Kazan medical journal

Medical peer-review journal for physicians and researchers.


  • Kazan State Medical University
  • Eco-Vector



  • Ayrat U. Ziganshin, MD, PhD, Professor.


Kazan Medical Journal is a peer-reviewed journal for clinicians and medical scientists, practicing physicians, researchers, teachers and students of medical schools, interns, residents and PhD students interested in perspective trends in international medicine.

Missions of the Journal are to spread the achievements of Russian and international biomedical sciences, to present up-to-date clinical recommendations, to provide a platform for a scientific discussion, experience sharing and publication of original researches in clinical and fundamental medicine.


  • Russian Science Citation Index
  • BIOSIS Previews
  • Biological Abstracts
  • CNKI
  • Google Scholar
  • Ulrich's Periodical directory
  • Dimensions
  • Crossref

Published bimonthly since 1901, distributed by subscription.

Current Issue

Open Access Open Access  Restricted Access Access granted  Restricted Access Subscription or Fee Access

Vol 104, No 4 (2023)

Cover Page

Full Issue

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Theoretical and clinical medicine

Changes in heart rate under the influence of nitroglycerin in patients with stable angina pectoris of functional classes III and IV in combination with hypertension
Safronova E.A., Ryabova l.V., Kharlamova U.V., Grigoricheva E.A., Tantsyreva I.V.

Background. For many years, nitroglycerin has been the primary treatment for coronary pain in patients with angina pectoris, but its effect on heart rate is not fully understood.

Aim. To study the change in heart rate under the influence of nitroglycerin in patients with stable angina pectoris of functional classes III and IV in combination with hypertension.

Material and methods. The study included 122 men aged 40 to 65 years (mean age 58.42±5.8 years) with stable exertional angina of functional classes III and IV in combination with hypertension. A rhythmocardiographic study was performed with simultaneous recording of an electrocardiogram initially and 5 minutes after sublingual administration of nitroglycerin. The number of ventricular and supraventricular extrasystoles was assessed in each vegetative test (background, Valsalva, Ashner, active orthostatic and with physical activity) initially and after taking nitroglycerin. To evaluate the compared values, the mean value, standard error of the mean, maximum, minimum, frequencies, Wilcoxon criteria, Pearson's χ2 were calculated.

Results. Under the influence of sublingual intake of nitroglycerin, the number of supraventricular extrasystoles decreased in approximately 7% of patients in the background sample, in the rest, an increase prevailed in 7.4–9.0% of patients, depending on vegetative test. At the same time, the number of ventricular extrasystoles decreased in the background (in 13.9% of patients) and orthostatic (in 9.8%) samples, in the rest, their growth prevailed in 9–17% of patients, depending on vegetative test.

Conclusion. Sublingual use of nitroglycerin leads to an increase in the number of supraventricular extrasystoles, as well as a variable effect on ventricular extrasystoles, depending on the vegetative test performed.

Kazan medical journal. 2023;104(4):485-490
pages 485-490 views
Factors associated with the development of a lethal hospital outcome in patients with pulmonary embolism in different age groups
Shmidt E.A., Berns S.A., Barbarash O.L., Erlikh A.D., Duplyakov D.V.

Background. The study of the tactics of managing patients with pulmonary embolism in the hospital period allows to find new approaches to treatment to reduce mortality. At the same time, it is known that the risk factors for death in patients of different age categories differ.

Aim. To study the features of the course of the disease and risk factors for a fatal hospital outcome in patients with pulmonary embolism in different age groups of participants in the All-Russian registry, which was named SIRENA (RusSIan REgister of pulmoNAry embolism).

Material and methods. The study included 570 patients with pulmonary embolism (database of the SIRENA multicenter registry in 2018–2019), who underwent a standard examination. They were divided into two groups according to age: the first group was 18–69 years old inclusive (n=369), the second group was 70 years and older (n=201). Differences in clinical history, laboratory and instrumental parameters in the studied groups of patients were assessed. Statistical comparison of data was performed using the Mann–Whitney test, Pearson test, and Fisher's exact test. For a quantitative description of the closeness of the association of a sign with the outcome of the disease, the odds ratio with a 95% confidence interval was determined.

Results. In the group of patients aged 18–69 years, deaths occurred 3 times less frequently than in the group of patients aged 70 years and older (8.9 vs 26.3%; p <0.0001). The risk of death increases in the presence of atrial fibrillation by 2.6 times (p=0.032), anemia with hemoglobin <113 g/l — by 4.3 times (p=0.0002), chronic kidney disease — by 5.5 times (p=0.001), increase in blood creatinine >125 mmol/l — 5.8 times (p <0.001). Additional risk factors in patients aged 70 years and older are ischemic heart disease (p=0.02), a history of stroke (p=0.003), and immobilization for 12 months prior to hospitalization (p <0.0001).

Conclusion. In patients aged 18–69 years, atrial fibrillation, anemia, and impaired renal function are fatal risk factors; at the age of 70 years and older, along with these, previous immobilization and comorbid cardiovascular pathology have an adverse effect.

Kazan medical journal. 2023;104(4):491-500
pages 491-500 views
Influence of hypoxic therapy on the content of individual cytokines in women with autoimmune thyroiditis
Ignatenko G.A., Maylyan E.A., Lesnichenko D.A., Kaluga A.A., Golchenko V.M.

Background. The high prevalence of autoimmune thyroiditis and the insufficient effectiveness of hormone replacement therapy dictate the need to explore alternative methods of treating the disease. These methods include interval hypoxic therapy, but its effect on the cytokine profile in autoimmune thyroiditis has not been studied enough.

Aim. To study the effect of interval hypoxic therapy in combination with hormone replacement therapy on cytokine status in autoimmune thyroiditis and hypothyroidism.

Material and methods. 136 women with primary diagnosed autoimmune thyroiditis and hypothyroidism were examined. Half of them (n=68) received only hormone replacement therapy for 12 months. The rest of the women (n=68), along with sodium levothyroxine, underwent sessions of interval hypoxic therapy (every 3 months for 10 days according to the formula 5–5–5). The concentrations of interleukins-4, -6, -8, -10 and tumor necrosis factor α in blood serum were determined. To compare the results in groups, Kruskal–Wallis rank univariate analysis and Dunn's test were used. The Wilcoxon t-test was used to compare two related samples.

Results. Both isolated hormone therapy and its combination with hypoxic therapy did not affect the concentrations of interleukins-4, -8, -10 and tumor necrosis factor α in the blood serum of women with initially diagnosed autoimmune thyroiditis and hypothyroidism. However, hypoxic therapy caused a decrease (p=0.0001) in the initially elevated concentration of interleukin-6 to the level of the control group, which did not happen with the isolated intake of levothyroxine sodium.

Conclusion. The combination of sodium levothyroxine with hypoxic therapy causes a decrease in the level of interleukin-6, which is elevated in women with newly diagnosed autoimmune thyroiditis and hypothyroidism.

Kazan medical journal. 2023;104(4):501-508
pages 501-508 views
Long-term results of early orthodontic treatment of children aged 3–5 years
Shishmareva A.S., Bimbas E.S.

Background. The frequency of dentoalveolar anomalies and the severity of dentoalveolar disorders in children increases with age. Early orthodontic treatment allows to take advantage of the growth and eruption of teeth and stop pathological development before significant compensatory deformities of the dentition occur, which are more difficult to treat.

Aim. To study the long-term results of early orthodontic treatment of children aged 3–5 years.

Material and methods. A prospective study of the long-term results of orthodontic treatment in 50 children aged 3–5 years was carried out. The state of the dentoalveolar system of children was analyzed: the magnitude of the disproportion in the sagittal, transversal and vertical directions; direction and magnitude of displacement of the lower jaw; the presence of anomalies in the development of teeth before and 3.5 years after treatment. Statistical analysis was carried out using the program Statistica 13.3. The Shapiro–Wilk and Kolmogorov–Smirnov tests, asymmetry and kurtosis indicators, and the Student's test were used.

Results. A high frequency (52%) of cases of severe occlusion disorders was revealed (occlusion disorders in two planes — 44%, in three — 8%). Often there was a displacement of the lower jaw — 72%. These disorders require early orthodontic treatment. When analyzing the results of early orthodontic treatment after 3.5 years, physiological occlusion was established in 86% of cases: a decrease in the size of the direct sagittal fissure (before treatment 3.9±2.5, after treatment 1.1±1.5; p=0.000005); elimination of the reverse sagittal fissure (before treatment –0.8±0.5, after treatment 0.03±0.1; p=0.000000); decrease in the depth of vertical overlap (before treatment 4.6±0.6, after treatment 2.2±1.1; p=0.000043); elimination of the vertical gap (before treatment 3.12±1.3, after treatment 1.0±2.0; p=0.05011); elimination of exocclusion (before treatment 4.9±2.3, after treatment 0.3±0.9, p=0.000000); elimination of endocclusion (before treatment 5.5±0.7, after treatment 0.7±0.3, p=0.033475); elimination of the displacement of the lower jaw. In 14% of cases in children, the occlusion was not ideal, while the physiological development of the dentition was noted.

Conclusion. Early orthodontic treatment of children aged 3–5 years can eliminate severe disorders and, in most cases, create conditions for the physiological development of the dentoalveolar system.

Kazan medical journal. 2023;104(4):509-515
pages 509-515 views
Microvesicles and neutrophil aggression factors in the pathogenesis of chronic periodontitis
Fefelov A.A., Tsybikov N.N., Fefelova E.V.

Background. It is known that the number of polymorphonuclear leukocytes increases with the development of periodontitis. However, their role in the pathogenesis of chronic periodontitis has not been fully defined.

Aim. To study the pathogenetic role of polymorphonuclear leukocytes in the development of chronic periodontitis, realized by microvesicles and aggression factors (metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2).

Material and methods. 30 patients aged 30 to 50 years with a diagnosis of “chronic generalized periodontitis of moderate severity (K05.3)” and no severe somatic pathology were under observation. The comparison group included 20 people with no inflammatory diseases in the oral cavity, comparable with the main group in terms of gender, age, nationality, and the presence of bad habits. Using a standard set of indices, the state of periodontal tissues was assessed, and all examined patients underwent X-ray examination. In the oral fluid of the examined, the total number of microvesicles and their phenotype, the concentration of matrix metalloproteinases-2 and -9, myeloperoxidase, calprotectin, lipocaine 2 were determined. The parameters were determined using a flow cytometer. Descriptive statistics are represented by the median and interquartile range (25th and 75th percentiles). Two independent sample sets were compared using the Mann–Whitney test. Correlation analysis was carried out according to the Spearman method.

Results. The total number of microvesicles in the oral fluid in patients with chronic periodontitis was 11 times higher than in healthy volunteers (p=0.00001). More than a third of them had neutrophil markers. The levels of neutrophil aggression factors were also higher in patients with periodontitis and correlated with the value of the periodontal index, the depth of the periodontal pocket, bleeding index, indicators of periodontal health. Thus, a strong positive relationship was found between the total number of microvesicles and the value of the periodontal index (r=0.675), the depth of the periodontal pocket (r=0.763), the bleeding index (r=0.704); the number of neutrophilic microvesicles and indicators of periodontal health — r=0.816, r=0.837 and r=0.776, respectively. The content of metalloproteinase-2 correlated with the depth of the periodontal pocket (r=0.754), bleeding index (r=0.811), papillary-marginal-alveolar index (r=0.675).

Conclusion. Neutrophils contribute to the pathogenesis of chronic periodontitis through the secretion of aggression factors: metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2, and microvesicles.

Kazan medical journal. 2023;104(4):516-522
pages 516-522 views

Experimental medicine

Hematological changes and structural morphological changes in the liver and spleen in mice against the background of acute toxic effects of cyclophosphan
Kokaya G.N., Kokaya A.A., Vasilieva E.A., Guseva M.S., Mukhina I.V.

Background. Disturbances in the body associated with bone marrow failure caused by the administration of lethal doses of cyclophosphan to animals make it possible to use this experimental model to solve important pathophysiological problems.

Aim. To reveal hematological changes and structural morphological changes in the liver and spleen in mice against the background of acute toxic effects of lethal doses of.cyclophosphan.

Material and methods. The studies were performed on 200 outbred male mice weighing 27–29 g. Acute cytotoxic syndrome was modeled by a single intraperitoneal injection of a solution of cyclophosphan at doses of 500 and 750 mg/kg of body weight. Blood sampling for hematological studies was carried out on the 3rd, 6th, 10th and 15th days of intoxication, and the removal of the liver and spleen for morphological studies was performed on the 6th and 15th days. Statistical analysis was performed using Statistica 10 and MS Excel. Results were presented as mean (M) ± standard error of the mean (mx). To determine the significance of differences between groups with a significance level of p <0.05, Fisher's test and Mann–Whitney U-test were used.

Results. Mortality against the background of acute cytotoxic action of cyclophosphan at doses of 500 and 750 mg/kg reached 83.3 and 100%. The initial content of leukocytes in the peripheral blood of mice was (8.6±2.3)×109/l, and on the 6th day of intoxication it decreased to (1.0±0.3)×109/l and (0.6±0.1)×109/l (p=0.01). Blast cells of all hematopoietic lineages were present in blood smears. In the morphological picture of the spleen, the connective tissue stroma was sharply distinguished, and the white and red pulps were almost completely absent. Signs of acute toxic effects of cyclophosphan were found in the liver tissue.

Conclusion. The course of acute cytotoxic syndrome caused by cyclophosphan is accompanied by high mortality, the development of pancytopenia, pronounced destructive changes in the spleen tissue and toxic changes in the liver tissue.

Kazan medical journal. 2023;104(4):523-533
pages 523-533 views


The role of microRNAs in the development of gastric and duodenal ulcers
Sagadatova Y.R., Khasanov A.G., Gilyazova I.R., Sufiyarov D.I., Sufiyarov I.F.

The research highlights the fundamental concepts of microRNA, the mechanisms of RNA interference, the importance of microRNA in the development of diseases. Combining the experience of domestic and foreign researchers, the authors identified the main miRNAs involved in the development of gastric and duodenal ulcers. The article also describes the main mechanisms of regulation of the inflammatory process in gastric and duodenal ulcers associated with Helicobacter pylori, the influence of microorganisms on the expression of various microRNA types and the control of the cellular immune response. In addition, the review presents the latest research on methods for diagnosing Helicobacter pylori-associated peptic ulcer based on the determination of circulating microRNAs. The results of an experimental model of treatment of patients infected with Helicobacter pylori with drugs that act on non-coding RNA are presented.

Kazan medical journal. 2023;104(4):534-540
pages 534-540 views
Hypertrophic cardiomyopathy: a modern view of the problem
Kalyagin A.N., Gamayunov D.Y., Silkin V.I., Kurkov N.N.

Cardiomyopathy is considered one of the main causes of heart failure and sudden cardiac death, at least in young people. Approximately 50% of patients who die suddenly in childhood or adolescence or undergo heart transplantation suffer from this condition. The purpose of this literature review is to study and highlight the issues of etiology, pathogenesis, clinical features, diagnosis and treatment of hypertrophic cardiomyopathy from the point of view of modern ideas. The search and analysis of domestic and foreign literature materials using the PubMed and eLibrary databases was carried out. Of particular interest is the etiology of primary congenital cardiomyopathies, in respect of which research continues. As a result of the implementation of genetic factors, multiple structural and functional changes in the myocardium develop, which lead to changes in hemodynamics. Cardiomyopathy is a clinically heterogeneous disease, and one of the factors that determine the clinical phenotype is the genotype. In addition to standard laboratory testing, patients with suspected hypertrophic cardiomyopathy are advised to undergo medical genetic counseling to identify the causative mutation, and often to obtain prognostic information. The fundamental imaging method is echocardiography, but the role of magnetic resonance imaging in the diagnosis of the disease is also considered. Patients with symptomatic obstructive hypertrophic cardiomyopathy are usually recommended first-line pharmacotherapy with β-blockers or non-dihydropyridine calcium channel blockers. Currently, research on new drugs for the treatment of hypertrophic cardiomyopathy — inhibitors of cardiac myosin is ongoing. Surgical methods of treatment are developing progressively, however, methods of conservative treatment require further active research of drugs that have not been used before.

Kazan medical journal. 2023;104(4):541-551
pages 541-551 views
Postcovid necrosis of the cranio-maxillofacial region
Ivanyuta S.O., Khristoforando D.Y., Spevak E.M., Tsymbal A.N.

The review article is devoted to one of the new topical problems in medicine — necrosis of the organs of the cranio-maxillofacial region in patients with coronavirus infection, which was first discussed at the end of 2020. Later, doctors of various specialties (otolaryngologists, ophthalmologists, maxillofacial surgeons, neurosurgeons, dentists) from many countries of the world met in their practice with inflammatory-necrotic lesions of the mucous membrane of the nasal cavity and paranasal sinuses, facial skeleton and skull, eyeball, brain. The article highlights the main points of view of scientists about the etiology and pathogenesis of the studied pathology. Summarized data from the largest studies on the epidemiology, risk factors, and symptoms of post-covid necrosis of the cranio-maxillofacial region are presented. The results of various methods for diagnosing this complication — multislice computed tomography, magnetic resonance imaging, angiography, are described in detail. Due to the fact that today the role of fungal flora is recognized as the leading one in the etiology of post-covid necrosis of the cranio-maxillofacial region, much attention is paid to cytological, microbiological and pathohistological research methods, which should be aimed at the search for mycelium. The main approaches to the treatment of patients with this pathology are formulated. The article highlights issues important for practical healthcare: interpretation of national clinical guidelines for coronavirus infection in terms of post-covid necrosis of the cranio-maxillofacial region, classification options according to the International Classification of Diseases of the 10th revision, the procedure for providing medical care to this category of patients, the economic consequences of the lack of active prevention methods of the presented complication in patients with COVID-19.

Kazan medical journal. 2023;104(4):552-563
pages 552-563 views
Options for the development of colorectal cancer immunotherapy
Mustafin R.N.

In colorectal cancer immunotherapy, the use of antibodies against the PD-1/PD-L1 checkpoints showed low efficacy and the development of a number of side effects with damage to the liver, lung, and thyroid gland. For this reason, to stimulate the antitumor immune response, it is necessary to search for other targets, which can be used as retroelements. Epigenetic activation of their expression with inhibitors of histone methyltransferases and deoxyribonucleic acids (DNA) leads to the formation of double-stranded ribonucleic acids (RNA) that stimulate the antiviral response of interferon, which causes apoptosis of tumor cells. This method of viral mimicry shows an objective response in colorectal cancer and other malignant neoplasms. However, activation of retrotransposons is an inducer of carcinogenesis and a necessary condition for clonal evolution and the development of chemoresistance. Therefore, the most rational combination of the method of viral mimicry is with selective inhibition of retroelements involved in the pathogenesis of colorectal cancer. For this purpose, specific miRNAs, that recruit DNA methyltransferases to the loci of the location of retroelements due to the complementarity of nucleotide sequences, which is due to their evolutionary relationship, can be used. An analysis of the scientific literature revealed 28 miRNAs derived from transposons and associated with colorectal cancer, some of which exhibit oncosuppressive activity, while others exhibit oncogenic activity. These miRNAs can be used as guides for epigenetic effects on retroelements involved in colorectal cancer carcinogenesis.

Kazan medical journal. 2023;104(4):564-572
pages 564-572 views
Transitional lumbosacral vertebrae
Skryabin E.G.

Transitional lumbosacral vertebrae in the form of SI lumbarization and LV sacralization are classified as spinal anomalies. In the domestic medical literature, there are few publications devoted to these pathological conditions. In the course of a study of the available literature on the problem of transitional lumbosacral vertebrae, it was found that the frequency of cases of transitional lumbosacral vertebrae diagnosis ranges from 4 to 30% of clinical cases. The share of patients with lumbar vertebrae accounts for an average of 40% of cases, the share of patients with sacralization of the vertebrae is 60% of clinical observations. Mutations in the Hox gene are considered to be the trigger for the development of pathology, and pain is usually the leading clinical symptom. Plain radiography, computed tomography and magnetic resonance imaging are used to diagnose the pathology. Radiation imaging of the entire spine is required to eliminate errors in vertebrae counting. The type of pathology is determined using various classifications. As conservative therapeutic agents, drug blockades applying anesthetics and hormonal drugs are used. The arsenal of surgical interventions includes resection of the enlarged transverse process of the supracacral vertebra, decompression of stenotic intervertebral foramina, impulsive radiofrequency ablation, and posterior fusion. Measures for the prevention of pathology are not currently developed.

Kazan medical journal. 2023;104(4):573-583
pages 573-583 views
Immune сheckpoint inhibitors in ovarian cancer
Zhurman V.N.

The review considers modern immunotherapy for ovarian cancer with immune checkpoint inhibitors that interfere with the ability of the tumor to activate control proteins on the surface of T-cells, preventing cancer from evading the immune response and allowing the immune system to generate an antitumor response. The presence of spontaneous tumor-specific T-cells in cancer patients is a factor in creating ways to overcome the blockade of the immune system's ability to inactivate tumor cells. The use of immunotherapy with monoclonal antibodies makes it possible to influence the checkpoints of immunity, leads to the activation of the immune response, blocking the interaction of the PD-1 protein with the corresponding PD-L1/PD-L2 ligands and the attack reaction on tumor cells. The antitumor effect is achieved by releasing effector T-cells, reducing the function, number and suppressor activity of intratumoral Tregs. For antitumor drug therapy, anti-PD-1 and anti-PD-L1 monoclonal antibodies are used. This therapy is accompanied by various adverse events that are associated with the ability of PD-1 to interact with CD80 and the second PD-L2 ligand. Encouraging results of anti-PD-1/PD-L therapy in ovarian cancer resistant to platinum-containing chemotherapy may become an additional option in the treatment against the progression of ovarian cancer.

Kazan medical journal. 2023;104(4):584-589
pages 584-589 views
Influence of nutritional status and body mass index of patients on the prognosis and course of chronic obstructive pulmonary disease
Prokonich D.A., Saprina T.V., Bukreeva E.B., Sadovnikova A.Y., Chuprunova A.K.

The problem of the relationship of nutritional status with the risk of development, course features and prognosis of chronic obstructive pulmonary disease is of considerable scientific and practical interest, but remains poorly understood. However, in clinical practice, it is customary to calculate only the body mass index, but this indicator cannot provide a complete characterization of the nutritional status. We have reviewed the data of publications indicating the conditionality of the course of chronic obstructive pulmonary disease by the value of the body mass index, the amount of muscle mass of the body and such parameters of adipose tissue as its distribution in the body, hormonal activity and production of systemic chronic inflammation markers. To assess the dynamics of body mass index and spirometric parameters in patients with chronic obstructive pulmonary disease, 76 publications that were selected by the keywords “COPD”, “BMI” in the Scopus, PubMed, eLibrary databases for 1995–2022, were analyzed. Correlation analysis was carried out using Spearman's test. As a result, there was a trend towards an increase in body mass index in patients with chronic obstructive pulmonary disease in different countries and an improvement in spirographic parameters in a cohort of patients with chronic obstructive pulmonary disease over time. The data of the reviewed studies indicate the presence of a relationship between chronic obstructive pulmonary disease and nutritional status. At the same time, the mechanisms of the relationship between the pathogenesis of chronic obstructive pulmonary disease and adipose tissue dysfunction, as well as the role of adipose tissue and body composition in the course of the disease and its prognosis, have not been sufficiently studied.

Kazan medical journal. 2023;104(4):590-603
pages 590-603 views

Social hygiene and healthcare management

Assessment if the demographic aging scale of the region's population
Gaydarov G.M., Alekseevskaya T.I., Sofronov O.Y., Kindrat D.O.

Background. The current process of population aging manifests itself at the regional level with varying degrees of intensity, which should be taken into account when assessing the population's need for geriatric medical care and developing social support measures.

Aim. To give a comprehensive description of the dynamics of special indicators of population aging and to assess the demographic aging scale of the population of the Irkutsk region.

Material and methods. A comprehensive assessment of the dynamics of population aging was carried out using 6 special indicators of population aging and 3 indicators of demographic movement. The calculation of the values of the indicators was performed in accordance with the methodological provisions on demographic statistics. The scale of aging was calculated based on the results of determining the stages of aging using 4 parameters of population aging: the level of aging, the depth of aging, aging factors, and the rate of aging. The data source was the statistical accounting tables of Rosstat for the Irkutsk region: А12а_25 — natural population movement; t_pt1n — general results of population migration by incoming territories; 25_2PH — population by sex and age. The number of statistical accounting tables separately for each municipality of the Irkutsk region and the region as a whole amounted to 99 units for each year under study.

Results. The dynamics of the aging level parameter indicates an aggravation of the aging processes of the population, and not due to an increase in people at the age of longevity (from 75 to 90 years) and centenarians (90 years and older), but due to the population older than working age, women from 55 years old and men from 60 years — up to the age of 75 years. Indicators of aging factors that characterize reproductive and migration compensatory mechanisms are at a level that does not allow compensating for the growing processes of population aging. The value of the aging rate parameter in terms of the growth rate of the aging coefficient in dynamics indicates the stability of the demographic aging of the population. An analysis of the scale of population aging in the Irkutsk region and its districts showed that the Irkutsk region has an average value of parameters and is at an intermediate stage between the aging and old population.

Conclusion. The scale of the aging of the Irkutsk region is primarily due to the high value of the parameter of aging factors, the parameter of the level of aging is characterized by the presence of prerequisites for the transition to a more aggravated stage of population aging.

Kazan medical journal. 2023;104(4):604-613
pages 604-613 views

Clinical experiences

Features of local and systemic indicators in chronic rhinitis
Goncharova N.S., Smirnova O.V.


Aim. The study of the features of local and systemic indicators in chronic rhinitis.

Material and methods. The study groups included 21 patients with chronic allergic rhinitis, 20 patients with chronic vasomotor rhinitis, 9 patients with chronic atrophic rhinitis, 15 patients with chronic infectious rhinitis and 50 people from the control group. Diagnosis of chronic rhinitis, depending on the phenotype, taking into account the clinical recommendations of the Ministry of Health of Russia, was carried out by a doctor when the patient applied for treatment, followed by analysis of the data from a full range of instrumental examinations, clinical manifestations, anamnesis, and rhinoendoscopy results. 65 subjects with chronic rhinitis, as well as the control group, underwent a cytological examination of the nasal mucosa and an assessment of hematological parameters. Statistical analysis was carried out using the Statistica 10 package. Differences in groups were assessed using the nonparametric Kruskal–Wallis test (for three or more comparison groups) and Mann–Whitney test (for pairwise comparison). The critical level of statistical significance in testing scientific hypotheses was p ˂0.05.

Results. In chronic allergic rhinitis, three syndromes were locally identified: allergic syndrome (with a statistically significant increase in the absolute number of eosinophils up to 14 per field of view), non-specific inflammation syndrome (with a statistically significant increase in the number of leukocytes up to 9 per field of view) and a syndrome of protective changes in the nasal mucosa. At the same time, changes associated with allergic syndrome were recorded in the blood (with a statistically significant increase in the absolute number of eosinophils up to 0.84×109/l). In chronic vasomotor rhinitis, changes in the nasal mucosa did not cause significant changes in the activity of blood cells. In chronic atrophic rhinitis, degenerative changes in the nasal mucosa (with a statistically significant decrease in the number of epithelial cells up to 2 per field of view; p1–4 <0.001, p2–4 <0.001) with local hemorrhagic syndrome were accompanied by the presence of statistically significant anemic (hemoglobin up to 109 g/l; p1–4 <0.001, p2–4 <0.001, p3–4 <0.001, p4–5 <0.001) and inflammatory syndromes in terms of blood parameters (with statistically significant leukocytosis up to 10×109/l; p1–4 <0.001, p2–4 <0.001, p3–4 <0.001). In chronic infectious rhinitis, local inflammatory syndrome with a statistically significant increase in the number of leukocytes up to 75 per field of view (p1–5 <0.001, p2–5 <0.001, p3–5 <0.001, p4–5 <0.001) with protective changes in the nasal mucosa confirmed by systemic inflammatory syndrome with statistically significant leukocytosis up to 12×109/l (p1–5 <0.001, p2–5 <0.001, p3–5 <0.001, p4–5=0.04), neutrophilic granulocytosis up to 9×109/l (p1–5 <0.001, p2–5 <0.001, p3–5 <0.001, p4–5=0.03) and an increase in the erythrocyte sedimentation rate up to 22 mm/h (p1–5 <0.001, p2–5 <0.001 , p3–5 <0.001, p4–5 <0.001) according to blood tests.

Conclusion. The greatest number of local and systemic changes was found in chronic allergic and chronic infectious rhinitis, which requires increased attention to these diseases.

Kazan medical journal. 2023;104(4):614-622
pages 614-622 views
Immunocompetent cells of appendix in acute appendicitis in children with COVID-19
Demyashkin G.A., Gorokhov K.R., Pilipenko A.A., Maslow A.V., Kochetkova S.E.

Background. The study of the influence mechanisms of the SARS-CoV-2 virus on human homeostasis is still relevant. Of particular interest is the study of pathomorphological changes in the appendix in children with COVID-19 with the determination of the CD-phenotypic status of immunocompetent cells.

Aim. Immunohistochemical evaluation of appendix inflammation in children diagnosed with COVID-19.

Material and methods. The groups were formed on the basis of anamnestic, clinical and morphological data: the first group (n=42; age from 2 to 18 years, mean — 10.8±4.9 years) — surgical material of the vermiform processes of children with an established clinical diagnosis of “coronavirus infection” (COVID-19 based on PCR results); the second group (n=55; age from 2 to 18 years, mean — 9.7±4.2 years) — surgical material of the appendix after appendectomy in children with an established clinical diagnosis of “acute appendicitis” obtained before the onset of the COVID-19 pandemic; the third group (n=38; age from 2 to 18 years, mean — 10.3±3.2 years) — control group, autopsy material of appendixes (intact). Histological and immunohistochemical studies were carried out using primary antibodies to CD3, CD4, CD68, CD20, CD138. The number of CD+ cells was determined by computer morphometry in 10 fields of view. Student's t-test was used in quantitative analysis for a significant comparison between groups. Then, the quantitative density of CD+ cells per 1 mm2 was converted into a scoring system for visual presentation by a semi-quantitative method.

Results. Most samples (n=41) of the first group showed signs of destructive phlegmonous-ulcerative appendicitis. An immunohistochemical study revealed an increase in the number of T-lymphocytes (CD3+, CD4+), macrophages (CD68+), B-lymphocytes (CD20+) and plasma cells (CD138+) in the mucous membrane of the vermiform processes of children of the first group. In children of the second group, all clinical and morphological forms of acute appendicitis were found, the phenotype of immunocompetent cells corresponded to bacterial inflammation.

Conclusion. In children diagnosed with СOVID-19, confirmed by polymerase chain reaction, predominantly develop destructive forms of acute appendicitis, accompanied by microthrombosis and lymphocytic-plasmacytic infiltration with an increase in the number of immunocompetent cells CD3+, CD4+, CD68+, CD20+, CD138+.

Kazan medical journal. 2023;104(4):623-629
pages 623-629 views

History of medicine

To the 200th anniversary of the beginning of pediatric education in the Republic of Tatarstan: pages of the life of the outstanding pediatrician Pyotr Mikhailovich Argutinsky-Dolgorukov
Pikuza O.I., Fayzullina R.A., Zakirova A.M., Samorodnova E.A., Volyanyuk E.V.

The paper describes the main milestones in the life of one of the founders of the pediatric school in Kazan — Professor P.M. Argutinsky-Dolgorukov. He made a lot of efforts to organize the teaching of pediatrics at the Kazan Imperial University, was one of the initiators of the construction of a new children's clinic on the Arsk field in 1900. Professor P.M. Argutinsky-Dolgorukov connected mainly with the study of infectious pathology. His students Professor V.K. Menshikov, E.M. Lepsky, A.A. Agafonov later became well-known pediatricians and infectious disease specialists who took an active part in the creation of pediatric and infectious diseases services in the Republic of Tatarstan. P.M. Argutinsky-Dolgorukov was the founder of the study of malaria in children in Russia. Under the guidance of the professor, progressive methods of diagnostics and treatment were introduced into clinical practice, in particular, the method of treating scarlet fever with Moser's serum, the study of the measles causative agent, and X-ray examinations at the patient's bedside.

Kazan medical journal. 2023;104(4):630-633
pages 630-633 views
On the priority of V.S. Gruzdev in the experiment on in vitro fertilization
Chikmareva K.A., Kozlov L.A.

Among the many methods of teaching students, special attention is drawn to “becoming a specialist through the implementation of scientific research”. V.S. Gruzdev, having mastered under the guidance of Professor V.A. Manassein the first skills of scientific research, widely used them in his development as an obstetrician-gynecologist. Later he formed his own scientific school, which still exists today. One of his early works was the study of artificial insemination in mammals. This research, ahead of its time, marked the beginning of the study of in vitro fertilization. He revealed an important regularity in the development of a fertilized egg when it is planted in the oviduct. Other contemporary embryologists also spoke about this feature, mentioning that V.S. Gruzdev became the first scientist who described it. It is important that Viktorin Sergeevich proposed a plan to resolve the problem of infertile marriage, through his experiments — as a result of his research, followers were able to significantly increase the number of pregnancies that occurred as a result of the treatment of obstruction of the fallopian tubes and identify problems associated with the pathology of spermatogenesis in men, and their role in an infertile marriage. Professor P.V. Manenkov, being a student and follower of V.S. Gruzdev, continued the work of his teacher and was also able to further participate in the development of a bill draft on heteronomous conception.

Kazan medical journal. 2023;104(4):634-638
pages 634-638 views

Cochrane Review Summaries

Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Okwundu CI, Olowoyeye A, Uthman OA, Smith J, Wiysonge CS, Bhutani VK, Fiander M, Gautham KS. Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns. Cochrane Database of Systematic Reviews. 2023. Issue 5. Art. No.: CD012660. DOI: 10.1002/14651858.CD012660.pub2.

Kazan medical journal. 2023;104(4):639-640
pages 639-640 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies