Russian Military Medical Academy Reports


“Russian Military Medical Academy Reports” is a scientific and practical journal founded in 1900 by professor Viktor V. Pashutin, a world-famous physiologist and pathologist, one of the founders of pathological physiology in Russia, professor (1874), honorary member of the Royal Society of London.

In 2016, the Russian Military Medical Academy resumes publication, informing about the most significant achievements, new technologies, projects in educational and scientific work of the Academy in the form of original articles, as well as providing the results of scientific and clinical research. The editorial board of the journal includes honored doctors of the Russian Federation, honored scientists, professors and doctors of science.

The journal is intended for a wide range of medical and scientific responsibility


Professor Aleksandr Y. Fisun, MD, PhD

The journal publishes:

  • basic-research and clinical practice research articles, scientific reviews also with information-analytical and methodological articles aimed for developing advanced medical technologies and uncovering the latest scientific achievements in various fields of medicine, materials describing clinical cases, information of biographical and historical-medical nature.


The journal is indexing in the following international databases and directory editions:


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Current Issue

Vol 42, No 2 (2023)

Original articles

Clinical application of neodymium magnetic instruments for the removal of foreign bodies in blind wounds
Shvediuk V.V., Elin N.E., Dzidzava I.I., Fufayev E.E., Barinov O.V.

A feature of modern military conflicts is the high frequency of shrapnel wounds. The search for foreign bodies, even under X-ray navigation, can be technically difficult, lengthy and not always successful. Most injuring objects have ferromagnetic properties.

AIM: The Military Medical Academy, Saint Petersburg purpose of the study: to evaluate the effectiveness of removing ferromagnetic foreign bodies from blind wounds using neodymium magnetic instruments.

MATERIALS AND METHODS: Instruments based on a neodymium magnet for removing foreign bodies and a technique for their use have been developed. An analysis was made of 45 operations where traditional instruments were used and 75 operations using original magnetic instruments. Of these, in 40 cases of blind wounds, foreign bodies were removed from the soft tissues of various areas, and in 35 cases, foreign bodies were removed during videothoracoscopy operations for blind penetrating chest wounds. The criteria for evaluating the effectiveness of the method were the duration of the operation, the duration of work with the X-ray unit and the number of detected and removed foreign bodies in a fixed period of time.

CONCLUSION: High efficiency, simplicity, accessibility, minimally invasiveness of the developed instruments have been proven. Neodymium magnets made it possible to reduce the time of radiation exposure and the duration of the operation, to increase the efficiency of removing ferromagnetic foreign bodies. The use of original instruments makes it possible to detect 80% of foreign bodies in 10 minutes, and within 30 minutes to remove 90% of foreign bodies from the soft tissues of the wounded. With videothoracoscopy, the time of fluoroscopy was halved, and the total duration of the surgical intervention was reduced by 40%.

Russian Military Medical Academy Reports. 2023;42(2):105-114
pages 105-114 views
The effect of equipment on the functional state and performance of servicemen with different body composition
Emelyanov Y.A., Ovchinnikov D.V., Ryzhikov M.A., Baranov Y.V., Zhizhin V.R., Semenov A.A.

BACKGROUND: The development of an individual approach to planning the mass of equipment for each individual serviceman, taking into account the indicators of the component composition of the body and the preferences of servicemen, can in the future increase the level of effectiveness of combat operations by the Armed Forces of the Russian Federation.

AIM: Determine the effect of the mass of equipment on the functional state and performance of military personnel, depending on the indicators of the component composition of the body.

MATERIALS AND METHODS: The study was conducted on 140 volunteers, practically healthy male cadets of the Military Medical Academy aged 21 to 25 years. After bioimpedancemetry, all subjects were divided into two groups depending on the values of their fat mass. Next, the influence of equipment on the functional state of the body of cadets was determined using a step test.

RESULTS: The presence of a predominantly moderate positive correlation between the absolute, relative values of fat mass, BMI values and indicators of total power during the tests performed under the conditions of the work performed at loads of 0.5 (R-criterion values were 0.574–0.693) and 1 W/kg (R-criterion values were 0.624–0.681) without equipment. A similar correlation was found between the absolute, relative values of fat mass and indicators of total power during the test with a load of 1 W/kg (R-criterion values were 0.534–0.547) in equipment.

CONCLUSION: The obtained results suggest that the increase in weight load caused by equipment in individuals with a fat mass of more than 11 kg, both at rest and under conditions of moderate physical activity with a power of 1 W/kg, to a greater extent causes stress on functional systems, expressed in changes in most cardiorespiratory and metabolic parameters, compared with individuals with a lower fat mass.

Russian Military Medical Academy Reports. 2023;42(2):115-123
pages 115-123 views
The strength of restorations of hard tooth tissues with changes in atmospheric pressure, in vitro studies
Latif A.R., Vorobyeva Y.B.

BACKGROUND: It is known that the development of the carious process is promoted by microorganisms that secrete waste products that penetrate into the tooth tissue during the depressurization of the filling material. That is why high-quality restoration prevents the development of secondary caries.

AIM: Based on the study of the edge fit of restorations made of various types of filling materials, when restoring the chewing surface of the tooth, to determine the most optimal method of filling, which reduces the likelihood of violation of the edge fit of the seal in cases of significant changes in atmospheric pressure.

MATERIALS AND METHODS: The removed teeth were prepared and treated with the Single Bond Universal adhesive system, the samples were divided into 4 groups, the cavities were filled according to the classical method with traditional composite materials Estelite Sigma Quick (Tokuyama Dental), OptiShade (Kerr) and materials of the bulk fill Tetric N-Ceram (Ivoclar Vivadent), SonicFill (Kerr). After sealing, groups 3 and 4 were placed in a pressure chamber (the study was conducted at the Department of Aviation and Space Medicine) and exposed to low atmospheric pressure. Next, the restoration slots were made and the study was carried out using a scanning electron microscope JEOL JSM-6380LV.

RESULTS: As a result of microscopic studies, a violation of the marginal fit along the filling-tooth border was determined in all samples sealed with traditional composite materials (Estelite Sigma Quick, OptiShade) 65 ± 9.18% (p < 0.05) and bulk fill group materials (Tetric N-Ceram, SonicFill) 98 ± 2.69%, (p < 0.05) in cases of exposure to low atmospheric pressure. In the samples that were not exposed to atmospheric pressure, the marginal depressurization was 12 ± 6.25% (p < 0.05) — Estelite Sigma Quick, OptiShade and 21 ± 7.84% (p < 0.05) — Tetric N-Ceram, SonicFill.

CONCLUSION: It has been proved by laboratory method that traditional composite materials and bulk fill group materials are rational to use only in persons who are not associated with extreme effects on the body, since in cases of exposure to atmospheric pressure, there are violations of the marginal fit of the material along the seal–tooth border.

Russian Military Medical Academy Reports. 2023;42(2):125-130
pages 125-130 views
Impact of physical activity on the quality of life of pregnant women
Zakharov I.S., Shmidt А.A., Satushkina E.Y., Bondareva V.S., Ivanov V.I., Andrianova E.V., Fesenko T.V., Karpishchenko Z.M., Morozova G.Y.

AIM: To study the effect of physical activity on the quality of life of pregnant women at various gestational ages.

MATERIALS AND METHODS: An observational cross-sectional study of physical activity and quality of life was performed in 99 pregnant women at various gestational periods. Criteria for inclusion in the study: age 18–35 years; absence of acute extragenital pathology; consent to conduct research. Exclusion criteria: age younger than 18 and older than 35 years, the presence of acute extragenital pathology; lack of consent to participate in the study. To assess the physical activity of pregnant women, the international Pregnancy physical activity questionnaire (PPAQ), consisting of 36 questions, was taken as a basis. In order to study the quality of life, an abbreviated methodology of the World Health Organization — WHOQOL-26 (World Health Organization’s Quality of Life), including 26 questions, was used.

RESULTS: To achieve this goal, an adapted Russian-language version of the international questionnaire was developed that determines the level of physical activity in pregnant women — PPAQ-RUS, on the basis of which a computer program was created. In the study, data were obtained on the statistically significant effect of a number of parameters of physical activity on the quality of life at various times of the gestational period. The correlation of professional activity with self-perception and the level of physical and psychological well-being, as well as activity associated with physical exercises, indicators of physical and psychological well-being was determined.

CONCLUSION: The conducted study can be the basis for further study of the influence of the level of physical activity of pregnant women on the course of the gestational period, as well as the study of the possibility of managing the quality of life of women by changing physical activity depending on the duration of pregnancy.

Russian Military Medical Academy Reports. 2023;42(2):131-139
pages 131-139 views
The effectiveness of the organization and specific prevention of Rh-conflict during pregnancy
Kharkevich O.N., Dorovskaya E.N.

AIM: The aim of the study was to evaluate the effectiveness of the organization and medical provision of complex specific antenatal and postpartum prevention of primary isoimmunization with domestic anti-Rh0(D) immunoglobulin in Rh-negative women.

MATERIALS AND METHODS: To achieve the goal, an algorithm for managing pregnancy in Rh-negative women was developed, complex antenatal and postpartum prophylaxis of primary isoimmunization with anti-Rh0(D) immunoglobulin was carried out, and its effectiveness was evaluated in 37 women who gave birth to Rh-positive newborns. If antibodies to the Rh0(D) antigen were not detected, then at 28 weeks pregnant women were administered human immunoglobulin anti-Rh0(D) at a dose of 1500 IU (300 μg). Anti-Rh0(D) antibody titer was monitored every 2–3 weeks before delivery. Mothers were re-introduced with human anti-Rh0(D) immunoglobulin at a dose of 1500 IU (300 μg) within 24–72 hours after the birth of an Rh-positive child. 6 months after delivery, the antibody titer to the Rh0(D) antigen was re-determined.

RESULTS: After the introduction of domestic human immunoglobulin anti-Rh0(D), side effects and allergic reactions were not registered. All 37 (100%) women were delivered at term, of which 7 (18.9%) were delivered abdominally. All newborns were born with an Apgar score of 8–9 without hemolytic disease. The titer of antibodies to the Rh0(D) antigen was negative in 24 (64.9%) women 6 months after delivery. 13 (35.1%) mothers had a post-vaccination antibody titer not higher than 1 : 2, which is allowed by the instructions for the anti-Rh0(D) human immunoglobulin preparation. They tested negative again 12 months after delivery.

CONCLUSION: The results of the study showed a rather high efficiency of the organization and medical provision of complex specific antenatal and postpartum prevention of primary isoimmunization with domestic anti-Rh0(D) immunoglobulin in Rh-negative women.

Russian Military Medical Academy Reports. 2023;42(2):141-147
pages 141-147 views
The method of restoration of the second class by G.V. Black
Gabaraeva A.S., Vorobyeva Y.B., Zheleznyak V.A.

BACKGROUND: It is known that the carious process is one of the main causes of the destruction of the integrity of the hard tissues of the tooth, especially caries of the contact surfaces of the lateral teeth, which gives the most frequent complications and is difficult to treat. The question arises of finding a new method of filling cavities of class 2 according to G.V. Black. One of the ways to improve the quality of treatment is to add a reinforcing component to the restoration.

AIM: To develop a method of restoration of extensive defects of hard tissues of teeth of the second class according to G.V. Black with additional reinforcement, to study this method in an experiment.

MATERIALS AND METHODS: The removed teeth were dissected under the cavities of the 2nd class according to G.V. Blank, the wall thickness was measured using a dental micrometer, the cavities were treated with a Single Bond Universal adhesive system, the samples were divided into 2 groups, the cavities were sealed according to the classical technique with 3M ESPE Filtek Ultimate Universal Restorative composite material and according to the developed method using a thread with composite material (dental fiber light-cured formed CATERPILLAR), after the restoration of the teeth they were subjected to metered pressure on a testing machine, a hardness tester, a trademark “Shimadzu”.

RESULTS: When conducting studies in samples of class 2 according to G.V. Black, where the tooth walls are more than 3 mm with the use of a thread with a composite, the compression force increased by 455.4 N. in comparison with the generally accepted method of filling with a composite, by 53%, respectively. In the group of class 2 according to G.V. Black, where the walls are less than 3 mm, sealed with a thread with a composite, the compression force increased by 660.21 N compared to the classical sealing technique, therefore, the quality of sealing increased by 105%.

CONCLUSION: The “Method of restoration of molars in case of significant destruction of the crown part of the tooth” has been developed (RF Patent No. 2783060). A method for restoring defects of the second class according to G.V. Black using a composite tape as a reinforcing component is proposed. During the experiment on the Shimadzu bursting machine, it was revealed that restorations performed using composite tape have better physical and mechanical properties than restorations performed exclusively with composite material.

Russian Military Medical Academy Reports. 2023;42(2):149-154
pages 149-154 views
Pathophysiological markers of reduced resistance of healthy people to moderate hypoxic hypoxia
Kim A.E., Tsygan V.N., Shustov E.B., Ganapolsky V.P., Borisova I.V., Rzhepetskaya M.K.

BACKGROUND: Despite the abundance of research in the field of high-altitude physiology and medicine, the problem of resistance to moderate hypoxia has not been practically studied. This is partly due to methodological difficulties: the studies were conducted on healthy people and climbers who tolerated the effects of moderate hypoxia well. Such studies have become necessary in connection with the development of hypoxic therapy.

AIM: To search for indicators of the functional state of a person that are highly sensitive to the effects of moderate hypobaric hypoxia.

MATERIAL AND METHODS: The examined group consisted of 65 practically healthy men aged 19–25 years who were selected for work in high mountains. The main indicators characterizing the state of the central nervous system, cardiovascular and respiratory systems were studied in a state of relative rest and when performing a dosed two-stage bicycle ergometric test, in normoxia conditions (altitude 0) and during a pressure chamber rise in the TABAY climate complex (Japan) to altitudes of 3500 and 4500 m Statistically analyzed were the characteristics of the dynamics of indicators during the transition from normoxia to states of moderate hypoxia, correlations between indicators, their sensitivity to hypoxic effects, the significance of reactivity to hypoxic effects and mobilization of the body’s functional reserves in resistance to hypoxia.

RESULTS: It has been shown that the key pathophysiological markers of reduced body resistance to moderate hypoxic exposure are a rapid decrease in the level of peripheral blood saturation, high reactivity of the cardiovascular and respiratory systems to hypoxic exposure, as well as excessive mobilization of the body’s functional reserves in response to additional physical activity.

CONCLUSION: The presented materials confirm that the functional state of a healthy person under conditions of moderate hypoxia at rest is determined by the level of saturation of his peripheral blood. Maintaining saturation at a higher level ensures the maintenance of an optimal level of functional state, physical and operator performance, a lower degree of stress on the respiratory and cardiovascular systems.

Russian Military Medical Academy Reports. 2023;42(2):155-165
pages 155-165 views
Focus on the anti-inflammatory effect of glucocorticosteroids in experimental acute lung injury
Voloshin N.I., Zamiralova Y.A., Pugach V.A., Salukhov V.V., Tyunin M.A., Kharitonov M.A., Odintsova I.A., Slizhov P.A., Minakov A.A., Slutskaya D.R.

AIM: Assessment of the effect of various doses of dexamethasone as an inflammation modulator in experimental lipopolysaccharide-induced acute lung injury in rats.

MATERIALS AND METHODS: Acute lung injury in rats was modeled by intratracheal administration of cell wall lipopolysaccharide from the Salmonella enterica. White male rats were divided into groups: a group of intact animals (n = 10); the control group (n = 40), in which the animals were simulated acute lung injury without further treatment and removed from the experiment on day 3; three experimental groups (n = 40), in which, 3 hours after modeling acute lung injury, and then daily once a day for 3 days, dexamethasone solution was administered intraperitoneally in the following doses: in group 1 — 0.52 mg/kg (equivalent to 6.0 mg/day for a person), in group 2 — 1.71 mg/kg (20.0 mg/day for a person), in group 3 — 8.0 mg/kg (94.0 mg/day, pulse therapy for humans). On the 3rd day, blood samples were taken from the caudal vena cava in surviving animals for clinical analysis and evaluation of the function of mitochondria of peripheral blood leukocytes. To determine the severity of local inflammatory reactions and pulmonary edema, bronchoalveolar lavage was performed with the study of an endopulmonary cytogram and an assessment of pathomorphological changes in the lung tissue.

RESULTS: indicate that dexamethasone reduces the amount of lung tissue damage and animal mortality, dose-dependently reduces the functions of mitochondria and the number of lymphocytes and monocytes in peripheral blood, as well as neutrophils, lymphocytes and macrophages in bronchoalveolar lavage samples.

CONCLUSION: The use of dexamethasone at a dose of 0.52 mg/kg (equivalent to 6.0 mg/day for humans) is accompanied by better survival, minimal effect on the viability and functional activity of inflammatory cells. Pulse therapy leads to a significant decrease in the number of immunocompetent cells in bronchoalveolar lavage, mitochondrial dysfunction in the form of a decrease in the ability of these cells to use the reserve power of mitochondrial respiration in response to the action of a stress factor. Excessive inhibition of immunocompetent cells can contribute to the activation of latent and opportunistic infections, which must be taken into account when choosing a dosing regimen for glucocorticosteroids.

Russian Military Medical Academy Reports. 2023;42(2):167-176
pages 167-176 views


On the possible prospects for the use of cannabis for medical purposes
Titulova A.P., Grebneva N.Y.

The use of cannabis as a therapeutic agent in medical practice in the Russian Federation is one of the current and discussed issues. Cannabis is the tops of the eponymous plant of the genus cannabis (Cannabis sp.) with flowers or fruits (with the exception of seeds and leaves, if they are not accompanied by tops), from which resin has not been extracted, no matter what name they are designated, as well as other products from this plant. More than 400 different chemical compounds have been found in the chemical composition of the above-ground part of cannabis, of which 61 are cannabinoids. Among cannabinoids the most studied are tetrahydrocannabinol, cannabidiol and cannabinol. In Russia, the use of cannabis as a medicine is not currently permitted due to governmental and industrial prohibitions, which limits clinical research to determine the safety and effectiveness of its use in medical practice. At the same time, a number of countries have legalized the use of cannabis for medical purposes. Cannabis-based prescription medications (dronabinol, nabiximols, nabilon, epidiolex) are known to be used abroad to treat various medical conditions. The issue of the use of cannabis for medical purposes on the territory of the Russian Federation requires further elaboration, taking into account the legal and regulatory framework.

Russian Military Medical Academy Reports. 2023;42(2):177-184
pages 177-184 views
Genetic predictors regarding of infection-dependent pregnancy loss
Tsechoeva L.S., Dementyeva E.I., Leonova M.D., Poloskov A.I., Gavrichkova Y.V., Tapil'skaya N.I., Glushakov R.I.

A retrospective comparative cohort study investigated the prevalence of genetic variants are associated with immune hyper-response of the immune system in women (n = 96) with a history of infected miscarriage. The comparison groups subjects was 76 women of the same age with 2 or more normal pregnancies in history.

The frequency of gene polymorphism in patients in all patients of the main group and the comparison group: the G894T polymorphism (Glu298Asp, rs1799983) of the Nos3 gene, the C1234T (p.Leu412Phe, rs3775291) polymorphism of the Tlr3 gene, the C3954T (rs1143644) and C-511T (rs16944) polymorphisms of the IL1B gene, and G-308A (rs1800629) and G238A (rs361525) of the Tnf gene. For comparative statistical analysis, we used the chi-square test and Fisher’s exact test with the determination of relative risk and confidence interval (CI).

Comparative analysis showed that polymorphism in defined gene was associated with an increased the relative risk of infected miscarriage: T/T genotype of the Tlr3 gene (C1234T), the C allele of the Il1b gene (C3954T), and the A allele of the Tnf gene (G238A) increases the relative risk of infected miscarriage by 3.345 times (95% confidence interval 1.594–7.017; chi-square test = 10.779, p = 0.002), 5.077 times (95% confidence interval 2.743–9.396; chi-square test = 30.272, p < 0.001) and 2.958 times (95% confidence interval 1.451–6.032; chi-square test = 9.533, p = 0.003), respectively.

Russian Military Medical Academy Reports. 2023;42(2):185-195
pages 185-195 views

History of medicine

The baronet’s nephew Willie: materials from the collection of the library of the Military Medical Academy
Gordienko A.V., Mamaeva S.A.

The purpose of the article is to introduce into scientific circulation little-known handwritten materials from the library of the Military Medical Academy, containing additions to the facts of the biography, personal characteristics and close circle of the President of the Medical-Surgical Academy, the life physician of the three emperors, Baronet Yakov Vasilyevich Willie. The article presents the historical details of the transfer of the personal archive of the Willie and Ruhl families to the library of the Military Medical Academy by a descendant of famous doctors, a talented artist Mikhail Yakovlevich Willie. Fragments of the correspondence of Willie’s nephew — the full namesake and also the life physician Yakov Vasilyevich Willie Jr. (or 2nd) — with Scottish relatives and friends are given, in which, in particular, the features of medical education in Russia at the beginning of the 19th century are revealed. Handwritten in English in an illegible handwriting, the letters of young Willie lay in the manuscript fund for almost 100 years before, thanks to the efforts of the bibliographer Galina Mikhailovna Roslik, they were attracted to the attention of specialists who could read and translate them. The article also describes the details of the career and personal fate of the Scottish doctor Ya.V. Willie II in the Russian service, under Grand Duke Mikhail Pavlovich. The topic of the unprecedented testament of Baronet Willie on the transfer of the entire inheritance for the construction of a civil hospital in memory of Grand Duke Mikhail Pavlovich is touched upon.

Russian Military Medical Academy Reports. 2023;42(2):197-206
pages 197-206 views


Diagnostic imaging of ovarian endometrioma rupture with hemoperitoneum
Ryazanov V.V., Sadykova G.K., Zheleznyak I.S., Boykov I.V., Ipatov V.V., Postanogov R.A.

An endometrioid ovarian cyst (known as endometrioma) is the most common variant of external endometriosis. Clinical symptoms range from asymptomatic to negatively affecting on quality of life and daily activities of a reproductive age woman. Rupture of an endometrioid cyst with hemorrhage into the abdominal cavity occurs in 3% of women with this pathology, which is a rare complication.

Ruptured endometrioid cysts may present a diagnostic and surgical challenge: patients may have acute abdominal symptoms and hemodynamic instability, also imaging of a ruptured endometrioid cyst may mimic ovarian malignancy. Therefore, the emergency radiologist needs to know the semiotics of an endometrioid cyst with rupture and hemorrhage into the abdominal cavity.

We represent the clinical case of a prime diagnosed large endometrioid cyst in a 32-year-old patient, complicated by hemorrhage in the abdominal cavity. In the emergency department, the patient underwent native computed tomography and ultrasound investigation.

Based on the study of Russian and foreign literature, the review was made about main aspects of radiation semiotics of endometrioid cysts with rupture and hemorrhage in the abdominal cavity and about of differential diagnosis of rupture of endometrioid cysts with ruptures of functional cysts and malignant cystic ovarian formations.

Russian Military Medical Academy Reports. 2023;42(2):207-214
pages 207-214 views

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