19 patients) with high and 24.3% (17 patients) with normal.

In the control group the distribution of NOxwas as follows: 53,3% (16 patients) with reduced content; 30% (9 patients) with high and 16.7% (5 patients) with normal. Thus, in both groups of patients with GERD identified 3 types of response systems generate NO: a) increase of NO synthesis; b) reduction of NO synthesis; C) no change.

In numerous studies it has been shown that NO plays an important role as an endogenous regulator of vascular tone. Damage and disfun the function of the endothelium leads to reduced NO production. This is consistent with our data, because among our patients with GERD was dominated by patients with reduced levels of NOx. Analyzing the above data, we found that under the effect of the treatment was changed as in the main group and in the control group. Patients in the study group with the original reduced NO production was found that the level of its metabolites significantly increased and reached the normal values. Thus, the level of NOxchanged from 28,38±1.53 µmol/l to 35.32±2,16 µmol/l (p<0.01), and nitrite - from 5.25±0.41 mmol/l to 7,87±1,32 µmol/l (p<0.01), and nitrate - 23,13±0.95 mmol/l to 27,45±2,46 µmol/l (p<0,01). In the control group, the observed increase in similar figures, but it was not sufficiently reliable and was not associated with achievement indicators healthy persons Level of NOxincreased from 30,42±0.98 mmol/l to 31,51±2,84 µmol/l (p>0,05), nitrate - to 23.03±1,24 µmol/l to 25.47±1.48 mmol/l (p>0,05), nitrite - from 5.29±0.54 mmol/l to of 5.84±1,43 µmol/l (p>0,05), but the degree of increase was much less than in the main group.

Although the system of synthesis and release of NO by the endothelium has significant spare capacities, increased NO production may be no less dangerous, damaging factor than its deficits. Excess NO increases vascular permeability, has a direct cardiotoxic effect, leads to resistant GE is realizovannoy vasodilation. In the main group of patients with initial high content of NO was observed a significant decrease to normal values NOxwith 49,56±1,52 µmol/l to 36,45±1.35 mmol/l (p<0.01), and nitrates with 36,63±2.57 mmol/l up to 28.05±2,67 µmol/l (p<0.001) and nitrite with 12,93±0.24 µmol/l to 8.4±0.41 mmol/l (p<0,001). In the group of patients who received only medical therapy, there was also a reduction of NOxwith 52,32±2,97 µmol/l to 45,32±1.44 µmol/l (p>0,05), nitrates 40,34±3,22 µmol/l to 33,79±2,43 µmol/l (p>0.05) and nitrite from 11.98±1.6 µmol/l to 11,53±0.61 mmol/l (p>0,05), but it is statistically insignificant and does not reach the normal range. When the original normal level of stable metabolites after treatment in both groups, significant changes have not occurred. The level of NOxin the main group was 35,78±0.54 mmol/l (p>0.05) and 36,05±1,14 µmol/l (p>0,05), while remaining within the normal range. In addition, the level of nitrite increased from 6,38±0.29 μmol/l to 8,71±0.52 mmol/l (p>0.05) in the primary group and with 6,82±0.31 mmol/l to 7.3±1.4 µmol/l (p>0.05) in the control group, and nitrates decreased slightly with 29,4±0.82 mmol/l to 27,34±2,17 µmol/l (p>0.05) and with 28,67±0,94 µmol/l to 28.33±2.49 mmol/l (p>0,05), respectively.

Thus, the results of our study suggest that traditional medical therapy of patients with GERD is not accompanied with a significant improvement of the content in the square is the ZMA blood stable metabolites of NO, while in the patients in addition to medical laser therapy, we observed significant improvement of the results with the original high maintenance, and in the original reduced content of NOxincreased the number of patients with normal content of NOxpatients of the main group, in contrast to patients receiving only medical therapy.

Based on the foregoing, we can conclude that the inclusion in the treatment of patients with GERD laser therapy improves NO-producing endothelial function, which indicates the ability of the laser to improve the functional state of the vascular endothelium. Compensation deficit NO ongoing therapy leads to global protection of the body against the damaging action of free radicals, decrease in the intensity of oxidative stress.

We also in his research studied the content of cytokines and the possible influence of LLLT on the system cytokines as cytokines actively participate in the launch of inflammatory-regenerative cascade, restoration and regeneration of the epithelial layer.

Dynamics of indicators of the content of anti-inflammatory (IL-4) and proinflammatory (IL-1β, IL-6, TNF-α) cytokines in plasma of patients with GERD are presented in table 2.

Table 2
Dynamics of the content of cytokines in patients with GERD under the influence of laser radiation
The analyzed indicatorTNF-αIL-4IL-6IL-1β
Norma2,78±0,35 PG/ml4,4±0,42 PG/ml1,8±0,8 PG/ml1,5±0,3 PG/ml
Before the treatmentAfter the treatmentBefore the treatmentAfter the treatmentBefore the treatmentAfter the treatmentBefore the treatmentAfter the treatment
The main gr.7,3±1,3#3,8±1,43.3V±1,274,5±0,93,85±0,7#1,9±0,8*4,7±0,78##1,6±0,57*
Control gr.? 7.04 baby mortality±1,2##5,9±0,8*3,6±1,36#4,1±1,3*3,6±1,9#2,4±1,74,1±0,5##2,0±0,3**
*p<0,05; **p<0,01 - differences before and after treatment within the same group
#p<0,05;##p<0.01 to differences with the healthy group

As can be seen from table 2, in patients with GERD before treatment was noted increased levels of proinflammatory cytokines in comparison with the group of healthy persons Level of TNF-α in the main group was 7.3±1,3 PG/ml (p<0.05) in control? 7.04 baby mortality±1,2 PG/ml (p<0.01) compared with the healthy group (2,78±0,35 PG/ml). The content of interleukin IL-1β was 4.7±0,78 PG/ml (p<0.01) in the main group and 4.1±0,52 PG/ml (p<0.01) in the control group at the rate of 1.5 ą 0.3 PG/ml, the Level of IL-6 was also increased and amounted in the main group of 3.85±0,7 PG/ml (p<0,05), in the control of 3.6±1,9 PG/ml (p<0,05), which was significantly higher than in the group of healthy individuals (1,8±0,8 PG/ml). As for the anti-inflammatory cytokine IL-4, in contrast to the group of healthy individuals from patients with GERD was observed a significant decrease of this is the service provider, which was in the main group was 3.3±1,27 PG/ml and in the control of 3.6±1,36 PG/ml (p<0.05) in the rate of 4.4±0,42 PG/ml.

Thus, we identified a significant shift in the pattern of cytokines. On the one hand, these changes apparently due to the influence of etiological factors of GERD, and can themselves be the cause of the failure of remedial measures, lead to a prolonged course. A pronounced increase in the content of cytokines in peripheral blood is a reflection of the systemic reactions of the body and serves as one of the indicators of the intensity of the immune response, the activity of the inflammatory cascade and progression of GERD.

After treatment only in the group of patients in addition to medical laser therapy was statistically significant positive trend. So increased before treatment indicator TNF-α in the study group was significantly decreased to 3.8±1,4 PG/ml Observed increase in IL-1β reliably achieved a reduction of 1.6±0,57 PG/ml (p<0,05). Source increased proinflammatory cytokine IL-6 in the study group decreased to 1.9 ą 0.8 PG/ml (p<0,05). In the main group, you can observe the increase from baseline of anti-inflammatory cytokine IL-4 to 4.5±0,9 PG/ml.

In the group of patients who received only medical therapy, reported a positive trend, but it does not have access to the gala standards: indicator TNF-α was 5.9±0,8 PG/ml (p< 0.05), and IL-1β decreased to 2.0 ą 0.3 PG/ml (p<0.01), and IL-6 reached 2.4±1,7 PG/ml, also noted a moderate increase anti-inflammatory cytokine IL-4 to 4.1±1,3 PG/ml (p<0,01).

The content analysis of cytokines before and after treatment in the group of patients with GERD receiving combination therapy showed a significant decrease in anti-inflammatory cytokines (IL-1β, IL-6, TNF-α) and increased anti-inflammatory (IL-4), compared with patients receiving only medical therapy.

This again confirms the multidirectional nature of the action of laser radiation, including the role of the immune system in inflammatory-regenerative cascade.

We also studied the effect of low-intensity laser radiation on the motor function of the upper GI tract in patients with GERD. Motor-evacuation disorders can act as a leading pathogenetic factor of GERD and related disorders that can increase the effects of other stressors. Evaluation of motor-evacuation function of the upper GI revealed several types of motility disorders. In the main group hyperkinesia of the stomach was detected in 19 (27,14%) patients, duodenojejunal hypokinesia - 43 (61,43%) patients, and duodenojejunal hyperkinesia - 8 (11,43%) cases. In the control group, these figures were 9 (30%), 17 (56,67%) and 4 (13,33%) are appropriate to estwenno.

As is seen in table 3 the data before treatment in patients of the main group electrical activity (EA) of the stomach exceeded normal levels several times and amounted to 28.57±4,7% (p<0.01), and EA duodenum and jejunum, in contrast, was reduced and was 0.36±0.14% and 1,74±1,44%, respectively. The coefficient of variability (Kritm) was also changed in comparison with the healthy group: Kritmstomach - to 8.41±2,41; KritmKDP - 0,57±0,29 (p<0,05); Kritmjejunum - 1,27±0,88.

Coefficient comparison KS Pi/P(i+1) was significantly higher than in healthy people on a segment of the stomach/duodenum - 79,36±14,47 (p<0.01) and declined slightly on a segment of the duodenum/jejunum to 0.21±0,12.

Patients of the control group was similar picture: EA stomach was 29,47±5,6% (p<0.01), and EA KDP - 0,45±0,12% and extend the jejunum - to 1.38±1,24%. Kritmstomach - 8,92±2,23; KritmKDP - 0,64±0,38 (p<0,05); Kritmjejunum - 1,44±0,81; KS Pi/P(i+1) on a segment of the stomach/duodenum - 65,48±15,43 (p<0.01) and a segment of the duodenum/jejunum - 0,32±0,08.

In the main group, after drug therapy in combination with vlok, normalization of motor-evacuation function of the upper GI tract (34 patients (48,57%)) due to the reduction of hyperkinetic state of the stomach, which was diagnosed in 11 (15,71%) patients, reducing duodenojejunal hypokinesia to 22 (31,43%) patients and duodenojejunal hyperkinesis and 3 (4,29%) cases. Authentically revealed a trend toward normalization of parameters discussed above: EA stomach was 26,24±4,9% (p<0.01), and EA KDP - 1,86±0,13% EA jejunum - 3,37±1,36%. Kritmstomach - 7,31±2,32; KritmKDP - 1,24±0,32 (p<0,05); Kritmjejunum of 2.68±0,91; KS Pi/P(i+1) on a segment of the stomach/duodenum - 14,10±15,92 (p<0.01) and a segment of the duodenum/jejunum is 0.55±0,11. In the control group the frequency of disorders of motility after treatment did not change significantly, and the normal function of the detected only in 7 patients (23.33 percent). In patients receiving only medical therapy, the severity of positive dynamics was not comparable with that of the main group: EA stomach - 27,31±5,4% (p<0.01), and EA KDP - 0,87±0,15% and EA jejunum of 2.68±1,12%. Kritmstomach - 6,22±2,17; KritmKDP - 0,93±0,31 (p 0,05); Kritmjejunum - 2,34±0,94; KS Pi/P(i+1) on a segment of the stomach/duodenum - 31,39±14,26 (p<0.01) and a segment of the duodenum/jejunum is 0.33±0,09.

Table 3
Dynamics of motor function of the upper GI tract in patients with GERD against laser therapy
IndexNormaThe control groupThe main group
To treat After the treatmentBefore the treatmentAfter the treatment
EA P1/PsStomach (23,2±4,1)29,47±5,6##27,31±5,4**to 28.57±4,7##26,24±4,9**
WPC (2,1±0,9)0,45±0,120,87±0,150,36±0,141,86±0,13
Jejunum (3,48±1,67)1,38±1,242,68±1,121,74±1,443,37±1,36
KritmStomach (5,43±2,2)of 8.92±2,236,22±2,17to 8.41±2,417,31±2,32
WPC (1,1±0,5)0,64±0,380,93±0,310,57±0,291,24±0,32*
Jejunum (2,94±1,43)1,44±0,812,34±0,941,27±0,88 2,68±0,91
KS Pi/P(i+1)The stomach/duodenum (11,2±5,6)65,48±15,43##31,39±14,26*79,36±14,47##to 14.10±15,92
Duodenum/jejunum (0,6±0,17)0,32±0,080,33±0,090,21±0,120,55±0,11
*p<0,05; **p<0,01 - differences before and after treatment within the same group
#p<0,05;##p<0.01 to differences with the healthy group

From the analyzed data shows that the most common disorders of motor function of the upper GI tract in patients with GERD is hypokinetic condition of the duodenum and jejunum, which manifested itself in violation of rhythmic activity and coordinated work in these areas. This showed a significant decrease in EA of the KDP in the main and control groups before treatment. After treatment and in the control and main groups EA KDP has changed significantly, but the normalization of the metric (increasing the strength and speed of response) has occurred only in the group receiving vlok and drug therapy.

Thus, from above saganaga should what anti-inflammatory effect of combination therapy with a course of vlok-405 superior to conventional drug therapy.

As an illustration of the method of treatment of patients, including the use of drugs and laser therapy (ILIB-405), and normalizing effect on endothelial function, cytokines and motor function of the upper GI, here is a brief extract from a case history No. 245.

Example 1

Patient A., 56 years old, was admitted 27.07.11. to the gastroenterology Department with complaints of a burning pain behind the sternum, worse immediately after eating, lying down, while bending the trunk forward, feeling sour in the mouth, sore throat permanent. The above complaint was worried about two years. Turned to the ENT doctor, repeatedly received outpatient treatment for pharyngitis and tonsillitis, but the treatment was a relief not for long. Then was sent to an ENT specialist for a scope. If fibroesofagogastroduodenoscopia was diagnosed gastroesophageal reflux, the phenomenon of failure of the cardia, and therefore was referred to the gastroenterology Department for further evaluation and treatment.

Objectively: on the part of other organs and systems revealed no pathology.

In General blood analysis, biochemical blood analysis and urinalysis - without a pathology.

An ultrasound of the hepatobiliary system identified strain of the gall bladder.

On faggs: the cardia insufficiency, erosive esophagitis, gastroesophageal reflux.

The study of motor function of upper GI was observed hyperkinetic activity of the stomach and geokinetics activity of the duodenum and jejunum: EA stomach - 28,92%, EA KDP - 0,41%, EA jejunum - 1,27%, Kritmstomach - 8,12; KritmKDP - 0,54, Kritmjejunum - to 1.37; KS Pi/P(i+1) stomach/duodenum - 70,53, KS Pi/P(i+1) duodenum/jejunum - 0,43.

When studying the content of cytokines detected a shift in favor of Pro-inflammatory interleukins: TNF-α is 6.9 PG/ml, IL-1β and 4.5 PG/ml, IL-6 - 2,85 PG/ml, IL-4 and 2.6 PG/ml

In the study of nitric oxide detected source low content of its metabolites: NOx- 27,48 µmol/l, nitrite - 5,32 µmol/l, nitrate - 22,16 µmol/L.

The patient on the background diet, drug therapy was conducted by a course of intravenous laser therapy, one session per day, for a treatment course of 7 sessions. The used laser wavelength - 0,405 μm, pulse frequency of 80 Hz, power - 1-1,5 watts. Procedure duration is 15 minutes. After the end of therapy according to the patient, overall health has greatly improved, pain in the chest and throat were stopped completely.

After treatment was also observed position the positive dynamics of indicators of motor function of upper GI: EA stomach - 25,43%, EA KDP - 1,94%, EA jejunum of 3.28%, Kritmstomach - 6,18; KritmKDP - 1,57, Kritmjejunum - 2,96; KS Pi/P(i+1) stomach/duodenum - 13,12, KS Pi/P(i+1) duodenum/jejunum is 0.59. Conclusion: take note of the changes say about the normalization of motor function.

When you study the content in plasma cytokines detected a shift in favor of anti-inflammatory interleukins: TNF-α - 3,47 PG/ml, IL-1β - 1,92 PG/ml, IL-6 - 1,36 PG/ml, IL-4 and 4.8 PG/ml

If re-study of nitric oxide detected normalization of the level of its metabolites: NOx- 34,32 µmol/l, nitrite - of 7.96 mmol/l, nitrate - 26,36 µmol/L.

On faggs in the dynamics after 3 weeks of symptoms of GERD and erosions in the stomach has not been found.

In this clinical example, we consider the case of mild severity of erosive gastroesophageal reflux disease. During the examination according to fahds of the esophagus showed signs of GERD, also when additional research methods identified impaired motor function of the upper GI tract, endothelial function, which was reflected in the reduced content of metabolites of nitric oxide, increased proinflammatory cytokines.

In the process of treatment was normalizing effect of endovenous laser therapy on motor function of the stomach, duodenum and jejunum, endothelial function and cytokines.

Example 2

Bolnav., 42 years old (case history No. 525), entered in the second medical Department CBSP with complaints of pain in the chest, heartburn, painful passage of food when ingested. Considers himself sick about 4.5 years, when he was troubled by heartburn, then joined the rest of the complaints, on faggs detected failure of the cardia, drain erosive damage to the mucosa of the distal esophagus, gastroesophageal reflux.

Objectively: on the part of other organs and systems revealed no pathology.

In the biochemical analysis of blood parameters in the normal range. In General, the analysis of blood and urine - without a pathology.

In the study of content in the plasma is stable metabolites of nitric oxide (nitrate and nitrite) found increased concentrations of NOx- 44,56 µmol/L.

In the study of content in plasma cytokines detectable increase in Pro-inflammatory cytokine TNF-α to 6,97 PG/ml, the increase in IL-6 - 3,54 PG/ml, normal levels of IL-1β - 1,41 PG/ml, the reduction of IL-4 to 2.2 PG/ml

The study of motor function of upper parts of the GESTURE detected hyperkinetic activity of the stomach and geokinetics activity of the duodenum and jejunum: EA stomach - 26,98%, EA KDP - 1,95%, EA jejunum - 1,53%, Kritmstomach - 7,78; KritmKDP - 1,23, Kritmjejunum - to 1.37; KS Pi/P(i+1) stomach/duodenum - 13, 84, KS Pi/P(i+1) WPC/skinny kick is - 0,89.

The patient on the background diet, drug therapy was conducted by a course of intravenous laser therapy, one session per day, for a treatment course of 10 sessions, with a wavelength of 0,405 μm, output power at the end of the optical fiber 1 mW for 15 minutes.

After the end of therapy according to the patient, overall health has greatly improved, pain, and heartburn were stopped.

The results of the second survey

When you study the content in plasma cytokines normalization of Pro-inflammatory cytokines: TNF-α to 3.2 PG/ml, IL-6, to 2.45 PG/ml, and anti-inflammatory IL-4 to 4.6 PG/ml

When you study the content in plasma NOxnormalization of NOx- 34,83 µmol/L.

Repeated research has revealed normalization of motor function of upper GI: EA stomach - 24,67%, EA KDP - 2,15%, EA jejunum - 2,52%, Kritmstomach - 5,67; KritmKDP - 1,02, Kritmjejunum - 2,36; KS Pi/P(i+1) stomach/duodenum - 11,47, KS Pi/P(i+1) duodenum/jejunum - 0,85.

On faggs in the dynamics of the signs of GERD has not been found.

In this clinical example, we consider the case of moderate erosive gastroesophageal reflux disease. With additional research methods identified impaired motor function of the upper GI tract, endothelial function, which was reflected in asenna the content of metabolites of nitric oxide, the increase of proinflammatory cytokines.

In the process of treatment was normalizing effect of endovenous laser therapy on motor function of the stomach, duodenum and jejunum, endothelial function and cytokines.

Example 3 (extract from the case history No. 759)

Patient B., 52 years old. Suffering from peptic ulcer disease for 12 years, last year began to disturb pains in the heart, not associated with physical activity and not removable by taking nitrates. Repeatedly referred to the cardiologist. Routinely produced faggs found an esophageal ulcer. Was admitted to the gastroenterology Department. When entering the patient complained of persistent pain in the heart, increasing the patient lying with low head and belly.

Objectively: General condition is satisfactory, giperstenicheskom physique, skin and visible mucous regular color, peripheral edema no. Respiratory organs within the physiological norm. The borders of relative cardiac dullness is not extended, the auscultatory colours clear, regular rhythm, heart rate of 80 beats per 1 minute. HELL 130/80 mm Hg, abdominal palpation soft, moderately painful in the epigastric region.

In the biochemical analysis of blood parameters in the normal range. In General, the analysis of blood and urine - without a pathology.

On FAGD is: the cardia insufficiency, an esophageal ulcer, gastro.

The study of motor function of upper GI was observed hyperkinetic activity of the stomach and duodenum, hypokinetic activity jejunum: EA stomach of 27.84%, EA KDP - 2,93%, EA jejunum - 1,32%, Kritmstomach - 8,67; KritmKDP - 1,79, Kritmjejunum - to 1.37; KS Pi/P(i+1) stomach/duodenum - 9,50, KS Pi/P(i+1) duodenum/jejunum - 2,23.

In the study of nitric oxide detected source high concentrations of metabolites of nitric oxide: NOx- 48,72 µmol/l, nitrite - 13,64 µmol/l, nitrate - 35,08 µmol/L.

In the study of blood plasma found a predominance of Pro-inflammatory cytokines anti-inflammatory over: TNF-α - 6,58 PG/ml, IL-1β - 5,24 PG/ml, IL-6 - 2,93 PG/ml, IL-4 and 1.6 PG/ml

The appointed course of intravenous laser therapy for 10 days with wavelength 0,405 μm, output power at the end of the optical fiber 1 mW for 15 minutes. Treatments were performed daily, break on Saturday and Sunday. Laser therapy was carried out on a background of application of drugs. For the fifth procedure, the patient noted dulling pain, and by the end of the course of therapy, the patient pain has stopped completely.

The results of additional studies after treatment

After treatment with repeated study revealed normalization of motor function of the upper CTD is fishing intestine: EA stomach - 25,74%, EA KDP - 1,89%, EA jejunum - 2,62%, Kritmstomach - 6,21; KritmKDP - 0,96, Kritmjejunum - to 1.37; KS Pi/P(i+1) stomach/duodenum - 13,61, KS Pi/P(i+1) duodenum/jejunum - 0,72.

In the study of systems of cytokines revealed the predominance of anti-inflammatory interleukins proinflammatory over: TNF-α - 2,61 PG/ml, IL-1β - 1,82 PG/ml, IL-6 - 1,05 PG/ml, IL-4 - 4,78 PG/ml.

In the study of nitric oxide detected decrease to normal values of metabolites of nitric oxide: NOx- 35,24 µmol/l, nitrite - 7,97 µmol/l, nitrates 27,3 µmol/L.

On faggs dynamics: picture esophagitis.

In this clinical example, heavy severity of GERD identified violations rhythmic activities and coordinated work in the stomach, the areas of the duodenum and jejunum, as well as an imbalance in inflammatory-regenerative cascade and endothelial function.

As can be seen from the above observations, a comprehensive treatment with endovenous laser therapy had a beneficial effect on the patient's General condition, the rate of healing of the ulcer in this patient was significantly faster than that observed in patients receiving only medical therapy, was significantly confirmed to have a corrective effect on disturbed the studied parameters.

Clinical and laboratory studies of the proposed method for the treatment of pain is different gastroesophageal reflux disease, compared with the known method (prototype)showed the effectiveness of the proposed method of treatment, the possibility of correcting the changes occurring in this disease, improving the results of ongoing drug therapy, reducing treatment time.

A method for the treatment of patients with gastroesophageal reflux disease, including simultaneous integrated use of drugs: proton pump inhibitor, prokinetics, and laser therapy, characterized in that as a proton pump inhibitor used controloc 20 mg 1 tablet 2 times a day, before meals, additionally appointed trimedat 200 mg 1 tablet 3 times a day, and apply gaviscon daily for 2 to so 3 times a day, laser therapy is prescribed differentially depending on the severity of gastroesophageal reflux, the degree of endothelial dysfunction, namely nitric oxide, proinflammatory indicators, namely IL-1β, IL-6, TNF-α, and anti-inflammatory, namely IL-4, cytokines, disturbance of motor function of the upper parts of the gastrointestinal tract, namely the coefficient comparison of stomach/duodenum Pi/P(i+1): mild gastroesophageal reflux, when the level of nitric oxide 35,2±2.7 µmol/l or more, at the level of IL-1β, equal to and more than 1.5 ą 0.3 PG/ml, IL-6, equal to and greater than the 1,8±0,8 PG/ml, TNF-α, is equal to or more 2,78±0,35 PG/ml, IL-4, equal, and less of 4.4±0,42 PG/ml, with Pi/P(i+1), equal to and less of 11.2±5.6 per cent, held 6-7 daily procedures of intravenous laser irradiation of blood within 15 minutes wavelength 0,405 μm, output power at the end disposable intravenous fiber 1-1,5 mW, a pulse frequency of 80 Hz in CW mode, with moderate and severe severity level of nitric oxide less 35,2±2.7 µmol/l, with levels of IL-1β, equal to and less than 1,83±0,4 PG/ml, IL-6, equal, and less 1,98±0,8 PG/ml, TNF-α, equal to and less 10,04±2,84 PG/ml, IL-4, equal, and more 3,15±0,43 PG/ml, with Pi/P(i+1)equal to or more 12,3±4,8%, held 9-10 daily procedures of intravenous laser irradiation of blood within 15 minutes wavelength 0,405 μm, output power at the end disposable fiber 1-1,5 mW, a pulse frequency of 80 Hz in CW mode.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely psychiatry, and may be used for choosing a therapeutic approach to psychopharmacotherapy resistant schizophrenia. For this purpose, after pharmacoresistance has been stated, total blood serotonine and daily dopamine excretion are examined. If observing the reduction of serotonin and standard or low dopamine excretion, a course of electric electroconvulsive therapy is applied. High dopamine excretion regardless of the serotonin content, a course of electric electroconvulsive therapy is applied. In the other cases, family psychotherapy is used. The patient is treated with underlying supporting psychopharmacotherapy. At the same time, electric electroconvulsive and insulin-comatose therapy is contraindicated in case of active, decompensated physical and neurological diseases.

EFFECT: method provides the higher clinical effectiveness in the treatment-resistant patients with individual pathogenic direction of the therapeutic effect.

1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to intensive therapy and can be used in treatment of patients with sepsis. For this purpose clinical-laboratory analysis and tests are carried out and assessment of patient's state is given every five days by APACHE II scale. Simultaneously additionally reserve albumin binding capacity is determined. On the basis of said parameters prognostic index is determined by formula PIn=An(AnAn+1)×RABCnRABCn+1, where An, An+1 are quantity of points by APACHE II scale on the first and fifth day of examined period of patient's state assessment. RABC n, RABCn+1 are reserve albumin binding capacity on the first and fifth day of respective period of patient's state assessment. If value PI n<0 and PI n>8, high probability of lethal outcome is predicted, and in case of 0 ≤ PIn ≤ 8, low probability of lethal outcome is predicted.

EFFECT: method ensures more accurate prediction of lethal outcome in patients with sepsis, including patients with clinically positive dynamics due to determination of parameters, which make it possible to carry out integral estimation of intoxication manifestation, which will make it possible to correct performed therapy in due time.

2 ex

FIELD: medicine.

SUBSTANCE: females with threatening miscarriage in the second trimester of gestation and suffering influenza A(H3N2) are examined for the level of antibodies in paired blood serums with the level of antibodies in the first serum (A) used as a reference; the score showing a degree of manifestation of hyperemia of the posterior pharyngeal wall mucosa (B) is determined; the score showing a degree of manifestation of oedema of the posterior pharyngeal wall mucosa (C) is determined; a degree of manifestation of the threatening miscarriage symptoms is determined at temperature more than 37.8°, points (D). A discriminant equation is used to calculate a discriminant function: D=-0.080×A-1.767×B-1.487×C-1.068×D. If D exceeds 10.10, the absence of the intrauterine infection is stated, while D less than 10.10 shows the intrauterine infection.

EFFECT: using the method enables predicting the intrauterine infection accompanying said influenza in the females during the second trimester of gestation with the threatening miscarriage.

2 ex

FIELD: chemistry.

SUBSTANCE: analysed sample is treated with a protein-depositing reagent which is acetone; the extract is separated from the precipitate by filtering; acetone from the filtrate is evaporated in an air current at room temperature; the aqueous residue is diluted with water; the formed solution is treated with ammonium sulphate, extracted with 0.9 mol/dm3 of dimethyl phthalate solution in a 1,4-dioxane-chloroform mixture, taken in volume ratio of 1:1, with ratio of the aqueous phase to the organic phase of 5:1 by volume; the organic extractant is separated, and the amount of the analysed compound transferred to the extract is determined from the optical density of the extract which is diluted tenfold with 1,4-dioxane while measuring at wavelength of 279 nm.

EFFECT: high degree of extraction of azathioprine from biological fluids.

2 ex, 3 tbl

FIELD: medicine.

SUBSTANCE: lachrymal fluid is examined for lactoferrin to total protein relation. If the relation is 0.45 or more, the early acquired form of myopia is diagnosed. The relation less than 0.45 means the congenital form of myopia.

EFFECT: method enables choosing the well-timed adequate therapeutic approach to monitoring and treating the patients suffering the various forms of progressive myopia due to using the objective quantitative differential with prevention of the progression of the clinical and functional changes.

1 dwg, 4 ex

FIELD: agriculture.

SUBSTANCE: method includes performing histologic examination of biopsy materials of the affected skin, examination of peripheral blood serum, the definition of gender, age, socio-professional affiliation, as well as factors contributing to the disease, evaluation of prognostic coefficients of each of the said factors and summing the values obtained. In case when the said amount of the prognostic coefficients is 11.1-17.3 the low probability of deterioration of the clinical course of the disease is predicted, if it is 17.4-23.6 - the average probability, and 23.7-29.9 - a high probability of deterioration of the clinical course of the disease.

EFFECT: improvement of accuracy of predicting the clinical course of lymphoproliferative skin diseases for the rational choice of surveillance strategy, case management, selection of prevention form of unfavorable course of the disease.

9 dwg, 2 tbl, 3 ex

FIELD: chemistry.

SUBSTANCE: method of operating a device for measuring an analyte, having a display, a user interface, a processor, memory and user interface buttons includes steps of: measuring the analyte in the body fluid of a user using the analyte measuring device; displaying a value representing the analyte; prompting the user to select an indicator for linking with the displayed value; and pressing one of the user interface buttons only once to select an indicator linked with the value of the analyte, and storing the selected indicator together with the displayed value in the memory of the device. The group of inventions also relates to a method of operating the measuring device, which additionally includes a step of ignoring activation of any of the user interface buttons except the selected button.

EFFECT: more intuitive and easier use of the device for measuring an analyte, eg a glucometer.

20 cl, 12 dwg

FIELD: medicine.

SUBSTANCE: biomaterial is sampled at the height of the disease. That is ensured by tonsil scraping. The biomaterial is placed in a 1.5 ml disposable capped plastic tube, and 0.9% sodium chloride 1.0 ml is added; then the biomaterial is centrifuged; the supernatant is collected, and the residue is re-suspended in a buffer solution cooled to +4°C, to the final cell concentration of 5×106-10×106 cell/ml. Then the cell suspension 100 mcl is placed in a cytometric tube on the ice bath; annexin V-FITC 10 mcl and 7AAD 20 mcl are added; the 15-minute incubation is followed by adding the buffer solution 400 mcl cooled to +4°C, and mixed in a vibration mixer. The annexin V-stained and 7AAD-unstained cell are relatively counted in a flow cytometre. Provided that the tonsil scraping contains 16-40% of apoptosis mononuclears, a bacterial genesis of tonsillitis is stated, while the mononuclear count being 41% or more shows the viral tonsil involvement caused by infectious mononucleosis.

EFFECT: method improvement.

2 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: oral mucosa biopsy material of the patients suffering oral lichen acuminatus with underlying lipid storage disease is examined for macrophages containing apolipoproteins B. If an average positive cell count is 0.8-3.0 in the same visual field, a mild degree of the oral mucosa oxidative changes in the patients suffering oral lichen acuminatus with underlying lipid storage disease; the cell count being 3.1-6.0 in the same visual field shows a moderate degree, while the cell count of 6.1-9.0 and more provides stating a severe degree of the oral mucosa oxidative changes in the patients suffering oral lichen acuminatus with underlying lipid storage disease.

EFFECT: using the declared invention enables improving objectivity and accuracy of assessing a degree of severity of the oral mucosa oxidative changes in the patients suffering oral lichen acuminatus with underlying lipid storage disease.

1 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine. In order to determine fetoplacental insufficiency in pregnant women, who had cytomegalovirus infection exacerbation in third trimester of pregnancy, measurement of titre of antibodies to cytomegalovirus in peripheral blood, and after that, content of leptin in parturient woman's placenta is carried out at the moment of exacerbation. If antibody titre is 1:1600 and leptin level 29.18±0.71 ng/ml, presence of fetoplacental insufficiency is determined.

EFFECT: method makes it possible to diagnose fetoplacental insufficiency in pregnant women who had cytomegalovirus infection exacerbation in the third trimester of pregnancy.

2 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to preparing a drug possessing antiulcerogenic, antistress and hemostatic activities. The declared method involves mixing the dry extracts of great nettle leaves, knotgrass herb and nosebleed herbs with fine powders of ginger rhizomes and cinnamon bark in ratio, weight fraction 35: 30 : 10 : 20 : 5. The above dry extracts prepared by multiple extraction of the herbal raw materials in ethanol and water, filtration of the prepared extracts, evaporation thereof, concentration and drying in a vacuum oven, wherein the first and second extractions of the herbal material is carried out in 80% ethanol, the third and fourth extractions - in 40% ethanol, and the fifth and sixth extractions - in boiled water.

EFFECT: invention provides preparing the effective and safe drug for preventing the digestive diseases.

7 tbl, 1 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to new alkylthiopyrimidines of formula III or pharmaceutically acceptable salts thereof: In the compound III X represents a direct bond; R2 means hydrogen, halogen, (C1-C6)alkyl, (C3-C7)cycloalkyl, -NR8aR8b or the group -SR3; each R3 independently represents (C1-C6)alkyl, optionally mono-, di- or trisubstituted by halogen; or (C3-C7)cycloalkyl; R4a and R4b represent hydrogen; R6 represents aryl; or heteroaryl; wherein aryl and heteroaryl are optionally substituted in a substituted position by one or more substitutes specified in a group consisting of (a) halogen; (b) cyano; (c) nitro; (a) hydroxy; (e) guanidino; (f) heteroaryl; (g) phenyl; (h) phenyloxy; (i) benzyl; (j) benzyloxy (k) -NR8aR8b; (1) -C(O)R9; (m)-C(O)NR8aR8b, (n) - OC(O)NR8aR8b; (o) -C(O)OR9; (p) -NR7C(O)0R9; (q) -NR7C(O)R9; (r) sulphamoyl; (s) (C1-C6) alkylsulphonyl; (t) (C1-C6)alkylaminosulphonyl; (i) di(C1-C6)alkylaminosulphonyl; (v) (C1-C6)alkyl, optionally mono-, di- or trisubstituted by halogen; (w) (C1-C6) alkoxy, optionally mono-, di- or trisubstituted by halogen; and (x)(C1-C6)alkylthio, optionally mono-, di- or trisubstituted by halogen R7 represents hydrogen. The other radical values are specified in the patent claim.

EFFECT: compounds possess CRTH2 (G-protein related chemoattractant receptor expressed on Th2 cells) antagonist activity and are applicable for treating and preventing the diseases related to CRTH2, including treating allergic diseases, eosinophil and basophile related diseases.

14 cl, 6 dwg, 1 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: there are presented prolonged release pharmaceutical oral dosage form for preventing or treating an upper gastrointestinal disorder (dyspepsia, epigastric burning, erosive esophagitis, gastrooesophageal reflux disease, peptic ulcer, esophagitis, Barrett's esophagus and esophageal adenocarcinoma), containing a therapeutically effective amount of at least one bile acid sequestrant specified in colesevelam and colesevelam hydrochloride, and a carrier composition providing gastric retention containing one or more hydrogels, wherein the dosage form expands upon contact with gastric juice, respective methods of treating or preventing the upper gastrointestinal disorder and protecting the multilayer squamous epithelium against an attack of any hazardous substances by administering the composition, and a kit for the same application comprising the composition, a label or a package insert with instructions for use. The composition may contains a proton pump inhibitor, and one or more agents specified in antacids, histamine H2-receptor antagonists, γ-aminobutyric acid-b (GABA-B) agonists, and protease inhibitors.

EFFECT: invention aims at retaining the active agent in the stomach for relieving and improving prolonged delivery thereof.

16 cl, 2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine and aims at treating acute alcoholic enteritis. Gastric lavage, ample drinking, intravenous infusions of normal saline or 5% glucose are prescribed. At admission to hospital, the patient is additionally examined for blood triglycerides. If the value is more than 2.5 mmole/l, the antibiotics are withdrawn, while the preparations of lipoic acid 900 mg before meals are prescribed within the 7-day course.

EFFECT: method enables reducing side effects of the therapy of acute alcoholic enteritis.

3 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gastroenterology and physiotherapy, and may be used for treating acute gastric and duodenal ulcer. For this purpose, placental hydrolysate at 2 ml of the preparation per 200 ml of water at temperature 37°C is orally introduced on an empty stomach. That is followed by magnetophoresis. For this purpose, the patient is laid on a back, and an epigastric region and a projection of duodenum are exposed to MAG-30 magnetotherapeutic apparatus. The magnetic induction makes 30±15 mT at frequency 50 Hz of variable magnetic field. The length of the exposure is 10 minutes. The procedure length is prolonged to 15 minutes after 2 procedures to the end of the therapeutic course. The therapeutic course consists of 15 daily courses.

EFFECT: method provides faster ulcer healing and stable remission of the disease ensured by stimulation of the regenerative processes, manifested anti-inflammatory effect, functional normalisation of the coupled organs, and arrest of the asteno-vegetative syndrome.

4 tbl, 2 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: there are offered: a pharmaceutical composition for preventing or treating atherosclerosis, metabolic syndrome, diabetes, obesity or their symptoms, or the combinations thereof, containing a pharmaceutically effective amount of D-tagatose or a salt, sugar alcohol, hydrate, solvate, ester or amide thereof, and a pharmaceutically effective amount of a second pharmaceutically active agent containing stilbene or a stilbenoid component or any salt, alcohol, hydrate, ester, amide, polymorph, isomer thereof, or a combination thereof, a related method of treating or preventing these diseases, the use of said composition for preparing a medicine or vaccine for the same application and a food stuff containing a pharmaceutically effective amount of D-tagatose or a salt, sugar alcohol, hydrate, solvate, ester or amide thereof, and a pharmaceutically effective amount of a second pharmaceutically active agent containing stilbene or a stilbenoid component or a salt, alcohol, hydrate, ester, amide, polymorph, isomer thereof, or a combination thereof.

EFFECT: declared combination reduces blood plasma triglyceride, including in additional carbon diet.

30 cl, 3 ex

FIELD: chemistry.

SUBSTANCE: invention relates to a pyridine thio-derivative of general formula (I) or pharmaceutically acceptable salts thereof: , where R1 and R2, respectively, denote a hydrogen atom; R3 and R4, respectively, denote a hydrogen atom or a C1-8alkyl group; X denotes -O- or -S-; Y denotes a C1-12alkyl group, which can be substituted with a substitute selected from a group consisting of a hydroxyl group, C1-8alkoxy group or -(R5-O)n-R6 (where R5 denotes a C1-5alkylene group, R6 denotes a C1-8-alkyl group which can be substituted with a halogen atom, and n denotes an integer from 1 to 2) and Z denotes a hydrogen atom. The invention also relates to pharmaceutical compositions based on said compounds, having antibacterial activity towards Helicobacter pyroli.

EFFECT: obtaining novel compounds and a pharmaceutical composition based on said compounds, which can be used in medicine to prevent or treat diseases in which Helicobacter pylori participates, specifically gastritis, gastric ulcers, duodenal ulcers, gastric MALT lymphoma, hyperplastic gastric polyps or gastrointestinal malignant diseases.

10 cl, 3 tbl, 14 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely gastroenterology, and may be used for treating gastric and duodenal inflammatory diseases in children. That is ensured by the conventional drug-induced therapy. In addition, the epigastric area is exposed to Terahertz waves at 150,176-150,664 GHz at power density 0.2 mWt/cm for 15 minutes. The therapeutic course is 10 days.

EFFECT: method improves the clinical effectiveness and the patient's quality of life, ie normalising the main clinical and laboratory parameters ensured by normalising the nitrogen oxide values that leads to the faster relief of clinical symptoms, reduces the length of staying in hospital and the number of recurrences.

3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine and is intended for treatment of chronic erosive gastritis, associated with Helicobacter pylori. Urease test with dental plaques is performed and if microorganisms are identified, 30-minute long gingival applications with metronidazol (Metrogyl Denta gel) are carried out for 3 days in addition to anti-Helicobacter therapy. Starting with the 4-th day patient brushes the teeth with toothpaste of "Mexidol" series, adding Metrogyl Denta gel in "a match head" amount. After 15 minutes oral cavity is rinsed with 0.02% chlorhexidine digluconate solution. Said procedures are carried out for a month and repeated a month before supposed aggravation in stomach.

EFFECT: method makes it possible to prolong remission terms.

1 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely paediatrics and may be used for treating rumination syndrome in infants. For this purpose, the state of the infant's vegetative nervous system is assessed by cardiointervalography. It is followed by electrophoresis on the area of the cervical sympathetic ganglia by Steam 1 galvaniser apparatus at current density 0.01-0.03 mA/cm2. The electrophoresis procedure is performed in the infant lying on his/her back with a head lifted at 45°-60° in a fixed position from 13 to 14 o'clock 1 hour prior to the feeding. The length of the procedure is 8 minutes; the therapeutic course makes 8 daily sessions. If observing sympathicotonia, a cathode is placed on the both side surfaces of the infant's neck, an anode is placed on the posterior surface of the neck. In this case, 5% sodium bromide is introduced from the cathode. If observing vagotonia, the anode is placed on the both side surfaces of the infant's neck, and the cathode - on the posterior surface of the neck. In this case, 5% calcium chloride is introduced from the anode.

EFFECT: method provides the higher clinical effectiveness, reduced length of treatment, and faster rumination syndrome relief, reduction of complications, improved protective and adaptive body responses by correcting imbalances in the state of the vegetative nervous system depending on the characteristics of the patient's vegetative status.

3 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine and medical equipment, namely to apparatuses used in oncology and physiotherapy. The apparatus comprises two electrodes mounted in cavities of dielectric cup-shaped body connected to a UHF unit, each body of which is provided with an additional mesh electrode of a graphitised electrically conductive cloth with a lining adjoining thereto and impregnated with a drug substance. The mesh electrode is shaped and sized after the main electrode; it is parallel to the main electrode, separated therefrom with a dielectric lining and connected to a DC power source. An outer surface of each body comprises equispaced ribs with through holes flushes for flexible lightguide in the number of 4 to 10, assembled in a common cable and connected to a laser light source generating laser light to cover the tumour from both sides.

EFFECT: using the invention enables extending the physiotherapeutic functions of the UHF hyperthermia apparatuses.

4 dwg

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