The microbial community of the human gut has a crucial role in sustaining host homeostasis. High-throughput DNA sequencing has delineated the structural and functional configurations of gut metagenomes in world populations. The microbiota of the Russian population is of particular interest to researchers, because Russia encompasses a uniquely wide range of environmental conditions and ethnogeographical cohorts. Here we conduct a shotgun metagenomic analysis of gut microbiota samples from 96 healthy Russian adult subjects, which reveals novel microbial community structures. The communities from several rural regions display similarities within each region and are dominated by the bacterial taxa associated with the healthy gut. Functional analysis shows that the metabolic pathways exhibiting differential abundance in the novel types are primarily associated with the trade-off between the Bacteroidetes and Firmicutes phyla. The specific signatures of the Russian gut microbiota are likely linked to the host diet, cultural habits and socioeconomic status.

The high prevalence of Helicobacter pylori and the variety of gastroduodenal diseases caused by this pathogen necessitate the use of only accurate methods both for the primary diagnosis and for monitoring the eradication effectiveness. There is a broad spectrum of diagnostic methods available for detecting H. pylori. All methods can be classified as invasive or non-invasive. The need for upper endoscopy, different clinical circumstances, sensitivity and specificity, and accessibility defines the method chosen. This article reviews the advantages and disadvantages of the current options and novel developments in diagnostic tests for H. pylori detection. The progress in endoscopic modalities has made it possible not only to diagnose precancerous lesions and early gastric cancer but also to predict H. pylori infection in real time. The contribution of novel endoscopic evaluation technologies in the diagnosis of H. pylori such as visual endoscopy using blue laser imaging (BLI), linked color imaging (LCI), and magnifying endoscopy is discussed. Recent studies have demonstrated the capability of artificial intelligence to predict H. pylori status based on endoscopic images. Non-invasive diagnostic tests such as the urea breathing test and stool antigen test are recommended for primary diagnosis of H. pylori infection. Serology can be used for initial screening and epidemiological studies. The histology showed its value in detecting H. pylori and provided more information about the degree of gastric mucosa inflammation and precancerous lesions. Molecular methods are mainly used in detecting antibiotic resistance of H. pylori. Cultures from gastric biopsies are the gold standard and recommended for antibiotic susceptibility tests.

SUMMARYBackground: The optimal treatment of patients with Helicobacter pylori resistant to metronidazole has not been established. Aim: To compare the efficacy of quadruple and furazolidone-based triple therapy in the eradication of H. pylori resistant to metronidazole. Methods: Duodenal ulcer patients (n ¼ 70) in whom initial eradication therapy failed and who harboured H. pylori strains resistant to metronidazole were randomized to receive one of the following 7-day regimens: colloidal bismuth subcitrate, 240 mg, tetracycline, 750 mg, and furazolidone, 200 mg, each given twice daily (BTF), or omeprazole, 20 mg b.d., colloidal bismuth subcitrate, 240 mg b.d., tetracycline, 500 mg q.d.s., and metronidazole, 500 mg b.d. (OBTM). H. pylori status was assessed by culture, histology and rapid

Цель представления клинических рекомендаций, предназначенных для врачей-гастроэнтерологов, врачей общей практики (семейных врачей), врачей-терапевтов, заключается в изложении современных методов диагностики и лечения язвенной болезни. Основное содержание. Язвенная болезнь (ЯБ) представляет собой хроническое рецидивирующее заболевание, протекающее с чередованием периодов обострения и ремиссии, ведущим проявлением которого служит образование дефекта (язвы) в стенке желудка и двенадцатиперстной кишки. Большинство случаев ЯБ патогенетически связано с инфекцией Н. pylori. Различают ЯБ как самостоятельное заболевание и симптоматические язвы желудка и двенадцатиперстной кишки (лекарственные, «стрессовые», при эндокринной патологии, при других хронических заболеваниях внутренних органов). Всем пациентам с подозрением на ЯБ, при отсутствии противопоказаний, с целью подтверждения диагноза рекомендуется проведение эзофагогастродуоденоскопии. Всем пациентам с ЯБ с целью определения показаний к эрадикационной терапии рекомендуется проведение тестирования на наличие инфекции Н. рylori с помощью 13 С-дыхательного теста или определения антигена H. pylori в кале, а при одновременном проведении ЭГДС-с помощью быстрого уреазного теста. Всем пациентам с ЯБ с положительными результатами тестирования на инфекцию H. рylori с целью профилактики последующих рецидивов ЯБ рекомендуется проведение эрадикационной терапии, с целью достижения заживления язв рекомендуется проведение антисекреторной терапии ингибиторами протонного насоса в течение 4-6 недель. Клинические рекомендации содержат критерии оценки качества оказания медицинской помощи, алгоритм действия врача, а также информацию для пациента. Заключение. В клинических рекомендациях даются современные представления об этиологии и патогенезе язвенной болезни, ее клинических проявлениях, методах лабораторной и инструментальной диагностики, основных подходах к консервативному и хирургическому лечению. Ключевые слова: язвенная болезнь, язвенное кровотечение, перфорация, стеноз, H. pylori, эрадикационная терапия H. pylori, ингибиторы протонной помпы Конфликт интересов: авторы заявляют об отсутствии конфликта интересов.

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Background Escherichia coli (E. coli) has been increasingly implicated in the pathogenesis of Crohn’s disease (CD). The phylogeny of E. coli isolated from Crohn’s disease patients (CDEC) was controversial, and while genotyping results suggested heterogeneity, the sequenced strains of E. coli from CD patients were closely related.ResultsWe performed the shotgun genome sequencing of 28 E. coli isolates from ten CD patients and compared genomes from these isolates with already published genomes of CD strains and other pathogenic and non-pathogenic strains. CDEC was shown to belong to A, B1, B2 and D phylogenetic groups. The plasmid and several operons from the reference CD-associated E. coli strain LF82 were demonstrated to be more often present in CDEC genomes belonging to different phylogenetic groups than in genomes of commensal strains. The operons include carbon-source induced invasion GimA island, prophage I, iron uptake operons I and II, capsular assembly pathogenetic island IV and propanediol and galactitol utilization operons.ConclusionsOur findings suggest that CDEC are phylogenetically diverse. However, some strains isolated from independent sources possess highly similar chromosome or plasmids. Though no CD-specific genes or functional domains were present in all CD-associated strains, some genes and operons are more often found in the genomes of CDEC than in commensal E. coli. They are principally linked to gut colonization and utilization of propanediol and other sugar alcohols.Electronic supplementary materialThe online version of this article (doi:10.1186/s12864-017-3917-x) contains supplementary material, which is available to authorized users.

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ObjectiveThe concept of using naturally occurring compounds such as polyenylphosphatidylcholine (PPC) as an adjunctive therapy to treat non-alcoholic fatty liver disease (NAFLD) and alleviate or reverse hepatic steatosis appears a very attractive option for liver protection. We aim to evaluate if PPC adjunctive therapy can effectively improve the ultrasonographic features of NAFLD in routine clinical practice in Russian patients with cardiometabolic comorbidities.DesignThis 24-week, observational, prospective study was carried out in 174 medical sites across 6 federal districts of Russia. A total of 2843 adult patients with newly diagnosed NAFLD, who had a least one of four comorbidities, namely overweight/obesity, hypertension, type 2 diabetes mellitus and hypercholesterolaemia, and who received PPC as an adjunctive treatment to standard care, were enrolled. The assessment of liver ultrasonography was qualitative.ResultsOverall, 2263 (79.6%) patients had at least two metabolic comorbidities associated with NAFLD, and overweight/obesity was the most common comorbidity reported in 2298 (80.8%) patients. Almost all study participants (2837/2843; 99.8%) were prescribed 1.8 g of PPC administered three times daily. At baseline, the most frequently identified abnormalities on ultrasound were liver hyperechogenicity (84.0% of patients) and heterogeneous liver structure (62.9%). At 24 weeks, a significant (p<0.05) improvement in liver echogenicity and in liver structure was observed in 1932/2827 (68.3%) patients (95% CI 66.6% to 70.1%) and in 1207/2827 (42.7%) patients (95% CI 40.9% to 44.5%), respectively. The analysis of ultrasonographic signs by number of comorbidities revealed similar findings—liver echogenicity improved in 67.2%–69.3% and liver structure in 35.6%–45.3% of patients depending on the number of comorbidities.ConclusionThis study showed that PPC adjunctive therapy may be useful in improving the ultrasonographic features of NAFLD in patients with associated cardiometabolic comorbidities. It also supports evidence regarding the role of PPC in the complex management of NAFLD.