Russian Military Medical Academy Reports

About

“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

Editor-in-Chief

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.

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Current Issue

Vol 41, No 2 (2022)

Original articles

Effectiveness of various regimens of systemic anti-inflammatory therapy with glucocorticoids in the development of acute LPS-induced lung damage in the experiment
Salukhov V.V., Voloshin N.I., Shperling M.I.
Abstract

BACKGROUND: When studying new and effective methods of treating acute respiratory distress syndrome, an immunogenic model of lung injury occupies a special place. To date, the search for the optimal strategy and regimen for the use of glucocorticoids in the development of acute respiratory distress syndromе is relevant.

AIM: The article evaluates the effectiveness of various schemes of systemic anti-inflammatory therapy with glucocorticoids in an experimental model of acute LPS-induced lung injury.

MATERIALS AND METHODS: The study was conducted on 100 outbred male rats. Acute lung injury was modeled using an experimental model of direct acute lung injury by a single intratracheal injection of lipopolysaccharide (LPS) from the cell wall of the bacterium Salmonella enterica (Sigma-Aldrich) at a dose of LD50 (20 mg/kg). All animals were divided into groups (20 each): 1 — intact rats; 2 — control group (LPS + saline); 3 — LPS + dexamethasone 0.52 mg/kg (small doses); 4 — LPS + dexamethasone 1.71 mg/kg (average doses); 5 — LPS + dexamethasone 8 mg/kg (high doses). The drugs were administered intraperitoneally once a day for 3 days. Dexamethasone doses were calculated using the interspecies dose transfer method using a factor that takes into account differences in body surface area.

RESULTS: It has been established that an experimental model based on the endotracheal administration of S. enterica leads to the development of mortality from pulmonary causes. According to a preclinical study, the systemic use of low doses of dexamethasone (0.52 mg/kg) was found to be better than higher doses (1.71 mg/kg, 8 mg/kg) in the treatment of acute LPS-induced lung injury.

Russian Military Medical Academy Reports. 2022;41(2):111-116
pages 111-116 views
State of intestinal microbiocenosis and quality of life in patients with thyroid diseases
Raevskiy K.P., Solovev M.V.
Abstract

BACKGROUND: Non-invasive methods for diagnosing thyroid pathology with an inapparent, asymptomatic or clinically non-specific course is an urgent task of thyroidology today. It seems promising for such diagnostics to use a combination of mass spectrometry of microbial markers of the human intestinal microbiota with an assessment of the quality of life using the 36-Item Short Form Survey (SF-36) questionnaire.

AIM: to study the features of intestinal microbiocenosis and subjective assessment of the quality of life in patients with thyroid diseases.

MATERIALS AND METHODS: 21 patients were examined (8 men and 13 women, median age 40,5 [31,75; 54] years, respectively; 15 with thyroid disease of varying degrees of clinical manifestations, 6 without thyroid disease). In addition to the standard clinical and laboratory-instrumental examination, the patients underwent a study of the contents of the large intestine by the method of chromato-mass spectrometry of microbial markers. Through the use of the SF-36 methodology, an assessment of the quality of life was implemented. Descriptive, nonparametric statistics were used in the work, differences in relative frequency values were determined using Fisher’s exact test. The presentation of the results was carried out using range diagrams, compactly depicting a one-dimensional probability distribution, tables.

RESULTS: Differences in the composition of the microbiota of the control group and the study group for Alcaligenes spp., Staphylococcus spp. were revealed, a downward trend in the level of Megamonas hypermegale, Peptostreptococcus anaerobius in the main group is determined. A tendency revealing a decrease in the quality of life in the study group compared with the control in terms of social functioning, role emotional functioning was revealed.

CONCLUSIONS: Pathology of the thyroid gland is accompanied by deviations in the composition of the fecal microbiota, determined by the method of mass spectrometry of microbial markers. Characteristic features of changes in the intestinal microbiome are a decrease in the level of Alcaligenes spp., Staphylococcus spp., a tendency to decrease in the titers of Megamonas hypermegale, Peptostreptococcus anaerobius. Violation of the endocrine function of the thyroid gland can cause a deterioration in the quality of life, which is manifested by a tendency to reduce social functioning, role-playing emotional functioning.

Russian Military Medical Academy Reports. 2022;41(2):117-125
pages 117-125 views
Temporary prosthetics of the main vessels of the limbs: current experience and further prospects for use at the advanced stages of medical evacuation
Ibragimov R.I., Reva V.A.
Abstract

BACKGROUND: The study is devoted to the damage to the great vessels of the limbs and the surgery of temporary prosthetics of the main arteries during the advanced stages of a medical evacuation. A retrospective analysis of the database containing information from the register of combat injuries of the first and second Chechen campaigns was carried out, from which cases of temporary prosthetics of arteries performed in advanced medical institutions were analyzed.

AIM: The analysis of the cases of temporary artery prosthetics that have been carried out at the advanced medical institutions as well as the improvement of the technique of temporary prosthetic operations with respect to the use of the tool designed and developed by the authors- a three-branch mechanical deep vasodilator.

MATERIALS AND METHODS: A total of 14 wounded who underwent the temporary prosthetics operation were analyzed. The main indication for the patients to undergo surgery was uncompensated ischemia according to the classification of V.A. Kornilov, however, based on the data of the register, the operation was also performed on 5 wounded with compensated ischemia and 3 wounded with irreversible ischemia. At the same time, secondary amputations were performed on only 2 of the 14 wounded. Among the wounded with temporary prosthetics, not a single fatal outcome was detected, despite the presence of a terminal condition in one wounded person (more than 45 points on the “MFS-VD” scale (military-field surgery – vascular damage)). On average, for both Chechen campaigns, the average duration of the functioning of the temporary prosthetics was 8.1 ± 3.4 hours, provided that the role of the temporary prosthesis was mainly performed by their polyvinyl chloride tubes, and the prevention of thrombosis was carried out by local intraoperative administration of a heparin solution. To optimize the temporary prosthetics, the authors designed and manufactured (with the participation of MIZ-Vorsma) a special tool — a three-branch vasodilator, which facilitates the operation. The effectiveness of a three-branch vasodilator was studied on three anesthetized large biological objects (pigs weighing 45–51 kg) during the operation of the femoral arteries temporary prosthetics (diameter of the vessels from 3.9 to 4.3 mm) with a linear installation polyvinyl chloride prosthetics with a length of 3 cm and an outer diameter of 5 mm (a system from drip injection of infusion solutions). In the contralateral limb, temporary prosthetics was introduced without the use of a three-branch vasodilator. The ends of the prosthesis were fixed with ligatures to the artery wall. The time of manipulation without taking access to the artery into account with one assistant for temporary prosthetics was 41.1 (39.3–43.4) seconds, without temporary prosthetics — 59.3 (56.8–59.9) seconds. Manipulations with temporary prosthetics without the use of three-branch vasodilator were twice complicated by episodes of vaso slippage from the wall of the prosthesis, which led to massive bleeding. Such cases were not noted when using the expander.

RESULTS: As a result, the analysis of cases of temporary prosthetics of the main arteries of the limbs demonstrated the high effectiveness of the intervention aimed at stopping bleeding and maintaining temporary perfusion of the limb. Secondary amputations were performed on 14% of the wounded (2/14), no fatal cases have been reported. The tool developed to facilitate temporary prosthetics surgery can shorten the term of intervention, reduce intraoperative blood loss, limit the number of assistants and can be recommended for practical use in the advanced stages of evacuation.

Russian Military Medical Academy Reports. 2022;41(2):127-131
pages 127-131 views
Surgical treatment of patients with ruptures of the trachea
Tishchenko E.A., Fufayev E.E., Barinov O.V.
Abstract

BACKGROUND: Currently, the incidence of iatrogenic ruptures of the trachea averages 0.02–0.07% with elective tracheostomy and intubation, but in the event of an emergency procedure, this figure rises to 15%. The feasibility and validity of the use of one or another method of treating tracheal injuries is the subject of discussion among the authors of scientific studies and specialists. There is no single generally accepted method of treatment that would be effective for various types and degrees of damage to the tracheal wall.

AIM: to determine the indications for various types of surgical intervention based on the analysis of the results of treatment of patients with tracheal ruptures.

MATERIALS AND METHODS: The study included 10 patients with iatrogenic tracheal ruptures. All patients underwent a comprehensive diagnosis using physical, laboratory, radiation and instrumental methods of research, as well as an analysis of the effectiveness of various methods of treating tracheal rupture, depending on the nature of the injury.

RESULTS: Patients with grade 1 and 2 tracheal injury with no or uncomplicated gas syndrome are treated conservatively. In patients with grade 2 tracheal injury and progressive gas syndrome, tracheostomy and mediastinal drainage are effective. With ruptures to the entire depth of the wall (3A and 3B degrees), surgical intervention with suturing of the trachea is indicated. In the case of functional inoperability of a patient with severe tracheal ruptures, one of the effective treatment options is the use of extracorporeal membrane oxygenation in combination with minimally invasive drainage interventions.

CONCLUSION: indications for various methods of treatment of patients with tracheal ruptures have been formulated. The developed management algorithm is used in providing care to patients with tracheal injury in hospitals of the S.M. Kirov Military Medical Academy.

Russian Military Medical Academy Reports. 2022;41(2):133-142
pages 133-142 views
Innovative technology of total parietal peritonectomy for peritoneal carcinomatosis
Prosvetov V.A., Surov D.A., Gaivoronsky I.V., Nguyen V.
Abstract

BACKGROUND: Peritonectomy is an integral part of cytoreductive surgery, accompanied by a fairly high incidence of postoperative complications and mortality. In this regard, the improvement and development of easy-to-perform, low-traumatic and safe methods of peritonectomy are topical in oncology.

AIM: Based on experimental studies to develop a technology of pneumodissection of the peritoneum using carbon dioxide insufflation and evaluate its effectiveness.

MATERIALS AND METHODS: The study was conducted on 10 non-embalmed corpses of deceased people whose cause of death is not related to tumors of the abdominal cavity and pelvic organs. The Karl STORZ Thermoflator 26432020-1 Insufflator (FSZ registration certificate 2011/09444, dated 12/21/2017), carbon dioxide cylinders with a volume of 20 liters, silicone lines 1.5 meters long, 1 cm in diameter; Seldinger puncture needle 18 G; flexible polypropylene bougie 16 G were used.

RESULTS: The conducted experimental study made it possible to develop and test a method of total parietal peritonectomy based on the technology of peritoneal pneumodissection using carbon dioxide insufflation. The analysis of the obtained results made it possible to define the concept of a new technology as a method of tissue separation based on the insufflation of carbon dioxide into the connective tissue layers of the retroperitoneal space for the purpose of safe dissection of anatomical structures.

CONCLUSIONS: Peritoneal pneumodissection using gas insufflation is a new and promising technology with a number of obvious advantages. First of all, they include ease of execution, low injury, high safety and, probably, ablasticity, which can potentially create conditions for the prevention of unintentional dissemination of tumor cells in the abdominal cavity. The data obtained as a result of the experimental study allow us to conclude that pneumodissection of the peritoneum using carbon dioxide insufflation is an effective method of performing total parietal peritonectomy and can be used in performing cytoreductive surgical interventions in patients with peritoneal carcinomatosis.

Russian Military Medical Academy Reports. 2022;41(2):143-149
pages 143-149 views
Assessment of the state of the cardiovascular system in young and middle-age military men depending on the level of blood serum uric acid
Shapoval D.S., Dydyshko V. .
Abstract

BACKGROUND: The prevalence of asymptomatic hyperuricemia is about 10%. It is a frequent companion of cardiorenometabolic diseases. Hyperuricemia contributes to systemic inflammation, leads to endothelial dysfunction and impaired renal function. An increase in blood pressure occurs due the to the activation of the renin-angiotensin-aldosterno system in hyperurecemia. The level of uric acid more than 360 µmol/l in women and more than 420 µmol/l in men serves as an unfavorable prognosis factor. Increased attention is needed to monitoring uric acid, especially in those with multiple risk factors for the development of cardiovascular disease.

AIM: to study clinical, laboratory and instrumental indicators of the cardiovascular system in men with normouricemia and hyperuricemia to improve prevention.

MATERIALS AND METHODS: The clinic analyzed the case histories of 355 patients aged 30 to 50 years. All examined, depending on the level of blood uric acid, were divided into 4 groups: the 1st group (58 people) — 299 µmol/l, the 2nd (104 people) — 300–359 µmol/l, the 3rd (104 people) 360–419 µmol/l and the 4th (89 people) — 420 µmol/l. Clinical, laboratory and instrumental indicators of cardiovascular system, physical performance and hemodynamic response to physical activity according to bicycle ergometry were studied.

RESULTS: It has been established that hyperuricemia is associated with an increase in office and daily BP parameters, an increase in heart rate, R wave amplitude in the AVL lead on the ECG, glycemia, lipidemia, SCORE risk, relative left ventricular wall thickness and left atrial size, and left ventricular diastolic function. The total amount of exercise performed, maximum heart rate and exercise tolerance in people with normal uricemia significantly exceed those in patients with hyperuricemia, and the initial heart rate and peak and blood pressure in the recovery period are significantly higher with hyperuricemia, compared with men with normouricemia.

Russian Military Medical Academy Reports. 2022;41(2):151-161
pages 151-161 views
Characteristics of the metabolic profile and the state of the vascular wall in men with metabolically neutral obesity
Sokolov D.A., Serdyukov D.Y.
Abstract

BACKGROUND: The prevalence of overweight in the Russian population is increasing every year. A diet with an excessive amount of easily digestible carbohydrates, low physical activity contribute to the rapid development of obesity at a young age. In Russia, 26% of the male population and 30% of women are overweight. When examining obese patients, the adipokine activity of adipose tissue is not taken into account in daily medical activities. The current concept of metabolically healthy obesity causes certain discussions in the scientific community due to diagnostic difficulties in stratifying overweight patients into metabolically “healthy” and “unhealthy”.

AIM: was to characterize the lipid and carbohydrate profile, as well as to evaluate changes in the vascular wall in men with metabolically neutral obesity after a 3–4-year curation period.

MATERIALS AND METHODS: The hospital therapy clinic analyzed the case histories of 93 patients aged 30 to 45 years. The study group of patients was examined twice: initially and 3–4-years after the initial examination. An anthropometric profile was examined in the designated sample of patients, a study of biochemical blood analysis was performed, and an assessment of the cardiovascular system was carried out.

RESULTS: of the study showed that the metabolically neutral type is characterized by a low frequency of metabolic profile disorders, as well as parameters of the cardiovascular system.

CONCLUSIONS: The probability of developing new cases of prediabetes, type 2 diabetes mellitus and initial atherosclerosis is maximal in patients with previously diagnosed insulin resistance and metabolically healthy obesity, minimal — with normal body weight and in patients with metabolically neutral obesity.

Russian Military Medical Academy Reports. 2022;41(2):163-168
pages 163-168 views
Health-related quality of life in iron deficient young women
Kovalev A.V., Polyakov A.S.
Abstract

BACKGROUND: The most important cause of anemia in the world is iron deficiency. Young women are more susceptible to the formation of latent iron deficiency and iron deficiency anemia in comparison with other population groups. Iron deficiency conditions can lead to a deterioration in exercise tolerance and adaptation to them, however, the effect of latent iron deficiency and iron deficiency anemia on cognitive functions, emotional status and quality of life is still a subject of discussion, which may be due to the small number of studies in which iron deficiency conditions are studied in the absence of concomitant chronic diseases.

AIM: Evaluate the effect of latent iron deficiency and iron deficiency anemia on the quality of life in young women.

MATERIALS AND METHODS: a cross-sectional simultaneous study was conducted in women aged 18–21 years. The occurrence of iron deficiency conditions was assessed, a study of the quality of life was conducted using the SF-36 questionnaire. In the statistical processing of the results obtained, the assessment of normality within each group was carried out using Shapiro-Wilk test. For an intergroup comparison of the results obtained between two independent groups, Mann–Whitney test was used, and Wilcoxon test was used when comparing the results of two dependent groups. The intergroup comparison between the three groups was carried out using Kruskal–Wallis test. When detecting deviations from the null hypothesis, a posteriori analysis was carried out using Mann–Whitney test with Bonferroni correction.

RESULTS: 68 subjects aged 18–21 took part in the study. The median age was 18 years [18; 21]. 25 (36.7%) women were diagnosed with ID, 16 (23.5%) with IDA. The level of C-reactive protein in all subjects was <5 mg/l, median 2.4 [1.2; 3.1] mg/l. During a posteriori analysis, comparable indicators of the total blood count between the groups of healthy women and those with ID were revealed. At the same time, there were no differences in ferritin levels between the ID and IDA groups. In the study of quality of life, statistically significant intergroup differences between the study groups were obtained in the scales of general health, vital activity, role functioning due to emotional state, mental health and general mental well-being. When conducting a posteriori analysis, the number of points in the questionnaire scales turned out to be comparable between groups of healthy women and those with ID.

CONCLUSIONS: data on the high incidence of latent iron deficiency and iron deficiency anemia in young women have been obtained. The presence of latent iron deficiency does not independently affect the quality of life associated with health. Mild iron deficiency anemia moderately reduces the quality of life due to the emotional component.

Russian Military Medical Academy Reports. 2022;41(2):169-174
pages 169-174 views
To the question of the main of acute urinary retention development during myocardial infarction in young and middle-aged men predictors
Izmukhanov A.S., Rejza V.A.
Abstract

BACKGROUND: Importance in assessing the course and prognosis of myocardial infarction is given to the study of a combination of two or more chronic diseases in one patient, interconnected by a single pathogenetic mechanism. Urological diseases are not among the most common in myocardial infarction, but during this period they significantly worsen the quality of life, increase the cost of treatment and are also associated with a worse prognosis.

AIM: To study the development of acute urinary retention during the acute and subacute periods of myocardial infarction risk factors in men under 60 years old to improve prevention and outcomes.

MATERIALS AND METHODS: The study included men aged 19–60 years with type I myocardial infarction. Patients were divided into two age-comparable groups: I — study group, with acute urinary retention — 22 patients; II — control, without urination disorders — 644 patients. A comparative analysis of the main and additional cardiovascular risk factors observation frequency, the features of the clinical course in the selected groups were performed. Pearson’s Chi-square method was used to analyze the risks of developing acute urinary retention.

RESULTS: The structure of cardiovascular risk factors in the study group differed from the control group in a higher frequency of coronary artery bypass surgery in the medical history (I: 31.8%; II: 8.4%; p = 0.0002) and pacing (9.1 and 0.5%; respectively; p < 0.0001), as well as fibrillation and/or atrial flutter in the medical history (27.3 and 9.2%; p = 0.005), chronic cerebrovascular insufficiency (77.3 and 51.3%; p = 0.02), alcohol abuse (63.6 and 25.2%; p < 0.0001), frequent (four and more per year) colds (27.3 and 12.6%; p = 0.04), cardiac arrhythmias and conduction disorders at the onset of coronary artery disease (61.9 and 24.9%; p = 0.0007), smoking for 20 years or more (36.4 and 16.8%; p = 0.003), chronic kidney disease (46.7 and 16.2%; p = 0.02), chronic infection foci of internal organs (77.3 and 39.4%; p = 0.002), urinary (27.3 and 8.6%; p = 0.006) and cholelithiasis (13.6 and 5.4%; p = 0.006). Among the features of the clinical course of the disease, the study group was distinguished by a higher incidence of multiple complications of myocardial infarction (100 and 44.0%; p < 0.0001), severe and extremely severe condition of patients (59.0 and 19.6%; p < 0.0001). Asystole (absolute risk: 42.1%; relative: 18.0; p < 0.0001), hydrothorax (absolute risk: 41.7%; relative: 15.9; p < 0.0001), the patient’s severe condition in the first hours of illness (absolute risk: 100%; relative: 36.5; p < 0.0001), alcohol abuse (8.0%; 4.9; p < 0.0001), smoking (absolute risk: 4.4%; relative: 8.0; p = 0.01) and onset of CHD with heart rhythm and conduction disturbances (7.7%; 4.6; p = 0.0001) were the most significant predictors of acute urinary retention.

CONCLUSIONS: Patients with acute urinary retention are characterized by a more severe course of myocardial infarction. Combinations of listed above factors indicate an increased risk of developing this complication. It is advisable to use them for predictive modeling and the formation of risk groups for early prevention.

Russian Military Medical Academy Reports. 2022;41(2):175-186
pages 175-186 views
Stopping intra-abdominal bleeding with promising local biocompatible hemostatic agents
Kovalevskiy A.Y., Nosov A.M.
Abstract

BACKGROUND: In this study, for the first time, an experimental evaluation of the effectiveness of samples of a new local biocompatible hemostatic agent in the form of a gel based on chitosan was carried out with ongoing intra-abdominal bleeding.

AIM: to evaluate the effectiveness of promising local biocompatible hemostatic agents for ongoing intra-abdominal bleeding in an experiment using biological objects.

MATERIALS AND METHODS: When performing this work, an experimental model was developed on biological objects (rabbits) to evaluate the effectiveness of hemostatic agents in the form of a gel with continued bleeding from a liver wound.

RESULTS: During the experiment, the high efficiency of new LBHA samples was established, which allowed to avoid mortality in comparison with the control group, where the mortality rate was 100%.

CONCLUSION: The developed experimental model, which includes injury to the liver with the subsequent development of intense intra-abdominal bleeding, has fully justified itself. The use of local biocompatible hemostatic agents in the form of a gel is a promising way to achieve hemostasis in the early stages of medical evacuation for abdominal injuries, which in turn has the potential to significantly reduce the number of deaths caused by ongoing intra-abdominal bleeding. The data obtained, indicating the high efficiency of individual samples, make it possible to consider the continuation of research in this direction appropriate. Further evaluation of the efficacy and safety of local biocompatible hemostatic agents requires additional studies on medium and large biological objects with all the samples presented to determine their effect on the body, biocompatibility, as well as local irritant action.

Russian Military Medical Academy Reports. 2022;41(2):187-194
pages 187-194 views
Diagnosis of infectious complications in patients with acute pancreatitis
Sishchikov D.S., Alent’ev S.A.
Abstract

BACKGROUND: Up to 30% of patients with acute pancreatitis suffer from the severe form of the disease, of which 30% of cases are lethal, significantly rising to 80% at the development of infectious complications.

AIM: To improve treatment results of patients with acute pancreatitis due to early diagnostics of infectious complications.

MATERIALS AND METHODS: Expression of CD64 antigen on neutrophil membrane (DC64 index of neutrophils) was studied using a flow cytometer “Cytomics FC500” (Beckman Coulter, USA) using 3-color combination of direct monoclonal antibodies “Beckman Coulter”: СD14FITC/CD64PE/CD45PC5. Material was whole blood.

RESULTS: A direct correlation of moderate strength with the development of sepsis was found for both the procalcitonin value and C-reactive protein concentration at this period of illness. However, no relations of endogenous intoxication markers with the development of infectious complications were found (correlation coefficients less than 0.4). Thus, it should be noted that the difference in the indices of the studied parameters of the CD64 antigen expression in the groups began to increase exactly during the 2–3rd week of the disease.

CONCLUSION: Based on the literature data, we formulated a working hypothesis, which states that the degree of CD64 receptor expression on peripheral blood neutrophils is an early marker of infectious complications of acute pancreatitis. The value of average fluorescence intensity index of molecules CD64 equal to 10 conventional units was accepted as a threshold value with regard to the development of IE, and the value of 15 conventional unitsas a threshold value with regard to sepsis. The study was conducted in a prospective group of 28 patients. In accordance with the provision of the working hypothesis, the patients were divided into 3 groups depending on the level of average fluorescence intensity index of molecules CD64. Expression of the CD64 receptor on peripheral blood granulocytes as an early laboratory marker of infectious complications of the disease was studied for the first time. We determined sensitivity and specificity, optimal terms of the given research, detected regularities of CD64 expression changes in the course of acute pancreatitis, correlations with other clinical and laboratory indexes, including prospective markers of infection (procalcitonin, C-reactive protein), with the integral scales of severity estimation of patients with acute destructive pancreatitis. Determination of the level of the receptor CD64 expression on the peripheral blood neutrophils showed that this marker reflects the dynamics of the disease course and gives the possibility of the early diagnostics of the infectious complications of acute pancreatitis. The use of this method provides additional information about the development of the surgical infection. It is important that the changes of CD64 antigen expression in dynamics outrun other markers of systemic inflammatory response and sepsis. CD64 antigen expression data on peripheral blood neutrophils is an additional factor in determining differentiated surgical tactics in phase I of the disease’s development with regard to acute fluid collections in patients with acute pancreatitis.

Russian Military Medical Academy Reports. 2022;41(2):195-201
pages 195-201 views
Possibilities of antifibrotic therapy and correction of cognitive disorders in experimentally induced severe liver fibrosis and cirrhosis in rats
Chernenok M.G., Saulevich A.V., Zhdanov K.V., Zakharkiv Y.F., Kozlov K.V., Sukachev V.S., Zakharenko S.M., Mukhtarov R.M., Karev V.E., Gavrilyuk T.V., Ivanov K.S., Lyashenko Y.I., Zhabrov S.S.
Abstract

BACKGROUND: The main pathogenetic aspects of the correction of cognitive impairment of the brain and antifibrotic therapy against the background of experimentally induced severe fibrosis and cirrhosis of the liver in rats are considered. Viral hepatitis of various etiologies is one of the main problems of modern health care. The incidence of viral hepatitis is 30 million cases per year. Mortality from complications of acute viral hepatitis, such as cirrhosis of the liver and hepatocellular carcinoma, reaches 1.4 million cases per year. At the same time, in some cases, etiotropic therapy does not provide stabilization or regression of fibrotic changes in the liver tissue in comorbid patients, as well as in patients receiving antiviral therapy at the stages of severe fibrosis and compensated liver cirrhosis, which requires the search for new therapeutic approaches related to, first of all, with the possibility of influencing non-specific processes of fibrogenesis. Hepatic encephalopathy in such patients leads to the appearance of behavioral, cognitive and motor disorders of varying severity, thereby having a negative impact on the operator’s function in such professions as pilots, dispatchers, in a number of military specialties, etc. Thus, therapy aimed at the key links of pathogenesis often plays a decisive role in the treatment of liver diseases, especially in the later stages.

AIM: To identify the presence and severity of cognitive impairment in rats with induced severe liver fibrosis and liver cirrhosis before and after therapy with Bicyclol® and to assess the degree of its antifibrotic effect.

MATERIALS AND METHODS: The study included 70 male Wistar rats weighing 180–200 g, in which toxic fibrosis and cirrhosis of the liver were induced at stages F3 and F4. The control group consisted of 10 individuals who received a normal diet, the experimental group — 24, who, in addition to the standard diet, were prescribed the drug Bicyclol®. The assessment of cognitive impairment of the brain was carried out using a test with a hidden platform in the Morris water maze and statistical analysis. The evaluation of the results of the use of the drug was carried out using histological examination, methods of biochemical, molecular biological and statistical analysis.

RESULTS: The use of the drug Bicyclol® leads to a marked decrease in fibrotic changes in the liver tissue of experimental animals and was accompanied by a temporary decrease in the activity of alanine aminotransferase in blood serum. Against the background of the development of induced toxic fibrosis and cirrhosis of the liver in rats, cognitive dysfunctions of the brain were observed, which significantly decreased against the background of the use of the drug Bicyclol®.

CONCLUSION: Results The use of bicyclol for 4 weeks in laboratory animals with induced severe liver fibrosis led to a long-lasting decrease in the severity of fibrotic changes in liver tissue, as well as to the regression of cirrhosis in rats with liver cirrhosis. These changes were accompanied by a decrease in cognitive impairment in rats of these subgroups, as evidenced by an improvement in the estimated indicators when performing a control complex in a Morris water maze with a hidden platform.

Russian Military Medical Academy Reports. 2022;41(2):203-216
pages 203-216 views

History of medicine

The main milestones of the creation, formation and subsequent development of the military scientific society of cadets and trainees Military Medical Academy
Salukhov V.V., Ovchinnikov D.V., Kurenkova I.G., Sharypova T.G.
Abstract

The Kirov Military Medical Academy is the main training center for military doctors of the Ministry of Defense of the Russian Federation. Great Russian scientists worked within the walls of the Academy: N.I. Pirogov, I.M. Sechenov, S.P. Botkin, I.P. Pavlov, V.M. Bekhterev. Many scientists of the Military Medical Academy, who have ma

The Kirov Military Medical Academy is the main training center for military doctors of the Ministry of Defense of the Russian Federation. Great Russian scientists worked within the walls of the Academy: N.I. Pirogov, I.M. Sechenov, S.P. Botkin, V.V. Pashutin, I.P. Pavlov, V.M. Bekhterev. Many scientists of the Military Medical Academy, who have made a huge contribution to domestic and world medical science, began their scientific activities in their student years. Deep professional knowledge and love for the profession have always distinguished the students of the Military Medical Academy. These remarkable qualities were especially vividly manifested during wars, epidemics, and other social upheavals. The command of the Academy, the teaching staff have always supported the students’ desire for scientific research. A landmark event was the creation of the Theoretical medicine circle in 1910 under the patronage of the Academy Conference. For almost half a century of history (since 1910), with varying intensity, there was a School of Scientific Societies at the Academy and at various departments, which involved its students in scientific activities. The formal date of establishment of the Military Medical Academy named after S.M. Kirov “Military Scientific Society of cadets and trainees of the Academy” in its current form is 1950 (order of the Head of the Academy No. 812 of August 16, 1950). Military scientific activity of trainees and cadets is a form of independent work aimed at acquiring deep and solid knowledge in military professional activities. It is closely connected with the educational process and is in line with the scientific work of the departments and research units of the Academy. Students develop individual scientific topics, and at the meetings of the circles the completed works and current medical problems are discussed. The best works are heard at the annual conferences of listeners. In recent years, the level of scientific activity of students of all courses and all faculties has increased markedly. Students have at their disposal the latest medical equipment, extensive clinical material, electronic computing technology in complex mathematical processing of scientific materials, the help of teachers, the rich heritage of scientific medical schools. At present, the “Military Scientific Society of cadets and trainees of the Academy” of the Military Medical Academy is an effective forge of personnel to maintain the scientific potential of the Academy and the development of its scientific schools.

de a huge contribution to domestic and world medical science, began their scientific activities in their student years. Deep professional knowledge and love for the profession have always distinguished the students of the Military Medical Academy. These remarkable qualities were especially vividly manifested during wars, epidemics, and other social upheavals. The command of the Academy, the teaching staff have always supported the students' desire for scientific research. A landmark event was the creation of the Theoretical medicine circle in 1910 under the patronage of the Academy Conference. For almost half a century of history (since 1910), with varying intensity, there was a School of Scientific Societies at the Academy and at various departments, which involved its students in scientific activities. The formal date of establishment of the Military Medical Academy named after S.M. Kirov "Military Scientific Society of cadets and trainees of the Academy" (VNKS) in its current form is 1950 (order of the Head of the Academy No. 812 of August 16, 1950). Military scientific activity of trainees and cadets is a form of independent work aimed at acquiring deep and solid knowledge in military professional activities. It is closely connected with the educational process and is in line with the scientific work of the departments and research units of the Academy. Students develop individual scientific topics, and at the meetings of the circles the completed works and current medical problems are discussed. The best works are heard at the annual conferences of listeners. In recent years, the level of scientific activity of students of all courses and all faculties has increased markedly. Students have at their disposal the latest medical equipment, extensive clinical material, electronic computing technology in complex mathematical processing of scientific materials, the help of teachers, the rich heritage of scientific medical schools. At present, the ISS of the Military Medical Academy is an effective forge of personnel to maintain the scientific potential of the Academy and the development of its scientific schools.

Russian Military Medical Academy Reports. 2022;41(2):217-227
pages 217-227 views
History of the study of physiology and pathology of lacrimal secretion at the professor V.V. Volkov Ophthalmology Department at the S.M. Kirov Military Medical Academy
Kulikov A.N., Belokurova S.V., Poritsky Y.V., Kol’bin A.A.
Abstract

Вased on the analysis of literature data the information about the history of physiology and pathology of the lacrimal organs at the department of ophthalmology named after Professor V.V. Volkov of the Military Medical Academy is summarized and structured. The work is based on the historical-genetic method, including analysis of the literature and Internet resources represented by theses, abstracts, monographs and scientific articles. Materials from the libraries of the following institutions were used when writing the work: Helmholtz National Medical Research Center, Federal State Budgetary Educational Institution of Higher Education Kirov Military Medical Academy of the Russian Defense Ministry. The main works performed under each head of the chair which contributed to the development of national and world dacryology are shown. The work covers the period since the chair was founded in 1818 and headed by Josef Ernst Gruby up to the present day. Scientific works of the chair during the period of professors Boris L. Polyak and Veniamin V. Volkov leadership are analysed in detail. Modern methods and techniques used both for the therapeutic process and for teaching are described. The necessity of preserving traditions of the department and development of new directions is emphasized.

Russian Military Medical Academy Reports. 2022;41(2):229-237
pages 229-237 views


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