Summary. The purpose of the study is to develop a concept for the evacuation of victims with trauma requiring emergency surgery in a specialized medical institution in the metropolis. Materials and methods of research. Our study included 216 patients evacuated from emergency scenes and treated in Moscow hospitals with open craniocerebral injuries and/or internal bleeding. All patients were divided into two groups: group 1 included patients evacuated to hospitals using the developed algorithms for medical evacuation; group 2 included patients evacuated without using the specified algorithms. Results of the study and their analysis. The results of treatment of victims with combined trauma/internal bleeding were analyzed, the risks of fatal outcome in such victims were identified, the reasons that slow down the medical evacuation of these patients to the hospital were established, the results of treatment of these patients in hospitals were assessed. It was noted that the creation of algorithms for medical evacuation of such victims in the presence of indications for urgent surgery will allow timely initiation of measures to finally stop bleeding, improve treatment results and reduce mortality by 15%.

Summary. The aim of the study is to determine the average duration of inpatient treatment for victims who received injuries from limited-damage firearms (LLFWs) and the factors associated with these durations. Materials and methods. A statistical study (in the form of the documentary observation) was carried out based on the records from 248 case histories of patients who received hospital care in Arkhangelsk and Severodvinsk (Arctic zone of the Arkhangelsk region) being wounded by NLW in 2005–2022. Simple (SLRA) and multiple linear regression analyses (MLRA) were used to detect factors and covariates associated with the duration of hospitalization of those patients. Results of the study and their analysis. The study determined the average treatment times for victims in 2005–2014 and 2015–2022, as well as the average treatment times for victims: with a single wound, with two or more wounds; with a total severity of wounds, which was assessed using the CAP-P(OR) scale in points: less than 0.5 points, in the range of 0.5–0.99 points, and more than one point. In addition, the average treatment times were determined for victims whose condition at the start of treatment was assessed as satisfactory, moderate, and severe. It was concluded that the inpatient treatment times for victims with wounds from primary trauma depend mainly on the total severity of the wounds, determined using the CAP-P(OR) scale, and the severity of the victim’s condition upon hospitalization.

Summary. Investigation purpose – to analyze and assess status of normative and legal regulation, organizational and methodological support of functioning of Disaster Medicine Service of Ministry of Healthcare of Russia; to determinate some ways of its further improvement. Materials and methods of investigation. Materials: legal and legislative acts of the Russian Federation, normative and methodological documents used in the healthcare sphere of the country, including the Nationwide disaster medicine service and Disaster Medicine Service of the Ministry of Healthcare of Russia (DMS); questionnaire on assessment of normative and legal support of Service work, filled by DMS specialists; scientific publications on actual issues of the investigation topic. Methodes: historical method, method of content-analysis and expert assessment, statistical method, method of logical and informational modelling, analytical method. Results of investigation. In the research there are results of the study and analysis of status of normative and legal regulation, organizational and methodological support of the Service functioning, determining procedure of organization and provision of medical care and medical evacuation of victims in emergencies; inadequacy of these documents was shown and proved; the main ways of improvement of normative and methodological support of DMS working were proposed.

Summary. The purpose of the study is to analyze the provision of medical care to children injured as a result of road accidents by emergency medical teams and offer recommendations on how to prevent its mistakes. Materials and methods. The accounting data of the State Traffic Safety Inspectorate for the period from 2020 to 2023 inclusive, as well as statistical data taken from the database of the Saratov Regional Children’s Clinical Hospital for the period from 2020 to 2023 inclusive, on road accidents involving children and adolescents, were used. The results of the provision of medical care to children injured in road accidents by ambulance crews were analyzed. The research method is analytical. Research results. Analysis of the research results showed: The condition of children injured as a result of road accidents at the time of assistance is regarded as mild in 22.0% of observations, as severe in 21.0%, as extremely severe in 27.0% and as critical in 30.0% of observations. Medical care for children who have been injured as a result of road accidents is provided by medical emergency medical teams in 78.0% of cases and in 22.0% of cases by paramedic teams. Errors in the provision of assistance were noted in 4.0% of observations in the provision of assistance by medical teams and in 5.0% of cases in the provision of assistance by paramedic teams. The total number of deaths among children injured in road accidents was 35.0%. The causes of death in the victims of this group were as follows: traumatic shock – 11.0% of cases; hemorrhagic shock – 3.0% of cases; traumatic brain injuries – 9% of cases and injuries incompatible with life – 5.0% of cases. The main causes that led to traffic accidents involving children are violation of rules for transporting children – 32.0% of cases and driving into oncoming traffic – 18.0%. It is noted that the results of the study indicate the need to pay more attention to the organizational problems associated with the provision of medical care to children injured in road accidents. Often, the process of calling an ambulance team and waiting for its arrival takes too much time, especially if the accident occurred in a remote or hard-to-reach place, which can be critical for children with serious injuries. It is also necessary to pay attention to the lack of coordination between various medical services in a large number of cases, leading to delays and improper provision of medical care.

Summary. The purpose of the study is to determine the level of readiness of primary school children to act in life-threatening situations and teach them rules of first aid. Materials and methods of research. Research materials – test tasks. Prepared taking into account the age characteristics of schoolchildren. Research methods – observation methods, questionnaires, role-playing games, etc. Results of the study and their analysis. When teaching primary school children the rules of first aid, it is necessary to correct their ideas about first aid; use non-standard solutions aimed at developing first aid skills in children, and also carry out periodic monitoring of the effectiveness of reinforcing the acquired skills.

Summary. The purpose of the study is to develop modern organizational and methodological approaches that facilitate the inoculation of students (persons without special medical education) with the skill in providing first aid to victims (in the amount of self- and mutual assistance) with wounds, injuries and other life-threatening conditions. Materials and methods of research. The research materials include domestic and foreign experience in the training and retraining of first aid participants, as well as the practical experience of the Omsk region Territorial center for disaster medicine employees; normative legal acts regulating the training of students for first aid. Methods used: literary-analytical and formal-legal methods, method of content analysis, formalization, generalization, comparison and system analysis, story, display, training. The object of the study is the methodology of conducting classes (trainings) to instill the skill in providing first aid to persons without special medical education. The results of the study and their analysis. The methodology and elements of the lesson are presented, which contribute to instilling in students (persons without special medical education) the skill in providing first aid to victims. Attention was paid to the components of the Educational and material base (UMB) and the Educational and methodological Complex (UMK) on the subject of “First aid to victims”, the methodology of conducting (by elements) classes to achieve their goals.

Summary. Investigation purpose. To analyze data on treating of victims with polytrauma using new protocols of urgent medical care provision in hybrid surgery-reanimatological anti-shock rooms, which were represented in scientific publications. Materials and methods of investigation. Materials: scientific publications on issues of patients with poly-trauma treatment. PubMed, MEDLINE, ResearchGate, Scopus, Web of Science, Cochrane Library, eLIBRARY data bases were used for search of the publications. Publications written for last 12 years (from 2011 to 2023) were used for analysis. Methods: analytical method and method of generalization. Results of investigation. According to the most authors’ opinion, usage of hybrid surgery-reanimatological anti-shock rooms significantly reduces the time from admission of victims to the hospital till the start of treating, that increase chances of positive outcome for patients with severe combined injuries of various organ systems. It is concluded that there is a necessity of further study of capabilities of hybrid anti-shock rooms for increasing of effectivity of urgent medical treatment provision for patients with polytrauma and for patients with other pathology which need a combined usage of multi-component diagnostical and treating measures.

Summary. Purpose of the study – to evaluate the efficacy of different fractions of a peptide preparation in the treatment of post-burn corneal neovascularization in an experiment. Materials and methods. The experimental studies were conducted on 40 male Wistar rats. All animals had previously undergone a chemical burn of the cornea and conjunctiva. Various fractions of a peptide preparation containing paracrine factors of mesenchymal stem cells (MSCs) were used as treatment. For the experiment, MSCs were cultivated under hypoxic conditions. Four experimental groups and one control group of 8 rats (8 eyes) were formed. Group 1 – a peptide preparation of the total fraction was used for treatment; group 2 – a peptide preparation with a fraction of molecular weight up to 3 kDa; group 3 – with a fraction of molecular weight up to 30 kDa; group 4 – with a fraction of molecular weight from 30 to 120 kDa, in the control group a culture medium was used as treatment. Before the treatment, as well as on the 14th and 30th day of the experiment, the following studies were performed: photo registration of the fundus, biomicroscopy, corneal OCT, determination of corneal transparency. Results of the study and their analysis. The study showed that the total fraction and the fraction with a molecular weight of up to 30 kDa, obtained by culturing MSCs under hypoxic conditions, are effective in the treatment and prevention of neovascular corneal leukoma caused by a chemical burn, and these substances may be promising for the development of drugs used in medicine to minimize the effects of injuries in man-made disasters.

Summary. The purpose of the study is to develop a prognostic model based on a minimum and sufficient number of simple and standard indicators of heart rate variability (HRV), capable of determining the resistance of the organism to the toxic effect of oxygen. Materials and methods: 255 volunteers participated in the study: 109 women (mean age 23.9±5.7 years) and 146 men (mean age 25.7±5.4 years). All participants underwent hyperbaric oxygenation. To improve accuracy and confirm the obtained results, HRV measurements were performed in three stages: at rest, during the hyperbaric oxygenation (HBO) procedure and after its completion. Results of the study and their analysis. In the group of individuals resistant to the toxic effect of oxygen, the coincidence of the predicted and actual result was 83.3%. For the group with medium resistance, a higher coincidence of 91.8% was observed. In the group with low tolerance, the accuracy of the model was 91.7%. Conclusions. Changes in HRV indices are caused by the processes of regulation of the organism of the examined volunteers in response to oxygen exposure in conditions of increased ambient partial pressure. Significant (p<0.05) predictive indices of HRV, such as VLF log, stress index, SD2/SD1 ratio, NNxx, max HR, alpha 2, LF log, VLF Hz, LF/HF ratio, ApEn, whose values should be used in the developed linear function formulas, were identified. The developed model demonstrates high prognostic ability (89.4%), allowing timely and reliably (p<0.05) to determine the level of organism resistance to the toxic effect of oxygen.

Summary. This study was conducted with the aim of assessing the model for organizing the provision of first aid through an analysis of current legislation, educational and methodological materials, law enforcement practice, in order to make practice-oriented proposals for its improvement in the light of the changes that have already taken place due to the entry into force on September 1, 2024 the Federal Law of April 14, 2023 No. 135-FZ. Materials and research methods. The normative and empirical basis of the scientific research was made up of analytical material on the organization of first aid, contained in the works of Russian and foreign scientists. A study was conducted of federal laws and by-laws of the Russian Federation regulating the management of first aid activities, the organization of first aid provision and training and the provision of first aid kits, packs, kits, and first aid kits to various categories of first aid participants. The methodological basis of this study was made up of general scientific (dialectical, analysis and synthesis) and specific (method of legal hermeneutics, formal legal, systemic structural, historical legal, comparative legal, sociological) methods of scientific knowledge. Results of the study and their analysis. The study identified a number of problems in the regulation of first aid in the Russian Federation, including problems in the field of regulatory legal regulation of training, equipment, motivation of citizens to provide first aid and management in this area. The legislative changes in the field of first aid that have entered into force, provided for by Federal Law No. 135-FZ, have endowed the Ministry of Health of the Russian Federation with additional powers in the field of first aid regulation, the need for which has long been overdue. The implementation of the new powers makes it possible to regulate in detail the essential aspect of first aid, namely, to approve the procedures for first aid with a differentiated volume of first aid by various participants in its provision, requirements for completing first-aid kits, stowings, kits and kits for first aid not only with medical devices, as it was previously, but also with medicines for medical use. The provision of the aforementioned Federal Law, which is interrelated with these norms, has given the concerned federal executive authorities the authority to approve the requirements for the placement, storage and use of first aid kits, stowage kits and kits for first aid. Taking into account the results of the analysis, the authors have formulated and proposed for discussion by the professional community a number of normative and practice-oriented proposals aimed at improving first aid in the Russian Federation. To ensure the sequence of steps in this direction, the authors propose the development and implementation of a scientifically based and practice-oriented concept for the development of first aid in the Russian Federation, as well as the creation of a first aid management body, referring to a structural unit based on one of the leading medical organizations that provides organizational and methodological guidance and analytical activities in the field of first aid organization help.

Purpose: To introduce a wide range of specialists with the technique of reconstructive plastic surgery, which was first used in local radiation injury (LRI). Material and methods: clinical analysis of the case histories of the severe LRI of the hand. The report describes the results of the first autotransplantation of the II toe in the position of the right hand III finger for the restoration of grip function in LRI. Results: Patient L., 38 years old, was admitted to the A.I. Burnazyan Federal Medical Biophysical Center in 2010 for the treatment of late consequences of severe LRI of the right hand resulting from contact with a gamma radiation source (Ir 192) in 2008. In the period from 2010 to 2018, the patient underwent repeated surgical operations, including reconstructive plastic surgery, which made it possible to achieve healing of constantly recurring late radiation ulcers. However, multiple necrectomies, exarticulations, finger amputations and resections of the phalanges led to the formation of a functionally defective hand and persistent disability of the patient. In 2018, the patient was admitted to the clinic for reconstructive surgery to restore the function of hand grip - microsurgical transplantation of the II toe into the position of the III finger of the hand. As a result of the treatment, the function of grabbing objects with the right hand was restored, and the patient’s ability to work was largely restored. Conclusions: The obtained long-term functional and aesthetic results allow us to consider the applied method of fingerless hand reconstruction by autotransplantation of the toe with the imposition of microvascular anastomoses optimal. It is advisable to use this type of surgical treatment more widely for the rehabilitation of patients with severe and extremely severe hand LRI.

Purpose: To compare the effectiveness of different methods of treating severe local radiation injuries (LRI) under the same experimental conditions. Material and methods: Male rats of the Wistar-Kyoto inbred line were locally irradiated in the ilioplumbar region of the back using an X-ray unit LNK-268 at a dose of 110 Gy (tube voltage 30 kV, current 6.1 mA, Al filter 0.1 mm thick), at a dose rate of 20.0 Gy/min. The area of the irradiation field was 8.2 cm2. Such radiation exposure led to the occurrence of severe LRI in rats with long-term non-healing skin ulcers, without critical radiation exposure to the underlying tissues. For the treatment of severe LRI, surgical methods, cell or drug therapy were used, which were used separately from each other. Treatment began on the 28th day after local irradiation, that is, during the period when the radiation ulcer had already formed and regenerative processes began to activate in the affected area. Various surgical approaches were used: from complete excision of the radiation ulcer to removal of various volumes of necrotic tissue within the radiation ulcer. Cell therapy consisted of transplantation of syngeneous cells of the stromal vascular fraction of adipose tissue or cultured syngeneous multipotent mesenchymal stromal cells. The cells were injected subcutaneously around the radiation ulcer twice at 1-week intervals. For drug therapy of severe local radiation injuries, we used a veterinary complex antibiotic ‒ levotetrasulfin forte, as well as drugs that affect the microcirculation and trophism of irradiated tissues – pentoxifylline and detralex. The drugs were used once a day from the 28th to the 49th day after irradiation. Results and coclusion: The use of surgical methods, cell or drug therapy facilitated the course of the pathological process and accelerated the healing of radiation ulcers. However, different treatments for severe LRI have had different efficacy. In terms of the rate and quality of healing of severe local radiation injuries, drug therapy is less effective than cellular therapy, and cell therapy is less effective than complete surgical excision of radiation ulcers.

Purpose: We tried to create a hepatospecific paramagnetic contrast agent – a paramagnetic analogue of 99mTc-technefit, by obtaining a paramagnetic Mn(II) complex with phytic (D-myo-inositol-1, 2, 3, 4, 5, 6– hexakisdihydrophosphoric) acid. Material and methods: A hepatotropic magnetic resonance contrast compound was obtained as an aqueous solution containing a paramagnetic Mn(II) complex with D-myo-inositol-1, 2, 3, 4, 5, 6-hexakis dihydrophosphoric (phytic) acid in a concentration of 0.5 M, with the addition of a 0.5M aqueous solution of meglumine (N-methylglucamine) in a ratio of 1:4 by volume to maintain pH in the range of 6.2–7.8, as well as to improve the stability of the solution. The working name of the Mn(II) complex with phytic acid phytomang®. The toxicological properties of the compound were evaluated when administered to laboratory mice, R1 relaxation and imaging properties in Wistar laboratory rats weighing 350-400 g, using low-field (field strength 0.2 T) and high-field (field strength 1.5 T) MR tomographs. Results: For 0.5 M of an aqueous solution of Mn-phytate, with the addition of meglumine, LD50, when administered acutely to laboratory animals – mice, is more than 18.7 ml / kg of body weight, which allows this compound to be classified according to GOST 12.1.007-76 standards to group 4 – low-hazard substances. The thermodynamic stability constant was 17.5. Spin-lattice relaxivity R1 in aqueous solution at a field strength of 0.2T: R1 = 6.82 1/ms. After intravenous administration to healthy rats with preserved liver function, Mn-phytate is distributed in the bloodstream, with rapid absorption within 5 minutes by liver tissue, followed by partial (up to 7 ± 3 % of the dose) excretion into bile after 30 minutes or more. The total uptake of the drug by the liver is 72 ± 7 % of the administered dose. Conclusion: The complex compound Mn (II) with D-myo-inositol-1, 2, 3, 4, 5, 6– hexakis dihydrophosphoric (phytic) acid belongs to low-toxic substances, is stable in aqueous media and has a high relaxability R1, selectively accumulates and intensively contrasts the liver parenchyma, and can be considered as the basis for creating a hepatospecific paramagnetic contrast preparation for use in MRI diagnostics liver in experimental and clinical studies.

Rеlevance: Castleman’s disease is a relatively rare heterogeneous group of lymphoproliferative diseases, the incidence of the localized form is 15, and the multicentric form is about 5 people per 1 million population. Currently, surgical treatment is the most radical in the treatment of localized forms of Castleman’s disease, and in cases where the clinical situation is considered unresectable, the treatment strategy is not strictly defined. Studies of the effect of radiation therapy on the survival rates of patients with Castleman’s disease remain isolated to this day, up to the description of individual clinical cases. This is due to the low incidence of this pathology, which does not allow for high-power randomized clinical trials. However, empirical accumulation of experience suggests that conducting remote radiation therapy in total doses of 40 Gy helps to achieve long-term local control. The use of modern methods of radiation therapy in the form of volume-modulated radiation therapy makes it possible to avoid serious post-radiation damage to healthy organs and tissues adjacent to the tumor, and can help in achieving stable local control in the treatment of unrecoverable forms. It is possible to use DLT protocols used in the treatment of lymphomas, which may be comparable in their effectiveness for Castleman’s disease, which requires subsequent research. Purpose: Аn analysis of a rare clinical observation of the successful use of rotational volume-modulated radiation therapy in the treatment of an unresectable localized form of Castleman’s disease. Material and methods: The search and analysis of literature data in Russian and English for the period from 2000 to 2023 in the databases Medline/PubMed, RSCI/Elibrary, CyberLeninka, Google Scholar, devoted to the diagnosis and treatment of Castleman’s disease. Clinical observation of the use of rotational volume-modulated radiation therapy in the treatment of an unresectable localized form of Castleman’s disease with lesions of the supraclavicular lymph nodes (hyaline-vascular type, unicentric variant). Results: Rotational volume-modulated radiation therapy of an unresectable localized form of Castleman’s disease can have a stable and safe consolidating effect in the form of long-term local control.

Purpose: Review of methods for assessing cerebral energy exchange in order to select a method that has sufficient information content and a good degree of accessibility when examining nuclear industry workers. Results: To assess cerebral energy exchange, PET, SPECT, and measurement of local cerebral blood flow using isotope clearance are used. These techniques use the introduction of radioactive substances into the body. Their use is limited by the high cost of the equipment and its stationary nature. Also, to assess cerebral energy exchange, the polarographic method (invasive), REG and fMRI is used. REG provides insufficiently accurate data on cerebral energy exchange. fMRI provides fairly informative data, but is also a stationary method, which limits its use in the conditions of a comprehensive examination of people working at nuclear enterprises. A more accessible method is neuroenergy mapping, based on measuring the level of constant potential (LCP). Currently, this method is widely used in neurophysiological and neuropsychological studies. An equally accessible and effective method is EEG, based on the data of which the value of interhemispheric differences (VIHD) in the power of biopotentials of homologous leads is determined, based on the power characteristics of the EEG, reflecting the activity of nerve cells and metabolic processes in them. The indicator reveals the degree of uneven distribution of power characteristics between the hemispheres; this characterizes the interaction of the activating and inhibitory parts of the nonspecific brain system during the formation of functional interhemispheric asymmetry, which reflects the level of cerebral energy exchange. The advantage of the method is its close connection with EEG indicators, which makes it possible to simultaneously assess the functional activity of the brain and its energy processes. Conclusion: The EEG indicator of VIHD power of biopotentials of homologous leads is sufficiently informative and accessible for assessing cerebral energy exchange in conditions of mass examination, in particular of nuclear industry workers.

On August 29, 1949, exactly 75 years ago, the first test of the Soviet atomic bomb was conducted at the Semipalatinsk test site. More than one and a half thousand animals were brought to the landfill to conduct research, employees of the Institute of Biophysics of the Ministry of Health of the USSR under the leadership of B.M.Isaev provided equipment for conducting radiation reconnaissance on the ground, in the explosion area, for aviation reconnaissance and dosimetric control of irradiation of test participants. In the following years, more than 300 scientists from different laboratories of the Institute of Biophysics visited the landfill. In the field, medical and biological studies were conducted on large and small laboratory animals, the course of acute radiation sickness was studied when exposed to radiation in various doses and the effectiveness of anti-radiation agents used. During the testing period, new sections of medical science were created: radiation pathology, clinical and field dosimetry, toxicology of radioactive fission products, radiation hygiene, radiation epidemiology. It was during this period that original, modern anti-radiation agents for various purposes were developed: RS-10 and its analogue RS-11, prodigiozan (early treatment agents), B-190 (emergency radioprotector), hemosorption (detoxification method), as well as a scheme of complex therapy and means to combat early manifestations of the primary reaction to radiation exposure. One of the important stages of research in those years, along with preclinical studies, was the evaluation of the effectiveness of new drugs in conditions simulating radiation damage in a nuclear explosion. Such large-scale tests were conducted at the Semipalatinsk test site.

Purpose: The study of regularities in the incidence of solid cancer in the Urals Cohort of the Exposed Population Offspring over a 65-year follow-up period. Material and methods: The study was conducted by cohort method. The cohort under study is the Urals Cohort of the Exposed Population Offspring. It includes offspring of the population exposed in the period from 1950 to 1960 in the Southern Urals (on the Techa River and at the East Urals radioactive trace). The catchment area includes 5 districts of the Chelyabinsk region, as well as the city of Chelyabinsk and the city of Ozyorsk. The follow-up period was 65 years, from 01.01.1956 to 31.12.2020, the number of the analytical cohort for 2024 is 24952 people, the number of person-years under follow-up is 850698. Calculation of cases, incidence rates, person-years and statistical processing of data were performed by standard methods using the DATAB program module of the Epicure statistical package. Results: During the 65-year period, 569 cases of solid cancers were registered in the catchment area. In women the most frequent cases were neoplasms of female reproductive organs, breast, thyroid gland, whole intestine and upper digestive tract organs; in men - respiratory organs, upper digestive tract and whole intestine. A significant increase in the incidence rates was found in women in age groups older than 20 years and in men in groups older than 30 years. Statistically significant sex-depended differences were observed only in the age groups between 30 and 50 years. No significant differences in the incidence rates among offspring of different ethnic groups were found. An assessment of incidence rates by calendar periods was carried out: in women, a significant increase in incidence rates began in 1990, in men in 2005 and significant differences by sex were observed only in the period from 2005 to 2020. Conclusion: The study revealed patterns in the incidence of solid malignant neoplasms within the offspring cohort by sex, age and depending on the calendar period. These patterns will be taken into account in future studies when assessing the dependence of the incidence of solid malignant neoplasms in offspring on parental gonadal dose.

Purpose: The study of the kinetics of the spatio-temporal distribution of cisplatin, as an agent capable of increasing the effectiveness of chemo-radiation therapy of solid tumors. Material and methods: The material was the data of literature on the results of experiments of various groups of authors who studied the content of platinum in tissues on biopsy materials. The method of simulation mathematical modeling (in silico) is used, based on the biological patterns of tumor growth, morphofunctional changes in the structure of tumor cells and tissues. Model is based on reaction-diffusion equation system, coefficients of which are random functions of space and time. The model takes into account the sequence of processes from intravenous administration of cisplatin and its spatial distribution in various tissues, until the excretion of its addicts from the cell. Results: The heterogeneity of the distribution of the concentration of platinum atoms in the tumor is shown. Perhaps this is due to the varying degree of vascularization of tissues, the rate of metabolism of the tumor occurring in the outer layer and in its hypoxic core. These processes lead to significant errors when evaluating the biopsy data obtained in the experiments and the analysis of platinum content in the biopsy. Conclusions: The calculation assessments of the distribution of platinum atoms in the tumor are consistent with the literature on the concentration of cisplatin in biopsy samples for carcinoma. The results of the calculations on the described model are fair, taking into account the morphological type, the size of the tumor and the plan of the administration of the drug. For other conditions (cancer types, treatment regimens, etc.), new calculations are necessary. To increase the efficiency of combined chemo-radiation therapy, cisplatin should be introduced at least 72 hours before the start of radiation therapy.

Purpose: To demonstrate the possibility of a combined approach in the treatment of a patient with locally advanced squamous cell carcinoma of the nasopharynx, complicated by massive erosive bleeding using endovascular embolization, proton therapy and targeted therapy. Material and methods: The Federal Scientific Research Center for Reconstruction and Research has developed a method of a combined approach to the treatment of patients with malignant neoplasms of the nasopharynx, during which endovascular embolization and proton beam therapy in combination with targeted therapy are consistently used. Results: A set of sequential treatment procedures and drug administration allowed us to eliminate life-threatening bleeding, normalize the patient’s general condition, conduct a course of proton radiation therapy for a patient with locally advanced squamous cell carcinoma of the nasopharynx, complicated by massive bleeding, and achieve stable local control over the process. Conclusion: The use of the described tactics in the treatment of tumors of the nasopharynx and oral cavity allows in a short period to move from urgent endovascular occlusion of bleeding vessels to the stages of special antitumor treatment, providing a combined approach to the treatment of head and neck tumors.

A computational assessment was made of the possibility of verifying dose distributions during proton radiation therapy using PET imaging of positron activity in human tissues, which was formed as a result of proton irradiation. To compare the dose distribution of a particle energy-modulated proton beam with a diameter of 10 mm with an initial particle energy of 100 MeV, ensuring uniform irradiation of the target in a 13 mm zone (at the level of 90 % of the radiation dose) at the end of the particle path, with a map of induced activity from the radionuclides 11C, 13N and 15O, numerical calculations were performed in a Monte–Carlo code using the Geant4 simulation program. In the modeling process, a volume with dimensions of 50 × 50 × 100 mm was used, simulating soft tissues of the human body with a density of 1 g/cm3, consisting of hydrogen atoms (62 %), carbon (12 %), oxygen (24 %) and nitrogen (1.1 %). The cross sections for the formation of radionuclides 11C, 13N and 15O in the reactions 12C(p, pn)11C, 14N(p, α)11C, 16O(p, αpn)11C, 14N(p, pn)13N, 16O(p, α)13N, 16O(p, pn)15O have been calculated, which were used to calculate the distributions of positron activity in the irradiated volume. Taking into account the short half-lives of the radionuclides under consideration (primarily oxygen-15), calculations of isoactivities and depth distributions of accumulated radioactivities were performed for various time intervals after irradiation. The performed computational modeling of the distributions of activities of radionuclides 11C, 13N and 15O during the passage of a modulated proton beam, taking into account the decay of produced radionuclides after irradiation, shows that by recording for 15 minutes the induced activity of PET radionuclides 2 minutes after irradiation, it is possible to obtain data on the compliance of the planned and irradiation of tumors performed during proton therapy. However, small levels of generated activity (at a level of 2 Gy for finely fractionated irradiations) require a device with high efficiency in recording annihilation radiation and high spatial resolution at the level of 1.5–2.0 mm.

The article describes the methodological approaches and principles used by the author to overcome the difficulties encountered in the process of conducting an expert assessment of the professional success of nuclear power plant personnel. This procedure was part of a professiography research, and its purpose was to identify groups of the most and least successful specialists of various profiles, followed by an analysis of their psychological and psychophysiological characteristics. As a result of trial and error, the author concluded that reliable results can be obtained by consistently using a set of expert assessment methods, starting with a point assessment by experts of individual qualities of the evaluated specialists belonging to the same job group, continuing with the method of their alternative ranking based on professional success. At the final stage, the experts subdivided the ranked lists of evaluated persons of each job position into five qualitatively different levels according to this integral feature (from the most to the least successful). The algorithm of expert personnel assessment described in this paper has allowed minimizing the impact of some traditional problems that inevitably occur when solving such tasks. It was successfully applied by the author and his colleagues in the process of professiography research conducted at nuclear power plants.

Purpose: Characterization of the response of mouse microglia cells of the SIM-A9 line to the γ-irradiation. Material and methods: Irradiation of the cells in suspension was carried out using a GUT-200M installation (cobalt-60 γ-radiation source). The radiosensitivity of cells was assessed by the number of surviving cells and their clonogenic activity. The effect of γ-radiation on the phenotype and expression of colony-stimulating growth factor receptor-1 and of epidermal growth factor, which are required to stimulate microglial cells proliferation, was studied using flow cytometry after staining the cells with appropriate fluorescently labeled CD11b, CD45, TMEM119, CSF-1R и EGFR antibodies. Analysis of the relative expression of mRNA genes for the cytokines IL-1β, IL-6, and TNFα in response to γ-radiation was performed using RT-PCR. Statistical analysis was carried out using Student’s t-test in the Origin program. Results: High radiosensitivity of SIM-A9 cells has been demonstrated. When analyzing the dependence of the clonogenic activity of cells on the radiation dose, it was shown that the D37 value for these cells was equal to 1 Gy. Irradiation caused a cell cycle block in the G0/G1 phase with a decrease in the proportion of cells in the S– and G2/M-phases. The cell death of irradiated SIM-A9 cells occurred by apoptosis. The peculiarity of SIM-A9 cells compared to brain microglia is their phenotype of activated microglia CD11b+/CD45high with an insignificant content of CD11b+/CD45-/low cells and no change in it after irradiation. An increase in the level of mRNA expression of the proinflammatory cytokine genes IL-1β, IL-6 and TNFα in response to γ-irradiation of SIM-A9 cells was shown, which reflects their activation and corresponds to the response of brain microglia cells during total mice irradiation and local cranial irradiation. Conclusion: The obtained patterns indicate the possibility of using the SIM-A cell line in model radiobiological studies, including the study of intercellular interactions of brain cells of different types with microglia cells.

Background: Analysis of the Relationship of biomarkers of Cytogenetic and Psychophysiological Status (CGS and PPS) of personnel under conditions of the combined influence of occupational factors. Material and methods: CGS was determined using a non-invasive Buccal Micronucleus Cytome Assay (BMCA) and determination of the accumulation index of cytogenetic damage and the level of cytogenetic stress. PPS of personnel was determined in accordance with MR 2.2.9.84 – 2015 FMBA of Russia and the Health-Test program. Results: People with average and high levels of psychophysiological adaptation have a low level of cytogenetic damages. Also, in the group with a high accumulation index of cytogenetic damages a low level of psychophysiological adaptation was determined. Conclusion: An increased level of cytogenetic damages has been established in people with a low level of psychophysiological adaptation. Taking into account the literature data, we can assume an indirect dependence of the cytogenetic status of the organism on its psychophysiological adaptation, which may be due to hormonal imbalance and the induction of oxidative stress.

Purpose: To study the effect of the phenomenon of mutual aggravation on the early diagnosis of the severity of acute radiation bone marrow syndrome (ARBMS), which develops within the framework of combined radiation-mechanical injury (CRMI). Material and methods: According to the general blood test data, the dynamics of the relative and absolute number of lymphocytes in 36 patients was studied during the first 10 days after receiving polytrauma. There are 35 men and one woman among them. The average age of the victims at the time of injury was 40.24 ± 4.07 years. The number of studied blood tests in one patient varied from one to 16 during the specified follow–up period (on average, 6). The dynamics of the absolute number of lymphocytes at the same time was also studied in 11 patients (men, average age – 30.00 ± 2.01 years) diagnosed with acute radiation syndrome (ARS) I and in 15 men diagnosed with ARS II (average age – 28.47 ± 2.03 years). Statistical processing of the material was performed using the IBM SPSS Statistics software package.23 using the Kraskal–Wallis criteria and the Mann–Whitney U-test for independent samples. The differences between the obtained results were considered statistically significant at p < 0.05. Results: Relative lymphopenia was detected in 25 (69.4 %) patients diagnosed with polytrauma. A combination of absolute and relative lymphopenia was found in 15 (41.7 %) patients. Only transient relative lymphopenia was detected in 10 patients. The depth of absolute lymphopenia detected in polytrauma was compared with a similar indicator at the same time in ARS I and ARS II. The depth of absolute lymphopenia in trauma without exposure to ionizing radiation at the time when it is usually studied to determine the severity of ARBMS reached the indicators characteristic of ARS I and ARS II (up to 0.3–0.5 × 109/L.). At the same time, the nature of the dynamics of the absolute number of lymphocytes in trauma is radically different from that in acute radiation exposure. Conclusion: The data obtained allow us to consider the possible deepening of absolute lymphopenia in CRMI in 42 % of cases as one of the manifestations of the phenomenon of mutual aggravation, which can lead to an early aggravation of the predicted severity of the developing ARBMS. The data obtained indicate that this weighting may be + 1, in rare cases +2 degrees of severity of ARS to the true degree of severity corresponding to the absorbed dose of radiation exposure.