Dear readers of the "Baikal Medical Journal"! We present to your attention the winter issue, in which we published materials of fundamental research, lectures and clinical cases on the main scientific directions of the journal.

Background. Chronic autoimmune inflammation in rheumatoid arthritis has a negative impact on the progression of atherosclerosis, morphofunctional parameters of the myocardium, blood pressure, and the risk of mortality in such patients. 
The aim of the study. To perform a comparative analysis of the MAGGIC (Meta-Analysis Global Group in Chronic Heart Failure) score coefficients and galectin-3 levels in patients with chronic heart failure with and without rheumatoid arthritis. 
Materials and methods. We examined 216 patients with heart failure. Two comparable groups were identified: the study group consisted of 100 patients with chronic heart failure and rheumatoid arthritis, the comparison group – of 116 patients with chronic heart failure without rheumatoid arthritis. The analysis of key laboratory and instrumental data and galectin-3 levels was performed. A regression analysis of the associations between the concentration of galectin-3 and the parameters determined using the MAGGIC heart failure risk score was carried out.
Results. The study showed significant statistical differences in the level of galectin-3: in the group of patients with rheumatoid arthritis – 17.4 ± 4.2 ng/ml, in patients without rheumatoid arthritis – 14.3 ± 3.1 ng/ml (p = 0.005). 
The average MAGGIG heart failure risk score in the group of patients with chronic heart failure and rheumatoid arthri-tis was 14 ± 2.1, without rheumatoid arthritis – 12 ± 1.4 (p = 0.01). The risk of mortality during the first year was 7.0 and 4.8 % (p = 0.02), within 3 years – 17.5 and 12.2 % (p = 0.04), respectively. Using regression analysis of interrela-tions of galectin-3 levels with mortality risk identified using the MAGGIC score, a statistically significant association was found (β = –0.04; SD = 10 ± 2.5; r = 0.46; r2 = 0.37; p = 0.002).
Conclusion. Patients with chronic heart failure and rheumatoid arthritis have higher levels of galectin-3 in their blood compared to people without rheumatoid arthritis. In addition, they have an increased risk of death according to the MAGGIC score. A statistically significant association of galectin-3 with the parameters of the MAGGIC heart failure risk score has been revealed.

Relevance. The article analyzes the syntopy of the aorta and the left renal vein, as well as the hydrodynamic effect of the aorta on the hemodynamics of the left renal vein basin.

Aim. To study the relationship between the syntopy of the aorta and the left renal vein, as well as the hydrodynamic effect of the aorta on the left renal vein.

Materials and methods. One hundred corpses from 16 to 62 years old were selected for the study. All of them had no changes or damage to blood vessels in the studied area. Full name, gender, age, cause of death and date of autopsy were recorded. Calculations were carried out using mathematical and hydrodynamic research methods.

Results. With the retroaortic location of the left renal vein, the pressure in the vessel increases. From the peculiarities of the overlap of the left renal vein on the aorta, it follows that the larger the area of application, the greater the pressure exerted by the pulsation from the aorta on the renal vein. Considering that in the layer of fluid adjacent to the surface of the vein the flow velocity is close to zero, one would expect a pulsating flow in the opposite direction, but due to the presence of pressure in the vein providing blood flow, this does not happen.

Conclusion. It has been studied that the outflow of blood from the left renal vein basin is influenced by both compression of the venous vessel and pulse pressure

Relevance. Vacuum therapy is used worldwide to treat acute trauma, thermal injuries, osteomyelitis, purulent wounds, urological pathology, etc. The sanogenetic effect of vacuum therapy is associated with the effect of altered barometric pressure on the tone of microvessels. However, specific mechanisms of vacuum action on the course of typical pathological processes have been poorly studied.

Objective. To determine the degree of influence of barometric therapy on the severity of cellular reactions in the focus of experimental purulent inflammation.

Material and methods. The study was conducted on 2 series of outbred white male rats (control and experimental). To simulate purulent inflammation, diffusion chambers of our own design filled with an aqueous suspension of a one-day culture of staphylococcus aureus were implanted under the skin of the thigh of animals. Vacuum therapy was carried out in a pressure chamber where the pressure was maintained from 0.03 to 0.05 atmospheres. The procedure was carried out every day with an exposure of 10 minutes. The material was fixed in a 10% solution of neutral formalin.

Results. The following data on the development of inflammation were obtained: the thickness of the cellular shaft, the ratio of neutrophils and macrophages, the structure of cellular structures on the 1st, 3rd, 5th, 7th, 10th, 15th, 20th day after implantation.

Conclusion. Modeling of experimental microbial inflammation against the background of vacuum therapy resulted in a significant reduction in the duration of cellular reactions compared to the staphylococcal inflammatory process, improvement of the migratory, phagocytic, synthetic capabilities of cells implementing the inflammation process, which prevented the inflammation from protracted. Reduced barometric pressure increased the phagocytic activity of leukocytes, the rate of their migration to the inflammation site, collagen synthesis by fibroblasts, the interaction of cells in the inflammation site, and, therefore, reduced the duration of the process phases and inflammation as a whole, preventing the inflammation from becoming chronic and generalizing.

Relevance. The effect of the drug Omnic (Tamsulosin) reduces the tone of the smooth muscles of the prostate gland, bladder neck, prostatic part of the urethra, improves urine flow, reduces the symptoms of obstruction and irritation of the urinary tract in benign prostatic hypertrophy. However, there are no data on its anti-inflammatory effect.

Objective. To determine the mechanisms of the anti-inflammatory effect of the drug Omnic on the model of purulent inflammation in rats.

Material and methods. The study was conducted on 50 outbred white male rats divided into 2 series: Series 1 - control (they were implanted with diffusion chambers filled with an aqueous suspension of a one-day culture of staphylococcus aureus under the skin of the thigh; Series 2 - experimental (the animals of this series were modeled with purulent inflammation similar to the control, but from the 1st day of inflammation, the rats were injected intramuscularly with 0.02 ml of the Omnic preparation for 10 days). The materials were collected 2, 3, 5, 7, 10, 15, 20, 30, 60 days after implantation. The material was fixed in a 10 % solution of neutral formalin. In the peripheral zone of the inflammation focus, the state of the microvessels was qualitatively assessed, the concentration of mast cells, eosinophils, neutrophils, mononuclear cells and poorly differentiated fibroblasts was counted.

Results. After 48 Hours after the onset of inflammation, a cellular wall with a thickness of 313.18 ± 30.19 μm is observed around the chamber wall. Three days after the introduction of the chambers, the thickness of the leukocyte wall remains the same and is 334.38 ± 25.69 μm. Five days after the onset of inflammation, the thickness of the leukocyte wall decreases sharply compared to the previous period and is 157.86 ± 46.08 μm. Seven days after the introduction of the chambers, the thickness of the cellular wall increases to 220 ± 29.67 μm. On the 10th day from the onset of inflammation, the thickness of the wall decreases to 129.52 ± 21.01 μm. On the 15th day of inflammation, the thickness and condition of the leukocyte wall do not change. On days 20-30-60 from the moment of implantation of the chambers, the remains of the leukocyte shaft with a thickness of 117.86 ± 29.6 μm were observed around them.

Conclusion. The effect of Omnic on the dynamics of cellular reactions in the inflammation focus enhances the migration capacity of leukocytes, concentrates fibroblasts around the leukocyte shaft. At the same time, the synthesis of collagen by fibroblasts does not correspond to the thickness of the connective tissue capsule, which disrupts the maturation process of the capsule. Presumably, the action of Omnic is associated with the effect of the drug on the tone of capillaries and venules

Relevance. Back and neck pain is one of the most common reasons of visiting a doctor. Pain syndrome is mostly related to lesion of the musculoskeletal system components, but may be due to specific reasons as traumas, systemic inflammatory diseases, tumors, etc. The reasons of spinal pain may be spinal infections which refer to quite rare and difficult to diagnose diseases. A doctor should be concerned of the spinal infection in order to suspect this abnormality and to send a patient for respective examination. 

Case descriptions. The article presents a case of purulent epiduritis in a patient with chronic urological pathology. Difficulties in diagnosis were related to non-specific clinical symptoms of the disease, missing sings of the infection process in the spine as shown by computed tomography, presence of infection site of other localization. The patient was hospitalized in the therapeutic department with the diagnosis: Diabetes mellitus type 2, newly diagnosed. Vertebrogenic cervicobrachialgia on the left, exacerbation. Benign prostatic hyperplasia. Acute urinary retention. Chronic obstructive pyelonephritis, exacerbation. Antibacterial therapy, insulin therapy, and symptomatic therapy were administered. Intoxication, neurological symptoms, laboratory activity were observed during the therapy. The patient underwent MRI examination which resulted to diagnosing epiduritis of cervical and thoracic spine. Antimicrobial therapy regimen was changed which resulted to regression of neurological symptoms, pain syndrome, positive laboratory dynamics was observed. The patient was discharged following completion of intravenous therapy with recommendations on further treatment on outpatient basis.

Conclusion. This clinical observation demonstrates the difficulties in diagnosing purulent-inflammatory disease of the spine in a patient with chronic urological pathology undergoing treatment in the therapeutic department. Magnetic resonance examination was crucial in establishing the correct diagnosis. The conservative therapy with antimicrobial agents was effective in this case; no surgical treatment was required.

Background. Myocardial infarction with non-obstructive coronary arteries is defined by the presence of clinical symptoms and signs of myocardial infarction despite angiographic findings of normal or near-normal coronary arteries. Myocardial infarction with non-obstructive coronary arteries can be classified into myocardial infarction type 1 or type 2. Hypertrophic cardiomyopathy is a possible underlying etiology of myocardial infarction with non-obstructive coronary arteries.

The aim. To present the diagnosis of myocardial infarction in a patient with hypertrophic cardiomyopathy.

Case descriptions. A clinical case of myocardial infarction with non-obstructive coronary arteries in a man with hypertrophic cardiomyopathy is presented. 57-year-old man presented with retrosternal chest pain that appeared at rest but during an attack of tachyarrhythmia. Electrocardiogram showed right bundle branch block and T inversion in the I, avL, V1-V6. Cardiac troponin T was with a rise and fall in the level. Echocardiography demonstrated asymmetrical septal hypertrophy with thickness of the basal and medium segments of the septum 18 mm, systolic anterior motion of the mitral valve, and left ventricular outflow tract obstruction with a peak systolic pressure gradient of 50 mmHg, diastolic dysfunction of the left ventricle. Coronary angiography revealed stenosis of the left anterior descending artery < 50 %. All these data allow us to diagnose the myocardial infarction with non-obstructive coronary arteries.  Type 2 infarction is most likely, however, the absence of an intracoronary imaging does not completely exclude type 1 myocardial infarction.

Conclusion. The clinical case demonstrates myocardial infarction in the absence of obstructive coronary artery disease in patient with hypertrophic cardiomyopathy. To exclude plaque disruption intracoronary imaging should be performed.

Relevance. Rhinophyma is treated by plastic surgeons, otorhinolaryngologists and dermatologists.  It is observed mainly in men over 40 years of age, manifested by disfiguring face and nose nodes, which progressively enlarge. Surgical methods can achieve a rapid and cosmetically significant effect, but can be associated with complications and scarring.

Case descriptions. The article presents a case of successful radio wave treatment of 70-year-old man with rhinophyma. It was noted that radiowave surgery has advantages over other methods: the pain syndrome during and after surgery was insignificant, good hemostasis was noted due to the use of the cutting-coagulation mode, which provided good visual control over the tissues being removed. Different types of tips allowed manipulation on the uneven convex and concave surfaces of the external nose, the removed material was not subjected to destruction, which made it possible to take all tissues for histological examination. Due to the gentle effect on tissues during radiowave removal, it was not necessary to apply skin flaps or free skin grafting for a satisfactory cosmetic result.

Conclusion. Clinical observation shows that outpatient radiowave surgery of rhinophyma is possible without skin grafting with a good cosmetic effect.

Relevance. Histology, which studies the microscopic structure of tissues, is the basis for many biomedical sciences. The study of the histology history helps to understand better how modern research and diagnostic methods were formed. With the rapid development of technologies such as artificial intelligence and genomic research, the understanding of the histology history can help in evaluating new approaches and integrating them into traditional methods. The history of the histology development may be interesting to specialists and students who want to understand the evolution of scientific ideas.

Results. Histology originated long before the invention of the microscope, but its formation as a science is associated with the microscope creation. Therefore, there are three stages in the development of histology: before microscopic, microscopic and modern. Knowledge of the history of histological studies allows us to fully and deeply understand the processes occurring in the body at the cellular level. The article describes the main important achievements and scientific discoveries of scientists who have contributed to the development of histology, as well as to the improvement of microscopy. Histology creates a theoretical basis for the study of many clinical disciplines. It is a fundamental discipline. It has a great practical importance. Microscopy is necessary not only for making diagnoses, but also in the treatment process. Microscopes are used in surgery for operations requiring delicate intervention, in ophthalmology, neurosurgery, vascular surgery and many other areas of medicine.

Conclusion. This article presents a brief summary of the history of the formation and development of histology as a science, important discoveries and achievements that influenced the development of medicine and biology. The article is intended for a wide range of readers, especially for students and teachers of medical universities, as well as for clinical residents, graduate students and doctors of various specialties.

The article provides information about the life and scientific activities of Mikhail Konstantinovich Vasiltsov, MD, Professor, Head of the Department of Histology, Embryology, Cytology (1974-1996) of the Irkutsk State Medical Institute. During 22 years of leadership of the Department of Histology, Embryology, Cytology of IGMI, Mikhail Konstantinovich has educated dozens of highly professional scientific and pedagogical staff. His contribution to the development of microscopic technology is significant. He improved and introduced the method of manufacturing tooth grinds, developed a method for semi-quantitative determination of collagen content using micro-preparations, which was approved by the scientific community and subsequently widely introduced into histological practice. А cytophotometer was designed and manually assembled under his leadership. It made possible to determine the content of substances in cells of various organs and tissues with high accuracy. For many years, Professor Vasiltsov M. K. was a member of the Dissertation Council on Histology, Cytology, and embryology. For two decades, Mikhail Konstantinovich was the permanent head of the Bureau of Rationalization and Invention of the Medical Institute. M. K. Vasiltsov headed the Irkutsk branch of the Russian Society of Anatomists, Histologists and Embryologists for many years. Mikhail Konstantinovich remembered as a prominent morphologist, professor, teacher, lecturer, methodologist of the highest class, a man of high moral human principles. Vasiltsov is the author of more than 100 scientific and methodological works, many of which are fundamental in nature. Three doctoral and six PhD dissertations were completed and defended under his leadership, three copyright certificates for inventions obtained. Numerous diplomas from the Irkutsk State Medical Institute and the Ministry of Health of Russia worthily marked the long-term fruitful work of Professor M. K. Vasiltsov. M. K. Vasiltsov awarded medals, honorary titles: "Excellent Health Worker" and "Veteran of Labor".