Introduction. Type 1 diabetes mellitus (DM-1) and its complications pose a serious medical and social problem. Erosive changes in the gastric mucosa are among the most common lesions of the digestive system in diabetes mellitus, and can lead to life-threatening gastrointestinal bleeding and early disability of patients.Aim. Substantiation of the effectiveness of rebamipid course treatment based on an assessment of the functional state and antioxidant activity of the supraepithelial gastric mucosa in chronic erosive gastritis in patients with DM-1.Materials and methods. A comprehensive examination of 12 DM-1 patients with erosive gastritis and 11 healthy individuals was carried out, including FGDS with biopsy of the antrum mucosa and stomach body, exclusion of Helicobacter pylori infection, determination of the biochemical composition of structural glycoproteins of mucus and the concentration of degraded glycoproteins, evaluation of the antiradical activity of the supraepithelial mucous layer of the stomach.Results and discussion. In chronic erosive gastritis in patients with DM-1, a significant predominance of degraded monosaccharides in the supraepithelial mucous layer of the stomach was revealed (6 times higher than in healthy individuals), a decrease in the concentration of polymerized glycoproteins in gastric mucus (21% vs. 80%) and a significant increase in the antiradical activity of mucus. Course treatment of chronic erosive gastritis in patients with type 1 diabetes with rebamipid at a dose of 100 mg 3 times a day for 3 weeks contributes to the normalization of the indicators of glycoproteins of native mucus, antiradical activity of the mucosa and complete epithelization of the erosions of the antrum of the stomach.Conclusions. The use of rebamipid in the treatment of chronic erosive gastritis in patients with type 1 diabetes contributes to reducing the degradation of polymerized glycoproteins of native mucus, normalizing the antiradical activity of the mucosa and complete epithelization of erosions of the antrum of the stomach.

Aim. To study the effects of local paricalcitol injections into the parathyroid glands on bone turnover in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) with moderately elevated parathyroid hormone (PTH) levels (300–600 pg/mL).Materials and methods. The study included 48 patients with end-stage CKD and SHPT with PTH levels of 300–600 pg/mL. All patients received standard medical therapy before the study, including correction of hyperphosphatemia, hypocalcemia, and disorders of calcium-phosphorus metabolism. The main group (n = 14) comprised patients for whom ultrasound-guided paricalcitol injections into the parathyroid glands were technically feasible. The dynamics of PTH levels, vascular calcification, bone mineral density (BMD), and levels of PTH, b-CrossLaps, and FGF23 were assessed.Results. Multivariate logistic regression analysis demonstrated that osteoporosis and vascular calcification were significantly associated with age, PTH levels, dialysis duration, comorbidity index, b-CrossLaps, and FGF23. Threshold values for age and PTH were 33 years and 301 pg/mL for the development of osteoporosis and 29 years and 301 pg/mL for vascular calcification. Correlation analysis revealed a statistically significant relationship between FGF23 and dialysis duration, b-CrossLaps and PTH levels, as well as between FGF23 and b-CrossLaps. The comorbidity index also increased with age and PTH levels. After 3 and 6 months of treatment, PTH levels significantly decreased, while the volume of the parathyroid glands remained unchanged. No serious complications were observed after the injections, and transient local pain was reported in only 8 (57%) patients.Conclusion. Ultrasound-guided paricalcitol injections into the parathyroid glands contribute to reducing PTH levels, improving bone remodeling parameters, and creating conditions for preventing cardiovascular complications. These findings require further investigation in larger-scale studies.