No abstract

The article presents an overview of the development of hematology service in the Republic of Tatarstan. The well-known scientist Nikolay Konstantinovich Goryaev (1875-1943), who worked in Kazan for a long time, began to develop this direction and after passing an internship in Germany proposed an improved device for calculating the blood elements known throughout the world. Adherents of Professor Goryaev continued research in the field of hematology, a blood transfusion station was organized. Professor S.I. Sherman proposed new methods of diagnosis and treatment of B12 deficiency anemia. Professor Sh.I. Ratner studied the changes in the blood picture in diseases of the abdominal cavity. The first 15 specialized hematological beds were opened in 1968 in the hospital named “Old Clinic”. The physician who treated such patients was Rakhil Sholomovna Dashevskaya, PhD. At present, hematology service is provided by three hospitals in Kazan, hematological and therapeutical beds in Naberezhnye Chelny and Nizhnekamsk, outpatient hematology service in Zelenodolsk. In recent years, the introduction of stem cell therapy has begun, and modern combined methods of chemotherapy have been introduced.

In 1951, for the first time, cases of simulated hemorrhagic syndrome were described, when patients deliberately caused themselves to bleed, either by taking medications or mechanically. Later in the literature, there were reports of similar cases that arose, as a rule, in young women with personality psychopathization. Clinical manifestations are polysymptomatic and can proceed as profuse bleeding of various localizations, hyperthermia, paresis, paralysis, etc. Such patients are under the supervision of specialists of various profiles, more often by rheumatologists for suspected hemorrhagic vasculitis, periarteritis nodosa, etc. they are characterized by a combination of various symptoms that do not fit into the picture of any of the known diseases and syndromes, a complete discrepancy between the subjective symptomatology and the data of objective and laboratory studies. Patients often give extensive false information about their lives.

Peripheral blood and punctates taken in 13 primary patients, 6 of which had acute myeloblastic leukemia and 7 chronic myeloleukemia are studied. The peripheric blood in 3 healthy volunteers is studied for control. The method of revealing the tissue factor activity in blood cells of patients with leukemia is suggested. Previously described expression of the tissue factor by myeloblasts of patients with acute myeloblastic leukemia in peripheral blood as well as in bone marrow punctates is confirmed. It is shown that in patients with chronic myeloleukemia expression of the tissue factor activity is carried out by myeloblasts in peripheral blood as well as in bone marrow punctates. The results contradict the conception maintaining the principal impossibility of forming principal the tissue factor by blood cells. The development of disseminated intravascular blood coagulation syndrome and hemophilia under the influence of the tissue factor in leukocytes is possible not only in acute myeloblastic leukemia but in chronic myeloleukemia.