[The oleic triglycerides of palm oil and palmitic triglycerides of creamy fat. The reaction of palmitoylation, potassium and magnesium palmitate, absorption of fatty acids by enterocytes and microbiota of large intestine].

The decreasing of content of animal, palmitic milk fat (butter) by means of its substitution with vegetable, oleic, palmy oil in food of adults optimal by its quantity is physically chemically and biologically substantiated. In oleic palmy oil higher content of oleic mono unsaturated fatty acid and oleic triglycerides than in creamy fat is established. The biologic availability of palmitic unsaturated palmitic acid in the form of free fatty acid is decreased at its absorption by enterocytes of small intestines is detected. There are no transforms of mono unsaturated acids in palmy oil in contrast with hydrogenated margarines. In palmy, oleic oil there is not enough of short-chained fatty acids (C4-C6) and it has no taste quality and it has low level of unsaturated fatty acids and factually it is lacking of ω-6 polyunsaturated fatty acids. However, it is compensated in case of availability offish and sea products in food. If adults, especially older ones, will refuse to consume creamy fat and decrease intake of products with high content of palmitic unsaturated fatty acid and palmitic triglycerides (beef, sour cream, fatty cheeses) it'll positively impact their health. The refusal from these products is a real step in prevention of metabolic pandemic (atherosclerosis and atheromatosis, metabolic syndrome, resistance to insulin, obesity). There are still large number of people who at optimal amount of food retain in vivo increased amount of exogenous, endogenously synthesized from glucose palmitic unsaturated fatty acid in the form of unesterified fatty acids (syndrome of resistance to insulin) and increased content of palmitic triglycerides.

[The laboratory evaluation of dynamics of progression of liver fibrosis under chronic hepatitis].

The study was carried out to evaluate velocity of development of fibrosis of liver in patients with chronic hepatitis C using laboratory tests. The sampling of 150 patients with chronic hepatitis C were examined to analyze blood serum in phase of reactivation detecting concentration of hyaluronic acid, alpha-fetoprotein, iron, ferritin, vascular endothelial risk factor, malonic dialdehyde and activity of catalase. The degree of fibrosis of liver was evaluated using technique of ultrasound elastography. The velocity of development of fibrosis of liver was calculated as ratio of fibrosis (in points) to duration of infection (in years). The velocity of development of fibrosis of liver in group with slow rate of progression of disease made up in average 0.01±0.04 points per year and in the group with fast rate of progression of chronic hepatitis C - 0.45±0.34 points per year (p<0.001). In the group of patients with high velocity of development of fibrosis of liver were registered reliably higher values of density of liver (p<0.001). The fast velocity of development of fibrosis of liver was accompanied by increasing of serum concentrations of hyaluronic acid (p<0.001), alpha-fetoprotein (p=0.04), iron (p=0.03), ferritin (p=0.03) and decreasing of activity of catalase (p=0.04). The correlation analysis substantiated availability of reliable direct relationships of rate of progression of fibrosis with duration of disease (r=0.27, p=0.01), density of liver (r=0.86; p<0.001), hyaluronic acid (r=0.59; p<0.001), alpha-fetoprotein (r=0.23; p=0.04), ferritin (r=0.23; p=0.04), vascular endothelial risk factor (r=0.21; p=0.04). The association of increased serum levels of hyaluronic acid, alpha-fetoprotein, vascular endothelial risk factor, iron, ferritin and low activity of catalase with fast velocity of development of fibrosis of liver can be recommended as additional criteria of evaluation of rate of progression of fibrosis under chronic hepatitis C.

[FUNCTIONAL AND CLINICAL DISORDERS OF THE LUNG IN PATIENTS WITH CIRRHOSIS AND THEIR DYNAMICS IN OPERATIONS TUNNELING LIVER].

Aim: Aim. To evaluate lung function in patients with liver cirrhosis of the liver with conservative therapy and surgery tunneling liver. Materials and methods: The study involved 55 patients with liver cirrhosis with portal hypertension. Patients were randomized into 2 groups. In the first group (n = 40) patients received medication. Patients of the second group (n = 15) was performed tunneling liver shunt operation. Results: In patients with liver cirrhosis observed clinical and functional remodeling of the lung appears shortness of breath, coughing, wheezing, and restrictive ventilatory disorders. Conclusions: In patients with cirrhosis of the liver after tunneling is observed normalization of lung ventilation. After conservative treatment reliable normalization of lung function occurs.

[The dysfunction of endothelium and humoral mediators of blood plasma in patients with ulcerous colitis.]

The study was carried out to evaluate biological reaction of endothelium-depended vasodilation and disorder of its regulation by humoral mediators of inflammation in patients with ulcerous colitis. And also to compare disorders of function of endothelium with content of cytokines in blood plasma and severity of inflammation in intestine. The examined sampling consisted of 90 patients with diagnosis of ulcerous colitis at the phase of exacerbation of disease. The concentration of humoral mediators of inflammation was established: tumor necrosis factor-alpha, interleukins-6 and -4, monocyte chemo-attractant protein-1. The content of endothelium growth factor of vessels in blood serum was determined as a marker of damage of endothelium. The functional condition of endothelium of vessels was evaluated on the basis of photoplethysmography and software support Pulsware (Samara). In case of ulcerous colitis hyper-secretion of humoral mediators of inflammation was established in blood serum: tumor necrosis factor-alpha, interleukins-6, monocyte chemo-attractant protein-1. The median of concentration of endothelium growth factor of vessels thrice exceeded the level specific for control group of healthy individuals. The disorder of biological reaction of endothelium-depended vasodilation was established in 95% of patients with ulcerous colitis. The reliable correlation relationship between concentration of humoral mediator of inflammation, endothelium growth factor of vessels and severity of destructive alterations in large intestine wall. The combination of disorders of humoral regulation of biological reaction of endothelium-depended vasodilation and markers of dysfunction of endothelium reflects activity of local destruction of tissue. The severity of clinical manifestation of ulcerous colitis substantiates functional interaction of inflammation reaction and angiogenesis. The detection of humoral mediators of inflammation and endothelium growth factor of vessels is reasonably to implement as non-invasive techniques of evaluation of severity of inflammation in wall of large intestine under ulcerous colitis.

[The noninvasive evaluation of degree of expression of fibrosis of liver and significance of polymorphism of gene of hyaluronic acid under chronic hepatitis C].

The study was carries out to evaluate degree of expression of fibrosis, reparation processes in liver and value of polymorphism of gene of hyaluronic acid HASI (rs11084111) in progression of affection of liver in patients with chronic hepatitis C. The sampling included 100 patients with chronic hepatitis C. The control group included 83 healthy donors. The blood serum was tested to detect concentration of hyaluronic acid and alpha-fetoprotein. The stage of liver fibrosis (F) was evaluated by using ultrasound fibroflexography The polymorphism of gene (rs11084111) was analysed by polymerase chain reaction technique. In the group of patients with F1 the average concentration of hyaluronic acid in blood serum in 1.8 times surpassed this indicator in group with F0. The concentration of hyaluronic acid was almost 2 times higher under F3 as compared with F1-F2. This indicator permitted differentiating F3 and F4 which followed by activation of cytolysis and cholestasis in F1 and F3 and by increasing of level of alpha-fetoprotein at stages F1 and F4. The study detected no statistically significant difference between rates of genotypes and alleles of gene HASI (rs11084111) in groups of healthy patients and patients with chronic hepatitis C. The direct relationships are established between hyaluronic acid and markers of cytolysis, cholestasis, alpha-fetoprotein (p = 0.001), viral load (p = 0.003) liver elasticity index according fibroflexography data (p < 0.001) and fibrosis index (p < 0.001). The established relationships indicate association of hepatofibrosis with cytolysis, cholestasis, hepatocytes regeneration and virus activity. The hyaluronic acid permits to stratify minimal expressed fibrosis and also the transition of disease to the stage of cirrhosis.