bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic researches in standards of delivery of health care
Authors: Kravtsov V Yu , Solovev A I , Ivanov I A
Published: July 2021

The analysis of legal base of genetic researches in clinical practice is carried out. Modern standards of medical care are analyzed. The list of the diseases and pathological states demanding performance of genetic researches is made. The list of the medical services connected with genetic researches is also made. It is shown, that genetic researches make 10% of the nomenclature of medical services. From them about 60% medical services provide diagnosis of somatic pathology, the others are directed to identification of nucleinic acids of causative agents of infectious and parasitic diseases. Genetic researches are carried out mainly at a stage of specialized and primary medical care. Genetic researches are included in20% of standards of medical care. Genetic researches are conducted concerning 15 classes of diseases. More often genetic researches are conducted for diagnosis of the latent infections, enzimopatiya, hereditary diseases of a metabolism, and also cancer. There are some problems of cytogenetic and molecular genetic diagnostics in hospitals. Genetic researches are complex and expensive. Interpretation of the received results is difficult. It is necessary to develop standards of genetic researches. It is necessary to improve legal base of genetic researches.
Chemokines’ role in immunopathogenesis of atherosclerosis
Authors: Moskalev A V , Sboychakov V B , Tsygan V N , Apchel A V
Published: July 2021

The results obtained and conflicting data of immunopathogenesis of inflammation and atherosclerosis are analyzed. The role of macrophages and T-lymphocytes in the endothelium damage and formation of an atherosclerotic plaque is shown. Chemokine-leading processes initiating the data processes - macrophage chemotactic protein, interleukin 8, fractalkine. An important role in the initiation of intercellular interaction with the subsequent development of the alliance CD40 and their ligands, expressed by various cell types, participants in the immune-inflammatory process - CD154. The role of subpopulations of T-lymphocytes - 1st, 2nd and 3rd, as well as regulatory T-lymphocytes in the atherosclerotic process was analyzed. An experimental data on the role of chemokines in the development of atherosclerotic process is described. The role of the factor inhibiting migration and providing the concentration of effector cells in the area of atherosclerotic plaque, which lead to its destabilization, is of great importance. It has been shown experimentally that the expression of inhibition factor migration correlates with the intensity of atherosclerotic process. The information on the factor contributing to the output of stromal cells is presented. Experimental data show that the development of coronary heart disease is associated with it. Its deficiency contributes to the development of the disease, and an increase - improves the course of the disease and has a stabilizing effect on atherosclerotic plaques. The role of hemokine (CXC motif) ligand 10 and 11 in the process of atherosclerosis has been experimentally proved. They have a controlled effect on chemotaxis and T-lymphocyte function in the process of atherosclerotic lesion formation.
Possibilities of use of arc-type discharge low-temperature air plasma of atmospheric pressure for burn wound treatment
Authors: Zinovyev E V , Tsygan V N , Asadulayev M S , Borisov O V , Lopatin I M , Lukyanov S A , Artsimovich I V , Paneyakh M B , Kostyakov D V , Kravtsov S N , Zubov V V , Osmanov K F
Published: July 2021

Results of experimental assessment of efficiency of use of low-temperature air plasma of the arc category of atmospheric pressure at treatment of burns of skin of the III degree in small laboratory animals are given. It is established that use of low-temperature air plasma of the arc-type discharge of atmospheric pressure allows to accelerate terms of final healing of wounds for 49% (p0,05), to reduce development frequency in them purulent inflammation by 45,5% (p0,01). Positive influence of air and plasma processing on dynamics of the area of a hem which after single influence by 35 days is reduced for 67% is revealed (p0,01). The analysis of a histologic picture confirms acceleration of formation of an extracellular matrix and epitelization against the background of impact of an air and plasma stream on wounds. Processing of a wound of low-temperature air plasma of the arc category of atmospheric pressure after an early surgical escharotomy allows to form on a wound surface a so-called nanofilm of a layer the coagulated proteins of wound exudate and cellular fragments which has selective vapor permeability, reduces an rate of wounds pathogenic infection, prevents drying and as a result, allows to reduce the frequency of development of purulent complications and extent of zones of a secondary necrosis. Influence of a stream of low-temperature air plasma of the arc-type discharge of atmospheric pressure allows to optimize significantly processes of reparative regeneration in a zone of a deep burn of skin at a stage of preparation for their surgical treatment.
Experimental evaluation of the effectiveness of local treatment of skin burns with сarbopol easier to disperse 2020 hydrogel with human leukemia differentiation factor-6 peptide
Authors: Zinoviev E V , Tsygan V N , Artsimovich I V , Asadulayev M S , Paneyakh M B , Zubov V V , Lukyanov S A , Kostyakov D V , Zhilin A A , Lopatin I M , Umanskaya A A , Osmanov K F , Kravtsov S N , Apchel A V , Zolotarev Yu A , Dadayan A K , Dadayan K A
Published: July 2021

The results of experimental evaluation of the effectiveness of topical application of the peptide human leukemia differentiation factor-6 in carbopol hydrogel easier to disperse 2020 in thermal burns of skin of III degree are presented. It was found that local application of human leukemia differentiation factor-6 peptide in hydrogel carbopol in concentration from 0,01% to 0,00001% causes acceleration of wound epithelialization processes by 28 days by 71,11% (p0,01) and reduces the incidence of purulent complications by 62,5% (p0,05). Histological examination of biopsy specimens of wounds revealed essential features of morphometry, considering the chosen method of treatment and concentration of peptide of human leukemic factor-6 differentiation in carbopol hydrogel. The proposed method of local treatment of burn skin lesions is very promising for optimizing the flow of reparative regeneration processes. The low frequency of purulent complications in the group of animals treated with a minimum peptide content may be due to the combined action of carbopol hydrogel as determinants of wound healing in a wet environment, and the optimal concentration of the peptide human leukemia differentiation factor-6, providing anti-inflammatory effect in a minimum concentration. Analysis of the histological pattern in the studied groups of animals allows us to conclude about the acceleration of the formation of the extracellular matrix, and epithelialization of the wound surface on the background of an application of the peptide human leukemia differentiation factor-6 minimum concentration. On the 14th day of observation the number of microvessels in granulation tissue among animals treated with human leukemia differentiation factor-6 in carbopol hydrogel easier to disperse 2020 with minimum concentration (0,00001%) was 40,6-43,75% more than in the comparison groups. The use of biologically active peptides is one of the promising methods of wound process optimization. human leukemia differentiation factor-6 peptide can selectively stimulate proliferation by enhancing redox processes in cells.
Evaluation of the opportunity of conservation of plasma and blood serum by freezing for the following investigation of vitamins content
Authors: Kirichenko N N , Zakrevskiy V V , Smetanin A L , Konovalova I A , Martynova Ye S , Lazarenko L P
Published: July 2021

The possibility of freezing samples of human plasma and serum at minus 18°C for subsequent research on the content of vitamins has been experimentally proved. Plasma and serum samples of 40 military personnel were examined on the day of blood collection (without freezing) and then compared with the results of the analysis of the same samples that were frozen at minus 18°C after 7, 60 and 120 days of storage. We used the method of simple freezing of plasma and serum samples in the freezer at a temperature of minus 18°C for a period of not more than 120 min after blood collection. Defrosting after storage was carried out passively at room temperature. The content of folic acid, vitamins B1, B2, B12, C, A, D, E wasstudied using high-performance liquid chromatography, immunochemoluminescence, fluorimetric and spectrophotometricmethods. According to the results of the statistical comparison of the content of the studied vitamins in fresh and frozenplasma and serum samples, the absence of significant differences between the samples was established; the deviation from theinitial values did not exceed 1-2% on average. The proposed method of preserving samples of human plasma and serum byfreezing at a temperature of minus 18°C can be used to analyze the content of vitamins in frozen samples, without the use ofcorrection factors. Initially, the technique was tested to organize the study of the vitamin security of military personnel servingin the Arctic zone of the Russian Federation. The practical significance of the study is to offer a convenient and affordablemethod of preserving plasma and serum samples for transportation in frozen form from remote areas, where the laboratorypossibilities of studying the content of vitamins in the blood for therapeutic and prophylactic purposes are limited. Frozensamples are convenient for storage up to 12 days when their immediate laboratory research is impossible.
Modern approaches to diagnosis and treatment of bacterial liver abscesses
Authors: Dzidzava I I , Kotiv B N , Apollonov A A , Smorodsky A V , Slobodjanik A V , Soldatov S A , Kudrjavceva A V , Dmitrochenko I V , Afanasyev A A
Published: July 2021

Modern notions about etiology, pathogenesis and microbiological characteristics of bacterial liver abscesses are analyzed. Cholangiogenic abscess is a prevailing type among the incidences of liver abscesses. Today Klebsiella pneumoniae strains are the predominant cause of pyogenic hepatic abscess. Diagnosis of liver abscesses is based on a combination of clinical and laboratory findings and visualization survey methods. Success in the treatment of liver abscesses is provided by a multimodal approach, including sanation of purulent focus, rational antibacterial therapy and elimination of the main etiologic factor. Effective antibiotic therapy is based on the results of permanent microbiological monitoring of the abscess cavity, bile and blood contents. The question remains about what is the optimal time frame for antibiotic therapy. The main method of treatment of liver abscess is surgical. In the vast majority of cases, minimally invasive puncture-drainage under ultrasound or CT guidance proves to be an effective and sufficient method of treatment, regardless of the size, location and number of purulent foci. There is no consensus, however, on a differentiated choice of minimally invasive sanitation techniques, drainage periods and removal criteria in medical literature. An algorithm for treatment of cholangiogenic liver abscesses must include methods that ensure restoration of the bile ducts patency, relief of biliary hypertension and cholangitis. If the minimally invasive drainage techniques proves ineffective, as well as in cases of complicated abscess or presence of large sequesters in the destruction cavity, it is recommended to perform laparoscopic or traditional open surgery (including liver resections).
Experience of organizational-methodological and practical work doctors groups gain military medical units and organizations of the Ministry of defence of the Russian Federation
Authors: Zhdanov K V , Sidorchuk S N , Zakharenko S M , Potekhin I V
Published: July 2021

The epidemiological situation for acute respiratory diseases, chickenpox, meningococcal infection in the garrisons, as well as in the whole regions of Russia, is unstable. Group and flash morbidity are registered, which determines the relevance of this pathology. Diseases of the X class occupy a leading position in the structure of the overall morbidity, both among conscripts and contract soldiers. The prevalence of infectious diseases in the structure of morbidity of servicemen of the armed forces of the Russian Federation is due to the combined effect of factors of communal and domestic arrangement and military labor. The article summarizes the experience of organizational, methodological and practical work of doctors- specialists of strengthening the staff of the Department of infectious diseases of the Military Medical Academy. S.M. Kirov in the organization of medical-evacuation support of patients with infectious diseases in military units (training centers) and military medical organizations of the military districts (Northern Fleet) in the context of daily activities of troops (forces) in the period of the seasonal rise of morbidity. The problematic issues of the organization of medical and evacuation support of infectious patients, the task of improving the level of work as a medical service (especially pre-hospital level) and doctors- specialists strengthening groups to prevent the spread of infectious diseases among the personnel. It is established that the level of General morbidity increased during the analyzed period, mainly due to respiratory diseases. In the structure of infectious diseases, the most relevant are adenovirus diseases, chickenpox, meningococcal infection. Currently, in the military units (training centers) of the armed forces of the Russian Federation, there is no single guide (position) for the organization of additional (non-standard) insulator. The order of actions of commanders (chiefs) on the organization of its deployment and functioning is not defined.
Fundamental life motivations and the prerequisites for their realization in young men in different ethnocultural groups
Authors: Uliukin I M , Emelyanov V N , Berezovskii A V , Orlova E S , Zyukin A V , Makarova L P
Published: July 2021

Аbstract. The work deals with fundamental life motivation and preconditions for their implementation in young men of different ethnolinguistic groups in terms of existential fulfilment. It is shown as a similarity (due to a long common history in the groups of «Slavs-Turks» and well-expressed in all nations and nationalities by the concept of freedom), and the difference in scales of methodology by A. Langle and C. Orgler «Scale of Existence», conditioned for Eastern peoples by the commonality of religion and geographical features of residence, values, due to the ethnocultural characteristics of the surveyed persons. Therefore, in the process of medical and psychological support of people of different ethnolinguistic groups, it is necessary not only to pay attention to the evaluation of the characteristics of their personality, but also to take into account certain values (including religious norms) and expectations that are maintained within different cultures, as well as other circumstances, who can make psychological assistance effective or inconclusive. Since in the process of learning the personality is enriched, including by new psychological connections, relying on which and manipulating which it further solves the assigned professional tasks, when working with people, one must proceed from the basic components of self-awareness: self-understanding (cognitive aspect), relations to yourself (the emotional aspect); self-regulation (behavioral aspect). That is, all these tasks can be defined as the formation of new behaviours related to cooperation, mutual assistance, responsibility and autonomy that contribute to optimal adaptation, more successful social functioning in real life, and prevention of recidivism of unconstructive behaviour. However, a generalized view of behaviour and beliefs may not cover the diversity that exists within ethnic groups.
Systemic and morphological method of scheduling of medical support of troops (forces) and the population at elimination of medical and sanitary consequences of emergency situations by forces and means of Medical service of the Armed Forces of the Russian Federation
Authors: Lemeshkin R N , Savchenko I F , Blinov V A , Zhukov A A , Sidorov D A , Chekhovskikh Yu S , Dmitriyev G V
Published: July 2021

The technique of the systemic-morphological analysis allowing to create alternative decisions is provided. Options of medical support of troops (forces) and the population in case of elimination of medical and sanitary consequences of emergency situations of natural, technogenic and social character are developed: «Departmental», «Interdepartmental»,«International». Concerning each option, nine indices (criteria) are offered: legal regulation; controllability system; complexity of the organization of system; resource (material) cost intensity; personnel security; adequacy of medical care; efficiency; experience and innovations; self-sufficiency of actions. For the production of computation and a choice of the most rational option of planning of system the original dialogue program system of «MPRIORITY 1.0» (MY PRIORITY) realizing a method of the analysis of hierarchies by repetitions (iterations) is used. The results characterizing each of the considered alternative options with the replying weight priority are received and their preference is defined. During the first iteration priorities for the system of indices and criteria, characteristic of achievement of result with emphasis on normative legal regulation of activities with the organization structure and management system were defined. In the second - priorities for the system of indices and criteria with emphasis on the organization of delivery of healthcare with the existing system of material support, medical supply and also an adequate level of training of medical frames were changed. Results were subjected system to the analysis and sentences are developed for health service of the Armed Forces of the Russian Federation, in particular for Service of medicine of catastrophes the Russian Defense Ministry, on the organization of system of medical support of troops (forces) and the population in case of elimination of medical and sanitary consequences of emergency situations of natural, technogenic and social character.
Tumors of thymus gland: clinical features, diagnosis, treatment
Authors: Dzidzava I I , Kotiv B N , Dmitrochenko I V , Fufaev E E , Yasuychenya D A , Kudryavtseva A V , Bardakov S N , Apollonov A A
Published: July 2021

Main aspects of histogenesis, morphology and classification of tumors of the thymus, the current state of their diagnosis and treatment are submitted. Clinical manifestations of thymomas are dependent on their endocrine activity, pace and nature of growth, size and relationship with surrounding structures of mediastinum. Hormonal tumors of thymus are often accompanied by the development of generalized myasthenia gravis. Spiral computed and magnetic resonance tomography are recognized as the leading methods of diagnostics and differential diagnostics of the tumors of thymus gland. However, frequency of diagnostic errors can reach 10-30% of observations. The main method of treatment is surgical, as providing radical and the best long-term results. An adequate volume of surgical treatment of tumors of the thymus gland is thymomthymectomy- enblock removal of a tumor and the entire gland tissue along with fatty tissue and lymph nodes of anterior mediastinum. Various «open» and endovideosurgical approaches to thymus removal have been proposed. Minimally invasive endovideoscopic removal of thymus has a number of advantages over traditional, «open» thymectomy and is characterized by a much smaller intraoperative blood loss and duration of drainage of the pleural cavities, early activization of a patient and a shorter hospital stay. The implementation of endovideosurgical intervention is prescribed with the removal of thymoma I-II stage of cancer progression, as well as in some cases of combined operational benefits at stage III. However, international experience is not sufficient for making decisions regarding the selection of an optimal surgical approach in each case. In invasive tumors of thymus, combined treatment with the inclusion of radiation and chemotherapy is recommended. However, the choice of components of a treatment, modes and sequence remain controversial.
Morphological characteristics of the auxiliary elements of the knee joint in normal and deforming arthrosis
Authors: Gaivoronskiy I V , Hominets V V , Semenov A A , Goryacheva I A
Published: July 2021

The results of morphological studies of auxiliary elements (patella, meniscus, cruciate ligament, synovial bags) of 60 knee joints of adult corpses, 30 of which were intact (without signs of deforming arthrosis) and 30 with signs of deforming arthrosis of stages III-IV are presented. It is established that the auxiliary apparatus undergoes significant changes in the progression of deforming arthrosis. In a greater degree degenerative changes prone articular cartilage of the patella and medial condyles of the knee joint. The affected areas were characterized by thinning of the articular cartilage or its complete absence, as well as the presence of osteophytes along the edges of the articular surfaces. The measurements of the relative length, width, and thickness of the meniscus also confirmed the fact of their substantial deformation and degeneration, mainly of the medial meniscus. The posterior part of the body and the horn of the medial meniscus were most susceptible to the destruction of the cartilaginous tissue and were accompanied by the erasure and disintegration of the inner margin. Synovial membranes with deforming arthrosis were thickened, compacted and locally hyperemic, had papillary growths, which indicates the presence of synovitis and fluid accumulation not only in the joint cavity but also in synovial bags, the sizes of which were significantly increased. Intra-articular ligaments are hyperemic, and fragments are noted. Pterygoid folds are enlarged, locally hyperemic, with a vascular pattern, elongated processes are visualized along the edges. Identified morphological changes in the progression of deforming arthrosis lead to trophic and metabolic disturbances of all structures of the knee joint. The results of the study of the auxiliary elements of the knee joint can be used as a control in the diagnosis of deforming arthrosis.
Indicators of disability of the military personnel in able-bodied and retirement age for2015-2016 (territorial aspect)
Authors: Andreeva O S , Karasaeva L A , Shkurko M A , Naumenko L L
Published: July 2021

The indexes primary and secondary disability among soldiers working and retirement age because of «military trauma» in dynamics for 2015-2016. From the military in 90% of cases disability is defined in the working age. The socio- hygienic analysis of the data on primary and secondary disability, carried out on a territorial basis, points to the heterogeneous share of disability indicators among military personnel in the Federal districts of the Russian Federation. It is revealed that the North-Caucasus, southern and Central Federal districts are the leaders in the establishment of primary disability and the total number of disabled people. The heterogeneous proportion of persons with disabilities recognized as members of the armed forces in different districts determines the need to analyse the conditions and grounds on which the disability was established. The implementation of the Federal comprehensive program «Accessible environment» and sub-programs aimed at the creation of the subjects of the Russian Federation of rehabilitation centers for patients and disabled people, due to the territorial characteristics of the prevalence of primary disability and the specifics of the category of persons with disabilities. Therefore, the data of the conducted social and hygienic analysis can serve as a basis for making organizational decisions on the creation of complex rehabilitation centers for disabled people from among former servicemen in the territories of the Russian Federation.
Organizational and functional form of infectious diseases control of servicemen studying in military educational organizations
Authors: Zobov A E , Aminev R M , Kuzin A A , Kucherov A S
Published: July 2021

Control of infectious morbidity is considered as a functional tool for ensuring the sanitary-epidemiological well- being of servicemen studying in military educational organizations. At the same time, scientifically substantiated structural and logical schemes for interaction of officials of these organizations to control morbidity in the system of ensuring sanitary and epidemiological well-being of servicemen are absent. Literature data on the development of organizational and functional form of controlling the infectious morbidity of servicemen studying in military educational organizations is analyzed. The connection of infectious morbidity with the level of sanitary-epidemiological well-being of military contingents is mentioned. The concept of infectious morbidity in relation to the activities of officials of the military educational organization control in the sphere of ensuring sanitary and epidemiological well-being is explained. Existing approaches to the development of organizational and functional models in the field of health care are considered. The principles of development of the organizational and functional form of control of the infectious morbidity of personnel of the military educational organization are proposed and the expected results of its implementation are mentioned.
Comparative characteristics of the methods for determining the somatic sex of an adult person with the use of a skull
Authors: Gaivoronsky I V , Fandeyeva O M , Nichiporuk G I , Gaivoronskaya M G
Published: July 2021

The analysis of Russian and foreign literature on the definition of somatic sex on the skull is presented. Cranioscopic and craniometric approaches are considered in carrying out craniological studies and existing traditional and modern methods for their implementation. Cranioscopic studies reveal the advantages and disadvantages of W.M. Krogman, G. Acsadi, J. Nemeskeri and V.N. Zvyagina methods. It is shown that the method of V.N. Zvyagina, which includes 40 descriptive diagnostic signs, is the most informative. Its efficiency is 93,5%. The comparative analysis of the craniometric methods for studying the skull according to R. Martin and H. Welcker in the modification of A.P. Bogdanov and a number of English craniologists is presented. The authors point out that the Russian Forensic Center developed a craniological form, which includes 79 different sizes of a skull, by which is possible to determine not only the sex of a skull, but also the approximate age of a person. A comparative assessment of the Russian (V.I. Pashkova) and foreign (E. Giles) craniometric studies is presented. According to V.I. Pashkova using only craniometric techniques allows one to determine the sex of the skull only in 75-80%, and in the complex approach - in 80-93%. The method of E. Giles, based on the study of regression equations, is objective in 83-86%. Thus, studies of the sex determination by skull in an adult should be comprehensive, including both cranioscopic and craniometric techniques.
Formation history and problems of the system of resistance to human immunodeficiency virus infection in the Armed forces of the Russian Federation
Authors: Bulankov Yu I , Bulygin M A , Zhdanov K V , Kozlov K V , Lyashenko Yu I , Ivanov K S , Orlova E S
Published: July 2021

Infection rates of human immunodeficiency virus in Army forces have a clear structure divided into stages. Each stage characterized by objective socio-economic, political, epidemical prerequisites, which reflected conditions of epidemic developing, activeness of mechanisms and transmission factor, structure and possibilities of a protective system against infection in country and army. There are three stages of epidemic development. The first stage - infiltration (invasion), 1987 - 1995 years. The common feature this period of developing and functioning counteraction system against infection, produced by human immunodeficiency virus, and acquired immune deficiency syndrome in our country is «recognition by the state of the growing threat of the epidemic spread of infection caused by the human immunodeficiency virus in the absence of a real epidemic and limited material resources». The second period - epidemical infection spreading, produced by human immunodeficiency virus, 1995-2003 years. Significant efforts of counteraction system against infection, produced by human immunodeficiency, and acquired immune deficiency syndrome in the army was concentrated on improving diagnostic and approximation of the possibilities of military-medical expertise to the places where patients are identified. The third period - generalized - in the last2004 year to current period. Stabilization indicators identifying soldiers, infected by human immunodeficiency, archived as a result of barrier preventive measures (examination at the stage of conscription to the Armed Forces) are not accompanied by methodological and regulatory changes that have occurred in civilian health care, which contributes to negative trends in the later detection of the disease. So, the current system of medical help for soldiers, infected by human immunodeficiency, does not provide medical help enough, regulated by the governing documents of the Department of Health of the Russian Federation and state medical standards.
Functional state of the autonomic nervous system, adaptation, homeostasis and reactivity of the organism in the clinic of tuberculosis and sarcoidosis
Authors: Loshakova A I , Brazhenko O N , Brazhenko N A , Zheleznyak S G , Tsygan N V
Published: July 2021

In recent decades, the shift in priority in the treatment of patients with pulmonary granulomatosis in the direction of etiotropic therapy and reduced attention to the state of the macroorganism led to a decrease in the effectiveness of treatment. In modern conditions, when carrying out complex therapy for patients with tuberculosis and sarcoidosis, insufficient attention is paid to the state and dynamics of adaptation, resistance, homeostasis and reactivity of the organism. At the same time, the dynamics of these processes in patients is insignificant, the homeostatic balance of the organism is not restored, and the reactivity of the organism remains at the pathological level, with the predominance of paradoxical, hyporeactive and areactive types. This is due to the continuing influence on the regulatory centers of the vegetative system of not diagnosed, latent, ongoing tuberculosis intoxication. Undetected specific intoxication causes in patients activation of the sympathetic department, suppression of parasympathetic and development of dysfunction of the autonomic nervous system. Its dysfunction leads to a decrease in vascular supply of the organism, a high tension of anabolic processes, and a further change in the functional activity of both parts of this system when pathology develops. In addition, the emergence of vegetative dysfunction leads to a high consumption of plastic materials, energy resources, a decrease in the functional reserves of the body, a decrease and depletion of the body’s defense systems, its anti-inflammatory potential and the reactivity of the organism as a whole. These changes lead to an extension of the main course of treatment and the formation of expressed residual tubercular and sarcoidosis in the respiratory organs. To restore these disorders, it is necessary to carry out complex therapy with the inclusion of a personified appointment of activators of protective systems under the control of monitoring their effectiveness.
The contribution of the faculty of Departments S.M. Kirov’s Military-medical academy into the limitation the consequences of Chernobyl nuclear power plant acciden
Authors: Kuznetsov S M , Petreev I V , Terentev L P , Tsvetkov S V
Published: July 2021

There is information about the business of professorial and teachers’ faculty of the Department of naval and radiation hygiene and the Department of General and Military hygiene S.M. Kirov’s Military-medical academy into a limitation of consequences the most enormous radiation emergency, which happened on 26 of April 1986, on Chernobyl nuclear power plant. A significant part of the participants in the liquidation of the accident were servicemen, the cause of that military-medical service took the direct part in the implementation of preventive measures. A set of activities for the health protection liquidators and residents of settlements, placed on the contaminated areas allowed to significantly reduce the radiation exposure from external and internal radiation. The basis for the prevention of both acute lesions and long-term consequences was the maximum permissible level of the planned emergency radiation of 25 Rem. The entire faculty of the Department of Naval and Radiation Hygiene and a number of employees of the Department of General and Military Hygiene, who on a rotational basis were continuously in the zone of work to eliminate the consequences of the accident, went through the mill of Chernobyl. Their personal contribution to the solution of urgent scientific and applied problems of minimization of radiation impact and preservation of the health of servicemen-liquidators of the accident were noted.
Improving the automation of information support for medical rehabilitation and dynamic monitoring of the health of participants in wars and armed conflicts
Authors: Zakharov Yu M , Gypsy V N , Tyrenko V V , Galomzik N S , Borisov D N , Shershnev S V
Published: July 2021

An analysis of the experience of medical support of troops in the wars and military conflicts shows that their characteristic feature was and remains the constant improvement of the organizational forms of medical support for the troops aimed at optimizing the medical rehabilitation of the wounded and sick. The results of the analysis of medical support of troops during the Great Patriotic War showed that the composition and content of the sanitary minimum level for servicemen should be in constant accordance with the requirements for the level of professional training of servicemen. Organization of medical care for participants of the Great Patriotic War of 1941-1945 and the Afghan conflict of 1979-1989 in the postwar period shows that the basis of all measures to monitor the health of war participants must be a system of active personal dynamic observation. Active dynamic monitoring of the state of health using automated information systems allows to solve the problem of restoring health among participants in wars and military conflicts at the optimal level, provides medical information necessary for assessing the health status of participants in wars, determining the scope and composition of medical and recreational activities. Active invitation of the patient, who is on dispensary supervision, makes it possible to conduct a comprehensive assessment of his health status. However, the effectiveness of the system of medical control over the health of war participants largely depends on the high degree of automation of information processes in the system of dynamic control over the health of a workable and efficient resource on a national scale. The implementation of the principles of dynamic monitoring of the health of participants in wars can be carried out through the practical implementation of Decision 36 of the Plenum of the Academic Medical Council with the Chief of the Main Military Medical Directorate of the Ministry of Defense of the Russian Federation (1996). Special attention was paid to the necessity and urgency of the development and operation of an automated information system on the wounded and sick on the basis of the Military Medical Museum. At the same time, it is necessary that its electronic information module is located in the institution where the wounded and sick war veterans are kept in the hospital. At present, such an institution in the Armed Forces of the Russian Federation is an archive of military medical documents of the Russian Military Medical Museum.
Role sialic acids in maintenance of an immune homeostasis
Authors: Moskalev A V , Sboychakov V B , Apchel A V , Tsygan V N
Published: July 2021

The role sialic acids in maintenance of an immune homeostasis is considered. It is known, that sialic development both cleanly nonspecific protective effects, and specific, microbes agents providing interaction with specific receptors immunocompetent cells is peculiar to acids. Sialic acids represent components of cellular receptors, which are specific to viruses of family Adenoviridae, Reoviridae, Orthomyxoviridae and for many gram-positive bacteria. The facts reflecting the major role sialic of acids in maintenance of stability of a macroorganism to pathogenes of the various nature, and also in development of a somatic pathology and neoplatic processes are saved up. Concentration sialic acids also increases at sialydosis, a heart attack of a myocardium, oncological diseases, including at tumours of a brain. Especially high growth of this parameter is marked at the active form of a tuberculosis and rheumatism, at parenchymatous to a jaundice. After detachment from protein-carbohydrate complexes of fabrics free sialic acids inactivation many bacterial and virus agents. Therefore, the increase in the maintenance in blood sialoglycoproteines can be display compensatory, protective reaction of an organism. One of many reasons of formation immunology inconsistencies at ageing connect with reduction of concentration sialic acids in an organism. Sialic acids are capable is expressed to change process of recognition of tumoral antigens. The analysis of frequency expression different antigens on cells of various tumors in many cases can be used for an estimation of the forecast and a degree malignant tumoral process, and for reception of vaccines with the purpose immunotherapy.
M.I. Astvatsaturov - the founder of the biogenetic concept in the domestic clinical neurology (on the 140th anniversary of his birth)
Authors: Mikhaylenko A A , Litvinenko I V , Odinak M M , Tsygan N V , Dynin P S
Published: July 2021

Creative and life path of M.I. Astvatsaturov is exceptionally multifaceted: a fully educated physician and a surprisingly modest and intelligent person; a remarkable clinician and excellent medical teacher; a deep and original scientist and the owner of virtually absolute musical ear; the founder of the national military neurology, a connoisseur of high poetry and classical music of Russian composers. However, the top of his diverse creativity, which brought him fame far beyond the borders of the country, was the formation in the domestic neurology of a new and original scientific direction - biogenetic (evolutionary) analysis of polymorphic clinical phenomena in diseases of the nervous system. I. Ja. Razdolsky argued that «the most original and vivid direction in the development of neuropathology, not only in Leningrad, but also in the Soviet Union over the past 40 years was the introduction of M.I. Astvatsaturov’s evolutionary method in the analysis of clinical phenomena». The first publications on the problematic subject, which served as «the key to understanding a number of phenomena in the pathology of the nervous system, which before had not explanation...», date back to 1913-1916 after M.I. Astvatsaturov’s three-year scientific trip to the best European clinics and laboratories in Berlin, Frankfurt am Main, Hamburg, Heidelberg, Munich, Vienna, Paris, London, Zurich and work for outstanding neurologists and psychiatrists - G. Oppenheim, L. Edinger, M. Nonne, Erba, E. Krepelin, Z. Freud, J. Babinsky, J. Dezherin, P. Marie, V.Manyan, V. Horsley, K. Monakov. Especially widely and vividly the diversity of opinions and scientific hypotheses were presented within the framework of the Astvatsurov’s biogenetic concept in clinical neurology in terms of the formation and improvement of motility, the clinical manifestation of pathological reflexes.
60 years on the front lines of aviation and space medical support
Authors: Blaginin A A , Sinelnikov S N
Published: July 2021

The main historical aspects of the research work of the Department of Aviation and Space Medicine of the S.M. Kirov Military Medical Academy are presented for a 60-year period of its activity with a characteristic of the contribution of the department’s staff at different periods. One of the priority tasks of the department was not only training medical specialists for the Air Force but also carrying out scientific research aimed at solving both applied and fundamental problems of aviation and space medicine. The directions of these studies were laid by the founder of aeronautical physiology academician Leon A. Orbeli and are related both to the development and improvement of science and technology, and to the development of aviation and cosmonautics. Today, the main scientific areas of the Department of Aviation and Space Medicine are: improving the medical support system for flights on modern and promising aviation and space technology; development of methods and techniques for increasing the stability of the body of pilots and cosmonauts to flight factors; assessment and forecasting of the functional state and professional reliability of the flight crew, astronauts and operators for the management of space vehicles, as well as the development of tools and methods for correcting adverse changes in the functional state and improving the professional performance of pilots and astronauts. The Department continues research on one of the most important problems of flight safety - the loss of spatial orientation, new types of illusions are being studied. To ensure the work of the department at the present stage, the educational and material base is represented by the most modern medical and special equipment grouped into adjacent and complementary areas.
Department of Physical Training from the beginnings to the present
Authors: Storozenko I I , Nikolaeva K V , Gadylgareyev V G , Silchuk A M , Silchuk S M , Fedorin S V
Published: July 2021

The article is devoted to the history of the Department of physical training of the military medical Academy named after S. M. Kirov. The article briefly highlights the key periods of education and formation of the Department of physical training, since 1900, when the initiative of a number of progressive professors of the Academy was formed by the Commission on physical exercises of students, which included the great Russian scientists, professors I.P. Pavlov and G.I. Turner. For students, optional classes in gymnastics, fencing, skating, game in small towns, riding began to be carried out. It was 1900 consider the beginning of the introduction to the educational process of the Academy of physical education classes, which became the basis for the formation of Throughout the period, the faculty of the Department of physical training worked outstanding athletes, the merits of which the Department of physical training and the Academy will always be proud. This is the honored master of sports of the Soviet Union and Russia, Champions and winners of Olympic, World, Europe, Soviet Union, and Russia: a fencer B.B. Melnikov, biathlete N.W. Puzanov, volleyball A.N. Einhorn and P.I. Voronin, gunner M.B. Umarov, a fighter, A.B. Novikov, honored coach of Russia and honored worker of physical culture of the Russian Federation A.S. Rakhlin, and others. For the glorious, eventful history of the Department of physical training, repeatedly changed its name, but one thing has always remained unchanged: at the Department of physical training worked and work highly qualified specialists, and a historical essay about the Department of physical training allows us to come close to all generations from the date of its formation to the present time.
GENETIC MARKERS AS AN INDICATOR OF HUMAN RESILIENCE TO VARIOUS ECOLOGICAL AND PROFESSIONAL FACTORS
Authors: Rzhepetskaya M K
Published: July 2021

Various ecological and professional factors (hypoxia, a hot or cold climate, noise, vibration, radiation, intense physical activity, etc.) are peculiarities of the military activities. The introduction of molecular and genetic methods in medical practice and occupational selection can greatly improve the efficiency of selection and rational appointment of people into separate specialties, optimize working capacity, maintain human health, reduce the costs for rehabilitation and (or) specialists’ treatment
SURGICAL APPROACH AT IATROGENIC INJURIES OF EXTRAHEPATIC BILIARY TRACTS
Authors: Abdullayev A A , Abdullayev B A
Published: July 2021

Aim: To study the efficiency of reconstructive operations in “recent” iatrogenic injuries of extrahepatic biliary tracts. Methods. The experiment on surgical treatable of 22 patients with iatrogenic “recent” injuries of extrahepatic biliary tracts is submitted. Primary reparative operation has been performed to 1 patient (suturing of hepaticocholedochus injury after Laparoscopic cholecystectomy). Reparative operations throughout Roux-en-Y biliodigestive anastomosis were performed to 19 patients (Roux-en-Y hepaticojejunostomy - 4, Roux-en-Y bihepaticojejunostomy - 13, Roux-en-Y trihepaticojejunostomy - 2). The external drainage of extrahepatic biliary tracts of the 2nd patient has been the final method of surgical treatable. Results.Post-surgery complaints and mortalities. Among all the 22 patients with iatrogenic injuries of extrahepatic biliary tracts the post-surgery complaints of 4 patients have been registered: failure of stitches of Roux-en-Y bihepaticojejunostomy - 1, acute adhesive small bowel obstruction - 1, stenosis of bihepaticojejunostomy - 1, purulence of surgical wound - 1. Post-surgery mortality is 4,5 %. Conclusion.Roux-en-Y biliodigestive surgery is the main conclusive method in reconstructive treatment of iatrogenic injuries of extrahepatic biliary tracts.
SURGICAL MANAGEMENT OF MIRIZZI’S SYNDROME
Authors: Grinchesku A E , Butyrskii A G , Khilko S S
Published: July 2021

Complicated gallstone disease causes operative difficulties despite surgeon’s experience and patient’s examination. We have an experience of surgical management in patients with Mirizzi’s syndrome (MS) that made3,2% from a total number of operated patients with cholelithiasis (women 74%, men 26%). Patient’s age was from 28 to93years old.We want to stress that the final form of MS is defined only during surgery. We distinguish only 2 forms of MS without sharing according to involvement of common bile duct into destructive-and-inflammatory process.In 45% of patients I form of MS was registered, in 55% - II form. In MS-I the preferable surgery is cholecystectomy with outer bile ducts draining. Plasty of hepatocholedochus in MS-I is indicated for proved duct stricture. MS-II is the indication for performing different restorative or reconstructive surgery dependent on intraoperative data (application of primary suture on common bile duct, plasty of hepatocholedochus with the gallbladder wall, choleedochoduodenostomy, hepaticocholedochostomy, hepaticojejunostomy).