Over the past 10 years, it has become increasingly evident that nonalcoholic fatty liver disease (NAFLD) is a multisystem disease that affects multiple extra-hepatic organ systems and interacts with the regulation of several metabolic and immunological pathways. Recent observational studies have shown that the prevalence of NAFLD is remarkably higher in psoriatic patients (occurring in up to 50 % of these patients) than in matched control subjects. Notably, psoriasis is associated with NAFLD even after adjusting for metabolic syndrome traits and other potential confounding factors. Some studies have also suggested that psoriatic patients are more likely to have the more advanced forms of NAFLD than non-psoriatic controls. The use of drug therapy in patients with a combination of NAFLD and psoriasis with the inclusion of the drug Legalon is pathogenetically justified.

The article discusses the current understanding of risk factors, mechanisms of development, diagnostic criteria, therapy for various types of functional disorders of the biliary tract. Paying special attention for the adaptation of diagnostic and treatment algorithms which were described in the Rome criteria, rev. IV, for ambulant practice to provide effective medical assistance to patients with the pathalogy. The authors proposed the scheme of treatment and prophylaxis of functional disorders for using in clinical practice.

Recurrence of peptic ulcer disease, its comorbid with arterial hypertension is accompanied by calcium-phosphorus imbalance, contributing to the increase of acid-peptic factor, the changes of motor function of the stomach, regional microcirculation, activation of the ulcer process. The use of nifedipine in the therapy of comorbid peptic ulcer disease and arterial hypertension, contributes to the restoration of calcium-phosphorus balance, gastric functions and regional microcirculation, reduces the time and increases the frequency of scarring of ulcers.

The article presents scientific data on the role of ammonia in the human body, examines in detail the mechanism of formation and utilization of ammonia in the body. The questions of etiology and separate forms of pathogenesis of hyperammonemia, and its influence on the processes of fibrosis in the liver and the role of stellate liver cells in it are highlighted separately. The data on the influence of hyperammonemia on cognitive functions of the brain with the development of encephalopathy are presented, which is of great importance in clinical practice, during medical examination. The data of own observations are given, the questions of drug therapy are highlighted.

Infusion-nutrient accompanying therapy provides prevention of metabolic complications and their nutrient correction in oncopatients with colorectal cancer (CRС) and pancreatic cancer.

Material and methods. In patients with CRС and pancreatic cancer the effectiveness of detoxification alimentation was evaluated. Nutritional deficiency was specified by alimental-volemic diagnoses (AVD), nutritional risk-by NRI, sarcopenia by bioimedansometry. Hematological indices of intoxication (Krebs index, leukocyte index of intoxication) were calculated according to known formulas. Hepatological parameters (total protein, albumin, bilirubin, ALT, etc.) and the content of blood urea and creatinine, electrolytes were determined by conventional methods, the participation of the intestine in detoxification was monitored by plasma citrulline levels and activity of the intestinal microbiota. The severity of the condition was assessed by APACHE II, the quality of life by ECOG.

Results. The relationship between indicators of homeostasis and endotoxicosis, as well as more positive dynamics in the application of detoxification regimens with the addition of Remaxol.

Conclusion. In CRC T3–T4, it is advisable to use a combination of nutrient compositions with the addition of hepatotropic pharmaconutrients, in particular, Remaxol.

The article describes the results of a clinical observational study of patients with cholelithiasis after cholecystectomy. The article is about the metabolic disorders in patients with gallstone disease, the mechanisms of development of functional and metabolic disorders after cholecystectomy. Particular attention is paid to the genetic, hormonal mechanisms, the role of microbiota and bile acids.

The results of study at 96 patients with non-alcoholic fatty liver disease are presented. A high incidence of intestinal microbiome disorders was observed in the examined patients, especially at the stage of non-alcoholic steatohepatitis. The relationship between the persistence of impaired lipid metabolism and the degree of dysbiosis of the colon, namely between grade II dysbiosis and the level of total cholesterol in patients with non-alcoholic fatty hepatosis (r = 0.77; p < 0.01), and grade III dysbiosis and total cholesterol, triglycerides in patients with non-alcoholic fatty steatohepatitis.

In the light of modern ideas about the pathogenesis of non-alcoholic fatty liver disease (NAFLD), along with the decoding of the genetic polymorphism of genes that regulate lipid and carbohydrate metabolism, immune factors, metabolic disorders and inflammation, a key role in the pathogenesis of the disease belongs to the intestinal microbiota, which takes part in development of all stages of NAFLD. The article presents the pathogenetic relationships of intestinal microbiota and metabolic disorders.

The method of bioimpedance measurement allows to evaluate the use of a complex of surgical and chemotherapeutic methods accompanied by nutritional support. Patients with colorectal cancer need different saturation of postoperative nutritional support in 90 % of cases, as well as dynamic operational control of the corrected nutritional status. Vector analysis of bioimpedansograms provides qualitative indicators of soft tissue changes that do not depend on body size (information on hydration, exicosis, body cell mass and cell integrity). The study of body composition by bioimpedance method allows to reveal latent sarcopenia and to choose personalized nutritional correction programs that take into account the dynamics of metabolic disorders at the cell level.