[Physical rehabilitation for degenerative-dystrophic diseases of the hip joint in elderly and senile people (stage 1).]

Changes in the age structure of the planet's population are leading to an increase in the number of geriatric patients requiring replacement of large joints. Age-related weakness, loss of muscle mass, testosterone deficiency, excess weight, and the presence of concomitant diseases make the process of rehabilitation treatment labor-intensive and lead to various complications. The purpose of our work was to evaluate the effectiveness of the modernized method of physical therapy at the first stage of rehabilitation treatment in elderly and senile patients with osteoarthritis of the hip joint. All patients received standard complex therapy, including orthopedic treatment methods, drug therapy, myostimulation, massage, and manual therapy. For patients in the main group, in addition to the traditional complex, the method of physical therapy according to the stated method was added and it was recommended to wear compression hosiery (stockings) while performing the exercises. The advantage of the technique is the absence of complications and side effects, which is an important component compared to other methods of restorative treatment. Minimum costs, general availability and autonomy of performing exercises, high results achieved during the treatment process confirm the value and importance of creating similar techniques for other large joints. The developed method of physical therapy has shown its effectiveness and relevance among elderly patients and can be recommended for use among different population groups as a method of restorative treatment of osteoarthritis of the hip joint.

Molecular genetic characteristics of resistome and virulome of carbapenem-resistant Klebsiella pneumoniae clinical strains.

The characteristics of resistome and virulome structure of four carbapenem-resistant Klebsiella pneumoniae clinical strains are present in the work. Two strains belonged to the sequence-type ST395, one strain - ST2262, one strain - to the new sequence-type 5816. The genes of fimbriae, enterobactin, beta-lactamase SHV type, resistance to fosfomycin fosA and transport of fluoroquinolones oqxAB in all Klebsiella strains chromosome structure were identified. The determinants of yersineobactin and aerobactin are enriched the virulome of ST395 NNKP315 and NNKP343 strains. The aerobactin genes are located on IncHI1B plasmids (IncHI1B/FIB) which highly homologous to the virulence pLVPK and pK2044 plasmids. IncR, IncL, IncQ plasmids carrying blaOXA-48, blaCTX-M-15, blaOXA-1, blaTEM-1, qnrS1, tetA, sul1, dfrA1, aac(6 ')-Ib-cr, catA1, catB3 etc. were identified in these strains. As a result of in silico analysis, an assumption about the localization of the blaOXA-48 in the structure of the IncHI1B plasmid of NNKP315 strain was made. This plasmid also contains the aminoglycosidases genes inserted into a class 1 integron In822. The mutations were found in the porin proteins OmpK35, OmpK36 and OmpK37 genes, which increases the carbapenem resistance. The virulome of NNKP16 (ST2262) strain additionally includes of the iron utilization system kfuABC chromosomal genes, and the virulome of NNKP15 (ST5816) strain contains of the capsular polysaccharide kvgAS and microcin E492 genes. Additional determinants of resistance were not identified in the resistome structure of K. pneumoniae NNKP16 and only the blaCTX-M-15 gene was found in the NNKP15 strain. The absence of acquired resistance genes seems to be due to the presence of the type I-E CRISPR-Cas system. Multiple drug resistance of the studied strains is associated with mutations identified in the gene structure of porin proteins OmpK36 and OmpK37, as well as the activity of efflux systems. It was showed the stop codon formation in the nucleotide sequence of the regulatory gene ramR to both strains, which can potentially provide overexpression of AcrAB efflux proteins.

Selection of the optimal respiratory muscle training mode in patients with class II-III chronic heart failure.

Aim To study the effect of various types of respiratory muscle training (RMT) in patients with functional class (FC) II-III chronic heart failure (CHF) and more than 70% preserved diaphragm muscle mass.Material and methods 53 patients (28 men and 25 women) aged 50-75 years with NYHA FC II-III ischemic heart disease (IHD) and arterial hypertension with more than 70% preserved diaphragm muscle mass of >70% were randomized to one of four RMT types: static loads, dynamic loads, their combination, and breathing without applied resistance as a control. Peak oxygen consumption (VO2 peak) and maximum inspiratory pressure (MIP) were evaluated at baseline and in 6 months.Results All study groups showed significant improvement of physical endurance indexes compared to baseline values (р<0.05). In pairwise comparison, the groups significantly differed (р<0.01). The greatest improvement was observed for patients of dynamic and combined training groups. Furthermore, in the combined training group, results were significantly higher than in the group of isolated dynamic loads. The most significant (р <0.01), positive changes in the force of inspiratory muscles were observed in groups of dynamic and combined trainings with the best results displayed by patients of the combined training group.Conclusion With preserving more than 70 % of diaphragm muscle tissue (as determined by MIP >60 cm H2O), a combination of static and dynamic RMT is most effective for patients with FC II-III CHF.

Haploid biotechnology as a tool for creating a selection material for sugar beets.

Since the discovery of the phenomenon of haploidy, biotechnology has become an integral part in the successful creation of new varieties and hybrids of various plant species. In particular, these technologies are actively used in agriculture, which is concerned with increasing the volume and improving the quality of products. The integration of haploid production techniques together with other available biotechnological tools such as marker selection (MAS), induced mutagenesis and genetic engineering technologies can significantly accelerate crop breeding. This article shows the main stages in the development of biotechnology since 1921. Now they are successfully used to create doubled haploids to accelerate the selection process of various plants and, in particular, sugar beet, which is the most important sugar crop in regions with a temperate climate. There are several methods for obtaining forms with a single set of chromosomes. For sugar beets, the use of gynogenesis turned out to be expedient, since in this case the other methods turned out to be ineffective in the mass production of haploids. The article considers the stages of obtaining the H and DH lines of Beta vulgaris L., as well as the main stages of biotechnological production of homozygous breeding material of this culture. These stages include selecting parental forms - donor explants, sterilizing buds and introducing non-pollinated ovules in vitro, obtaining haploids, doubling their chromosome set, creating doubled haploids, determining ploidy at different stages, relocating the obtained plants to greenhouses and growing stecklings. A number of advantages that the technology of creating doubled haploids in vitro has in comparison with traditional methods of selection are described. It has been shown that the use of these approaches is relevant when obtaining new highly productive hybrids and varieties of agricultural plants; however, the methods for the production of homozygous forms in sugar beet still require additional research aimed at increasing the efficiency and reproducibility of each stage of the process.

The Genome Structure of Ciprofloxacin-Resistant Mycoplasma Hominis Clinical Isolates.

The genome structure of three ciprofloxacin-resistant Mycoplasma hominis clinical isolates was studied using next-generation sequencing on the Illumina platform. The protein sequences of the studied Mycoplasma strains were found to have a high degree of homology. Mycoplasma hominis (M45, M57, MH1866) was shown to have limited biosynthetic capabilities, associated with the predominance of the genes encoding the proteins involved in catabolic processes. Multiple single-nucleotide substitutions causing intraspecific polymorphism of Mycoplasma hominis were found. The genes encoding the efflux systems - ABC transporters (the ATP-binding cassette superfamily) and proteins of the MATE (multidrug and toxic compound extrusion) family - were identified. The molecular mechanism of ciprofloxacin resistance of the Mycoplasma hominis M45 and M57 isolates was found to be associated with the Ser83Leu substitution in DNA gyrase subunit A. In the Mycoplasma hominis MH1866 isolate it was related to the Lys144Arg substitution in topoisomerase IV subunit A.

Biotechnological methods as a tool for efficient sugar beet breeding.

Here we consider aspects of the application of biotechnological methods to rapid creation, propagation, and maintenance of plants with improved or new traits in sugar beet breeding. The results of the works carried out in these fields by the Federal State Budgetary Scientific Institution "The A.L. Mazlumov All-Russia Research Institute of Sugar Beet" are reviewed. A close association between morphological and physiological changes in in vitro cultured organs and tissues, on the one hand, and breeding traits, on the other hand, which allows the development of experimental systems for non-amphimictic plant reconstruction is shown. The influence of in vitro growth conditions on haploid cells of unfertilized sugar beet ovules in the course of obtaining doubled haploid lines with high degree of homozygosity and maintenance of valuable breeding properties is considered. As compared to common inbreeding, this method shortens the time for development of homozygous material from 10-12 to 3-5 years, which is of great importance for speeding-up the breeding process. The results of studies on the culturing of mature sugar beet zygotic embryos based on in vitro selective systems have made it possible to improve the adaptive potential of plants and to provide complex resistance to environmental stress factors. Strict selection under abiotic stress conditions allowed creation of sugar beet isogenic lines with tolerance of drought, salinity, and soil acidity. It is shown that the proposed original design of mass-scale microclonal in vitro reproduction and deposition of elite plants as components of highly productive hybrids can be used to obtain seeds of uniform high-quality breeding material. The technologies developed by biotechnological methods are a topical and innovative direction of inquiry, since the application of these techniques to sugar beet breeding will promote obtaining of competitive hybrids with a set of commercially valuable traits. The combination of biotechnology methods, including tissue culture, and traditional breeding techniques is expected to provide an opportunity to obtain a new starting material to develop domestic varieties and hybrids of new generation with heterosis effect and a wide resistance spectrum persisting across generations.

Morphofunctional Features of The Diaphragm in Patients With Chronic Heart Failure.

AIM: to study changes in the volumes of muscle, fat, and connective tissue in postmortem issue samples (autoptates) from diaphragm, right ventricle, lower limb (gastrocnemius muscle), as well as morphological changes of the diaphragm muscular structure in patients with different functional classes of heart failure (HF), and to compare them with some intravital parameters of external respiration (with maximal inspiratory pressure and its amplitude simultaneously measured by ultrasound method in particular). MATERIALS AND METHODS: Autoptates of the diaphragm muscle, right ventricle, lower limb (n=39) from 20 men and 19 women (with in vivo diagnosis CHF NYHA functional class (FC) I-IV, hypertension, ischemic heart disease) were examined within 24 hours after the fatal outcome. Light optical microscopy was used to assess the percentages of muscle, connective, adipose tissue, numbers of fibroblasts, and collagen fibers. Spirometric measurements, measurement of respiratory muscles strength, and examination of the diaphragm contractile function were performed by echolocation 56.7±11.9 days before death. RESULTS: In patients of all NYHA FCs most pronounced changes of volume of muscle tissue were observed in the right ventricle and diaphragm, while less pronounced - in the gastrocnemius muscle. The increase in the volume of adipose tissue in patients with I-III FC CHF was most pronounced in the right ventricle and diaphragm, and less pronounced - in the gastrocnemius muscle. The greatest increase in the adipose tissue volume was recorded in the diaphragm of patients with IV FC. Changes of connective tissue volume did not follow linear dependence. The largest "leap-like" increase in the volume of connective tissue occurred in the diaphragm of patients with III FC, what significantly outstripped this process in peripheral muscles and right ventricular myocardium. There was stable relationship between structure of tissue of the diaphragm, maximal inspiratory thickness of diaphragmatic muscle, and maximal inspiratory pressure. This relation (correlation) was positive for pairs muscle tissue volume - muscle thickness and muscle tissue volume - inspiratory pressure, and negative for pairs connective tissue volume - muscle thickness, connective tissue volume - inspiratory pressure, adipose tissue volume - inspiratory pressure (r>0.85, p<0.01 for all these correlations). CONCLUSION: Morphofunctional changes in the diaphragm are caused by progressive decrease in the content of muscle tissue, increases of volumes of adipose and connective tissues. These changes correlate with the CHF FC, maximal inspiratory thickness of diaphragmatic muscle, and maximal inspiratory pressure. Severity of these morphological changes is maximal in patients with FC III CHF.

Genetic Association between Alzheimer's Disease Risk Variant of the PICALM Gene and Auditory Event-Related Potentials in Aging.

Aging and genetic predisposition are major risk factors in age-related neurodegenerative disorders. The most common neurodegenerative disorder is Alzheimer's disease (AD). Genome-wide association studies (GWAS) have identified statistically significant association of the PICALM rs3851179 polymorphism with AD. The PICALM G allele increases the risk of AD, while the A allele has a protective effect. We examined the association of the PICALM rs3851179 polymorphism with parameters of the P3 component of auditory event-related potentials (ERPs) in 87 non-demented volunteers (age, 19-77 years) subdivided into two cohorts younger and older than 50 years of age. We found statistically significant association between the AD risk variant PICALM GG and increase in the P3 latency in subjects over 50 years old. The age-dependent increase in the P3 latency was more pronounced in the PICALM GG carriers than in the carriers of the PICALM AA and PICALM AG genotypes. The observed PICALM-associated changes in the neurophysiological processes indicate a decline in the information processing speed with aging due, probably, to neuronal dysfunction and subclinical neurodegeneration of the neuronal networks in the hippocampus and the frontal and parietal cortical areas. Such changes were less pronounced in the carriers of the PICALM gene A allele, which might explain the protective effect of this allele in the cognitive decline and AD development.

EFFECT THE CARDIOMETABOLIC RISK FACTORS ON VASCULAR AGING IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE CONCOMITANT WITH SUBCLINICAL HYPOTHYROIDISM.

The article presents the analysis of the relationship between thyroid function abnormality -subclinical hypothyroidism (SH) and non-alcoholic fatty liver disease (NAFLD), depending on age peculiarities (>50 years and <50 years), and the risk of cardiovascular complications in this category of patients. Research of early predictors of cardiovascular complications: dyslipidemia, insulin resistance, inflammatory marker- C-reactive protein, marker of vascular aging-telomerase activity and marker of endothelial dysfunction (ED) - CDECs and VEGF-A that have been analyzed are on the front burner. In this regard, the effect of the given values on the formation of cardiac risk in patients with NAFLD combined with SH was studied. 74 patients (29 men (39.2%) and 45 women (60.8%)), with verified NAFLD and SH have been examined. Patients were divided into two clinical groups: group 1 (n=31) - patients with NAFLD, with the mean age 47.2±2.6 years; group 2 (n=43) patients with NAFLD in combination with SH, with the mean age 56,8±6,5 years. Results of the performed tests have shown that patients with NAFLD combined with SH aged over 50 years have pro-atherogenic lipid profile and significantly more pronounced manifestations of endothelial dysfunction. The process of age-dependent shortening of telomere length predominantly in the buccal epithelium is an important point to be made. Consequently, the total effect of cardiometabolic risk factors in patients with NAFLD combined with SH probably is the determining factor of the rate of progression of vascular aging.

[Malnutrition: from pathogenesis to current methods for diagnosis and treatment]. / Nedostatochnost' pitaniia: ot patogeneza k sovremennym metodam diagnostiki i lecheniia.

Progressive weight loss is a frequent companion to somatic pathology. The risk of death is known to increase dramatically among those with a body mass index of less than 19 kg/m2. Even mild weight loss in the presence of severe diseases can have a substantial impact on the course of the disease. The paper presents current views on malnutrition, its prevalence in the presence of various somatic diseases, and clinical significance. It describes the basic pathogenetic components of weight loss and the possible ways of correcting nutritional status. Particular emphasis is placed on the methods of nutritional support that is currently regarded as one of the most important components of a comprehensive approach to treating patients with chronic diseases. The authors give recommendations for the assessment of the nutritional status of patients in clinical practice and algorithms for their malnutrition management.

CORRELATION OF HELICOBACTER PYLORI INFECTION WITH DEVELOPMENT OF CARDIOVASCULAR RISK IN PATIENTS WITH CORONARY HEART DISEASE IN ASSOCIATION WITH TYPE 2 DIABETES MELLITUS.

Recent years have demonstrated the possible existence of association between infection Helicobacter pylori (HP), coronary heart disease (CHD) and type 2 diabetes mellitus (DM-2). The refinement of traditional and non-traditional factors of cardiovascular risk in patients with CHD in association with DM-2 of HP-seropositiveis currently important. In this regard, we have studied the influence of HP infection on cardiovascular risk in patients with CHD and DM-2. 60 persons with CHD in association with DM-2with/without HP have been examined. The results of own studies have shown that HP-seropositive patients with CHD in association with DM-2have pro-atherogenic lipid pattern, significantly higher rates of glucose in fasting state, level of C-reactive protein against the background of hyperinsulinemia, hypoadiponectinemia compared with HP-seronegative patients. HP infection association with increasing cardiovascular risk, depending on the genotype of the polymorphic marker rs1044471 of ADIPOR2 gene have not been found. At the same time, HP-seropositive patients with TT genotype of the polymorphic gene ADIPOR2 rs1044471constitutethe risk group of cardiovascular events formation by main metabolic indicators. The received data suggest that HP infection is important in development of cardiovascular risk in patients with CHD in association withDM-2, the presence of which aggravates cardio metabolic status of the patient.

THE ROLE OF POLYMORPHISM - 634 G/C (RS 2010963) OF VEGF-A GENE IN THE DEVELOPMENT OF HYPERTENSION AND OBESITY IN PREMENOPAUSAL WOMEN.

The study of genetic dependency of developing cardiovascular diseases and factors of endothelial dysfunction in menopausal women is extremely important in today's world. The aim of the study was to assess the correlation of polymorphic marker -634G/С (rs2010963) of the VEGF-А gene and formation of AH combined with obesity in premenopausal women. The data of 115 women with stage II of AH, grade 1-2 and obesity I-II gr., aged 45 to 60 years. All patients were divided into groups according to menopausal status: 45 women without menopause (premenopausal), and who were registered with irregular menstrual cycle for 3-11 months, and 50 menopausal women whose period is less than 3 years. The control group was consisted of 20 healthy perimenopausal women matched by age. The VEGF concentration was determined by ELISA. The study of the allelic polymorphism -634 G/C (rs 2010963) VEGF-А gene was performed by polymerase chain reaction. It was found that the GG genotype polymorphism -634 G/C (rs 2010963) of the VEGF-А gene is more common among women with hypertension and obesity in premenopause, than in the menopause group. It was shown that the level of VEGF was significantly higher among premenopausal and menopausal women with the GG genotype polymorphism -634 G/C (rs 2010963) of the VEGF-А gene compared with genotypes GC and CC patients (p<0.05). The carriage of the GG genotype polymorphism -634 G/C (rs 2010963) of the VEGF-А gene can be considered as an early marker of the cardiovascular risk development of hypertensive disease combined with an obesity among perimenopausal patients.

Occupational risks in occupational morbidity structure and possibilities to reduce them.

The article presents results of occupational morbidity analysis in a region, with assessment of trends, levels, dynamics and structure of morbidity, factor dependency of occupational diseases, identification of occupational conditions of its occurrence. The information obtained helped to specify a system of occupational risk management, that increases efficiency in solving problems and better work safety in production.

[SOME PECULIARITIES OF ENDOSCOPIC ANATOMY OF THE GASTRODUODENAL TRANSITION AND ITS CHANGES IN DUODENAL PEPTIC ULCER].

Objective: To improve the diagnosis of the diseases of the pylorus and prepyloric region in patients with duodenal peptic ulcer based on the study of the mucous membrane folds Materials and methods: Endoscopic examination of 208 patients without diseases of the gastroduodenal transition (healthy) and 112 patients with duodenal peptic ulcer of three age groups from 35 to 90 years. Men were 72 and 61, women - 136 and 51 respectively groups. Endoscopic examinations were performed by endoscopes EVIS GIF-130, XP-150 N, GIF H-180 and instruments of the company «Olympus¼ (Japan). Results: Individual differences were revealed in the formation of mucous membrane folds of the pylorus and prepyloric region, in the frequency of participation of the walls in healthy people and patients with duodenal peptic ulcer. Age differences were revealed. Gender differences were not revealed. The clinical case of the patient with duodenal peptic ulcer and maltoma in prepyloric region was presented. Conclusion: The features of the formation of mucous membrane folds, the relief of the mucous membrane of the pylorus and prepyloric region in healthy people and patients with peptic ulcer of the duodenum are necessary to consider. It is important to perform a biopsy, histological, c.

MIOBLASTOMA GRAINYCLY CELL OF ESOPHAGEAL.

PURPOSE OF THE STUDY: Pay attention endoscopists doctors, oncologists surgeons, gastroenterologists on the ability to detect mioblastoma in the esophagus, as well as to present its endoscopic semiotics. MATERIAL AND METHODS: 32583 A primary esophagogastroduodenoscopy and only one patient S., 39 years old (0.0031%) showed polypoid masses in the lower third of the esophagus. Esophagogastroscopy underwent endoscopy XP iSON system Exera II. Patients underwent clinical evaluation and morphological study of endoscopically resected of education. RESULTS: Patient 39 years old 20.01.2012, in the lower third of the esophagus revealed polypoid formation with a flat, smooth surface covered with a mucous membrane, not different from the surrounding mucosa. Morphologic study after endoscopic resection of the tumor - grainycly cell mioblastoma. When viewed within four years of changes in the mucosa and not detected change in the esophageal wall. CONCLUSION: Abrikosov tumor in the esophagus is extremely rare localization has exophytic growth after endoscopic rernoval requires regular endoscopic surveillance.

[PECULIAR PROPERTIES OF SOME COMPONENTS OF MORPHOLOGICAL STRUCTURE IN A PLANT CELL VACUOLE REVEALED BY CONFOCAL MICROSCOPY].

Results of investigations of peculiar properties related to the structure of plant cell vacuolar membranes are discussed. The study was carried out using confocal microscopy, which allowed us in the process of scanning to identify membrane tubes and vesicules in the preparations of isolated vacuoles. Such membrane tubes were found both inside and outside the vacuoles, and, in the case of scanning intermittently at equal time intervals, transition of vesicles with the membrane tube was observed. Furthermore, scanning of isolated vacuoles was conducted at various distances from the glass substrate. Each time, in the upper area of the isolated vacuole lying on the substrate, we observed a large segment of vacuolar membrane and registered the effect of highly intensive fluorescing of some of membrane segments. The distributions of laurdan fluorescence generalized polarization (GP) values for the vacuolar membrane on the whole and for the intensively fluorescing membrane segments have been obtained. We have found that the microviscosity of the intensively fluorescing membrane segments essentially differs from that of the rest part of the membrane.

[Physical and chemical markers of chronic obstructive lung disease development in industrial workers].

The article demonstrates that patients with chronic obstructive lung disease (COLD) of both mixed and bronchitis forms with medium severity grade appeared to have 2 types of changes in morphologic types of serum faces. Patients with various clinical forms of severe COLD presented unidirectional change in morphologic types of serum faces. Patients with various forms of moderate COLD had one variant of morphologic types of serum faces was close to that in the patients with more severe clinical course--so that face can be considered as a "transitional form" between moderate and severe COLD. These results are interesting in specifying diagnostic criteria of COLD severity and additional diagnostic criteria of the severity grade.

[ENDOSCOPIC ANATOMY AND MORPHOLOGICAL CHANGES OF THE GASTRODUODENAL JUNCTION IN ULCER OF THE DUODENUM].

OBJECTIVE: To Improve the diagnosis of duodenal ulcer and preneoplastic changes of gastroduodenal transition. MATERIALS AND METHODS: 112 patients with duodenal ulcer, 208 healthy pearsons of three age periods: second period of mature age, elderly and senile age were examined. Video endoscopy equipment company "OLYMPUS" (Japan), morphological methods and the determination of Helicobacter pylori (Hp) were used. RESULTS: The connecting line of gastric and duodenal mucous membrane can be located on the gastric side of the pylorus (13% in normal cases and 22.3% in cases of ulcer disease), on pylorus and go into the bulbus of duodenum (87% and 77.7 %, respectively), in cases of duodenal ulcer the connecting line more often has jagged and tongue-shaped form. Mucous membrane forms folds in prepyloric part of the stomach most often on the front wall in healthy pearsons in 14.4% of cases, in patients with duodenal ulcer--in 75.9%. The number of folds decreases with age. HP, atrophy, intestinal metaplasia of the mucous membrane is more often found in duodenal ulcer disease--76.8%, 69.7% and 62.5% comparing with healthy persons: 51.4%, 5.3% and 47.7% respectively. Frequency of preneoplastic changes increases with age. The individual differences of the mucous membrane of the gastroduodenal transition are identified. They are expressed in the particular location and shape of the connecting line of gastric and duodenal mucous membranes in normal cases and in cases of ulcer disease in different age groups. Some endoscopic changes requiring biopsy and morphological studies are revealed.

[CLINICAL, ENDOSCOPIC AND MORPHOLOGICAL FEATURES OF GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH CERTAIN SURGICAL DISEASES OF THE UPPER GASTROINTESTINAL TRACT].

OBJECTIVE: To reveal the peculiarities of manifestations and treatment of gastroesophageal reflux disease (GERD) in patients with peptic ulcer disease of the stomach and duodenum, hiatal hernia (HH) and after stomach resection. MATERIALS AND METHODS: 387 patients with GERD, peptic ulcer disease of the stomach and duodenum (200 patients), after resection of the stomach Billroth II (150 patients), 37 patients with HH. Videoendoscopic equipment company OLYMPUS (Japan) was used. Biopsies of the mucous membranes of the pylorus, body, angle of the stomach and esophagus were studied to identify preneoplastic changes. HP was determined histologically, cytologically, urease tests. RESULTS: The patients with GERD and peptic ulcer disease of the stomach and duodenum were complained on the heartburn, the patients after resection of the stomach--on feeling bitterness in the mouth, with HH--on the pain behind the breastbone. More severe degree of GERD (C and D) was endoscopic feature in patients with HH and A degree or endoscopic negative form--after resection of the stomach. Preneoplastic changes of the esophageal mucosa with columnar epithelium were found in cases of less severe degrees of inflammation. The degree of esophagitis, presence of preneoplastic changes were determined depending on the presence of Helicobacter pylori. Antireflux surgery was performed under strict indications. CONCLUSION: Clinical features, endoscopic, morphological manifestations of GERD in patients with pectic ulcer disease of the stomach and duodenum, with resection of the stomach and patients with HH were determined. This is dictated the individual differentiated approach to the choice of the treatment.