Experience of Military Medicine in the Fight against the New Coronavirus Infection.

The results achieved by the medical service of the Armed Forces of the Russian Federation to overcome the new coronavirus infection are presented. The high efficiency of the established unified system of biological safety and strict ranking of the priorities of anti-epidemic measures is shown. The experience of organizing traveling medical and nursing teams, as well as temporary military medical units on the territory of Russia, as well as in foreign countries, is demonstrated. Among the priority scientific results of military doctors, especially noteworthy is the study of the world's first COVID-19 vaccine Sputnik V, its immunogenicity, the effectiveness of its use in previously ill patients and revaccination, as well as the use of immune plasma from those who have been ill and vaccinated. By the examples of organized military groups and the general population, the features of the formation of herd immunity have been studied. Military doctors were the first in the country to show the effectiveness of hormone therapy in the treatment of coronavirus infection and to study its effects. They carried out ultrastructural studies of the life cycle of the virus. It is shown that the system of comprehensive measures implemented by military medicine determined a lower incidence of new coronavirus infection among the personnel of the Ministry of Defense of Russia and a lower mortality among the military.

[Forum of military physicians of Asia Pacific region].

Forum of military physicians of Asia Pacific region. Authors proviae a report about the 3rd Military medical Asia Pacific congress, which was held in August 2016 in Saint Petersburg under the authority of the International military medical committee. Within the frame of the congress was held regional workshop, in the course of which was heard a report of the Thailand representative, requests of observer states for the entry. The country, which will hold the 4th Military medical Asia Pacific congress, is Iran. On the last day of the congress delegates visited the finals of the Military-medical race of the military physicians profession skill competition within <.

[Hygienic aspects of development and testing of individual military armour].

Hygienic aspects of development and testing of individual military armour. The article is devoted to scientific substantiation of proposals aimed at improving certain physical and hygienic properties of the personal body armour (PBA) and their test methods. The authors performed an analysis of the development of domestic and foreign PBA production. Analysed and described construction, ergonomic and medical-and-technical characteristics of PBA. The role of the study of hygienic, mechanical and ergonomic indicators in assessing the dynamics of the vector and the further development of PBA is presented. Substantiated proposals for their improvement.

[Anniversary of the science regulatory body of the S. M. Kirov Military medical academy].

Anniversary of the science regulatory body of the S.M.Kirov Military medical academy. In the nineteenth century the Military-medical scientific committee was responsible for organization of scientific activity in the system of medical service of the Armed Forces; in the soviet period - the Military-scientific committee of the Main military-medical authority (since 1930) and scientific department of the S.M.Kirov Military medical academy (since 1931). In 1931-1936 and in 2010-2014 the Military-scientific committee of the Main military- medical authority was dissolved, and in 1936-1940 and in 2014-2015 conducted a supernumerary activity, during these periods the scientific department of the S.MKirov Military medical academy was responsible for coordination of scientific work in the Armed Forces. An experience of organization of the scientific regulatory bodies brought positive results and allows developing medical science further in the interests of the Army and the Navy.

[Comparative characteristics of domestic and foreign means of the first aid on the battlefield and in the epicenter of emergency situation].

Comparative characteristics of domestic and foreign means of the first aid on the battlefield and in the epicentre of emergency situation. The results of comparative analysis of domestic and foreign means of the first aid on the battlefield and in the epicentre of emergency situation are presented. It was found that the first aid means used in the Armed Forces are effective and allow performing specified activities, regardless of the qualifications and assisting skills. Modern innovative means of providing emergency and urgent care may be used on the stages of medical evacuation of military and military hospitals.

Effectiveness of infrared-terahertz radiation with acupuncture in the initial period of ischemic stroke.

Effectiveness of infrared-terahertz radiation with acupuncture in the initial period of ischemic stroke. This article presents the data of observational retrospective clinical investigation aiming at generalization of the experience of usage of infrared terahertz radiation combined with acupuncture for treatment of the patients in the initial period of ischemic stroke. The experimental group contained 30 patients which had various clinical problems at the initial period of hospitalization. The attempts to dissolve these problems within the acceptable period of time employing domestic and international standard treatment approaches failed. The control group consisted of 31 patients with uncomplicated course of stroke. The patients of the experimental group in addition to the standard treatment received infrared terahertz treatment (device ) combined with acupuncture. Despite the fact that the condition of the patients in the experimental group at admission was much serious than in the control group, at the time of discharge the level of functioning of the first group was definitely higher than the second. In 6 months that superiority increased and has been retained during two years of following up. Despite the fact that the employed in the current investigation method has been used for dissolving different clinical problems, it has been resulted in increase of the general level of functioning proved by the dynamics of such an integral criterion as index Barthel. This means that employment of infrared terahertz radiation in the stroke patients possesses the systemic effect. To recommend the discussed method for treatment of all patients in the initial period of stroke as well as its repeated employment during rehabilitation the separate prospective randomized clinical trials should be undertaken.

Problems and prosnects of innovation development of technical support for military medicine.

Formation of the scientific potential and development of advanced medical equipment samples is one of the priorities for the development ofRussian military medicine. However, the main problem of innovation implementation into the daily routine of medical units formations and military units, as well as military and medical organizations is that the above mentioned innovation is not fully studied. The article defines the main ways of innovation development of technical equipment of military medicine, shows the characteristics of the most advanced models of medical equipment, as well as recommendations for their use to improve the efficiency of medical support of troops (forces) in modern conditions.

[Legal regulation of clinical drug trials for the use in military-medical organisations].

The authors identified problematic issues of legal regulation of clinical drug trials for medical use, and proposed possible solutions. It has been established that the conduction of clinical trials, of medicinal products is based on the norms of various branches of law embodied in the Constitution of the Russian Federation, the norms of international law, the Civil Code of the Russian Federation and federal laws and subordinate legislations regulating health and pharmaceutical activity. According to the authors, the norms of bioethics can be attributed to the sources of legal doctrine. It is proposed to oblige executives of clinical trials to make a report about effectiveness and safety of drugs and pass the results to the customer, in his/her turn the customer is obliged to accept the results of these trials and pay for them.

[Combined burn trauma in the array of modern civilian and combat burns].

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

[The current conceptions of non-pharmacological therapeutic methods capabilities and mechanism of their action].

The current conceptions of non- pharmacological therapeutic methods capabilities and mechanism of their action. The current article demonstrates the modern capabilities of non-pharmacological therapeutic methods on the example of effective use of infrared-terahertz radiation and acupuncture in cases when the standard treatments failed. The first clinical presentation describes the case of successful intervention in the stroke patient on his 18 day of staying in coma. The second presentation dedicates to rehabilitation of a post-stroke patient with hemiparesis and wheelchair use for five years. Then the modern approaches to understanding the employed methods are proposed. The developing concept is based on the idea that the applied therapeutic modalitiy forms an afferent matrix-challenge in the central nervous system to which the latter elaborates the reciprocal efferent matrix-response. In the process of reaction the central nervous system performs a kind of reboot of its system functional connections thus eliminating stagnant pathological dominants and inhibitions. It is proposed to employ the accumulated experience in the conditions of increasing restriction of drugs and medical devices import.

[Combat burn injury. The Afghanistan and Iraq military campaign experience].

The current article briefly reviews the experience of combat burns care obtained in the course of 2001-2013 military campaign in Afghanistan and Iraq as it has been covered in the foreign scientific medical publications. The following topics are covered: statistics, the prehospital medical care, aeromedical evacuation, the Burn Center of the US Army Institute of Surgical Research. The new method.of the .initial intravenous infusion rate estimation, so called the "Rule of 10 formula, is marked: At the end, the list of freely available publications summarized the modern combat burns care experience is presented.

[ Microstructure of the hippocampus in brain injury caused by non-lethal weapons].

Methods of histomorphometry and AFM investigation were used in research of hippocampus in acute phase of gunshot brain injury. Experimental sheep were used in research. Researches fired a shot in parietooccipital area with the gun "Makarych". It was found that shooting causes interstitial edema which disintegrates neuronal cytoarchitectonics of hippocampus in 30 minutes. Main factor for interstitial edema is peculiarities of microstructures of separate hippocampal layers. In surface tissue structures that have porous and viscous structure occurs infiltrative dissection of conduction structures. The energy of edema realizes as spalling and fragmentation in dense lamina of the fascia dentata. Independent from localization pressure cavitation occurs in interstitial tissue of hippocampus. Common pathogenic factors are acidotic picnosis and neuronal desynaptization.

[Membranes structure and physical and mechanical erythrocytes properties in the early period of traumatic brain injury caused by less-lethal firearms].

The dynamics of erythrocytes properties in the acute phase of traumatic brain injury caused by less-lethal firearms has been studied by the methods of atomic force and morphometry. The experiments have been performed on sheep by a Makarych pistol single shot at the parietooccipital area. It has been established that under the influence of the shock waves the erythrocyte disks and transmembrane liquid oscillatory fluctuations (flicker) are increased. The fluctuations are rapidly attenuated and the shock waves energy is accepted by cytoplasmic membranes lipoproteids. As a result the interface tlipid-protein, phase transitions are hastened. The membranes undergo heterogeneous structural, physical and mechanical transformations the character of which is determined by the phase transitions direction. In the spots of phospolipid liquid clusters accumulation the fluidity is increased and marks caused by membranes lamination and spreading appear. In the spots of phospholipids solid phase the surfaces become hydrophobic and marks caused by membranes local embrittlement and fragility appear. The transmembrane fluid hydrodynamic flows heterogeneity is increased due to deformation processes irregular spreading. The flows acceleration causes the hydrodynamic ruptures-like defects. The flows deceleration results in depressions evolving through the mechanism of creeping erosions.

[Development of combat medical robots in the US Armed Forces].

The current article is dedicated to the problem of scientific research organization in the field of combat medical robots development in the US Armed Forces. The role of the Telemedicine and Advanced Technology Research Center is singled out. The project A Robotic System for Wounded Patient Extraction and Evacuation from Hostile Environments is described in more detail. It is noted the high cost of such technical systems development and operation.

[The network organization of medical research in the US Armed Forces].

The current article is dedicated to the network mode of medical scientific research organization in the US Armed Forces exploring the Armed Forces Institute of Regenerative Medicine as an example. The following features of the institute are examined: the structure, definition of scientific research goals and tasks, financing, management, areas of research, the next generation of the institute. In conclusion some characteristic features of network scientific research establishment and required legal conditions are determined.

[Improvement of the health care delivery system in war-time: monitoring of servicemen's health status].

Authors came to conclusion that the constant monitoring of servicemen's health status allows the commanding officer to receive detailed information about combat effectiveness. In case of battle injury or trauma the information used by the medical service will be the base for early health care delivery and organization of evacuation. The information about health status of injured may be used as a base for diagnosis at all stages of evacuation. Authors came to conclusion that individual monitoring of health status will help to further health care delivery system and first stages of medical evacuation.

[Prospective methods of combat burn injury treatment].

The current article briefly reviews the projects of development of combat burn injury treatment as they have been presented in the US Armed Forces Institute of Regenerative Medicine 2013 annual report. Eleven projects have been reviewed, in particular: P12 polypeptide for limiting burn injury progression, gamma keratose gelfor enhancement skin cell survival, starch-polyurethane iodophor dressing effective against the most common burn infection, microorganisms, autologous stem and progenitor cells for single cell cytotransplantation by "skin gun" spray device or 3D skin bioprinting, a bioreactor for skin autotransplant expansion.

[Modern aspects of combat maxillofacial trauma (review of foreign scientific-medical publications during 2012-2013)].

The current article is dedicated to the modern aspects of combat maxillofacial trauma as they have been presented in 2012-2013 scientific publications. It has been shown that due to employment of more and more powerful explosive devices the facial trauma over the last decade has occurred more frequently and become more severe. Some new methods of facial injuries treatment are being tested now, among them KSL-W antimicrobial decapeptide, new bone regenerative biocompatible materials, scar-healing mesenchymal and adipose-derived stem cells, and a custom automated face dressing platform.

[Medical research in the US Armed Forces. (Report 5). The US Air Force and Coast Guard].

The present article is the last part of the review dedicated to organization and management of medical research in the US Armed Forces. The first through fourth parts were published in the previous issues of the journal. Specifically this article is dedicated to organization and management of medical research in the US Air Force and Coast Guard. It is shown that in the US Air Force the medical research is conducted in the Air Force Research Laboratory and in the US Coast Guard--in its Research and Development Center. The particular research programs conducted in the above mentioned units are discussed.

[Medical-and-economic substantiation of rational antibacterial therapy for patients with pleural empyema in the conditions of military medical institutions].

We have performed a post-hoc analysis of the results of using antibacterial therapy in patients with pleural empyema. The cost-effectiveness analysis of rational and empiric antibacterial therapies was performed. The cost-effectiveness ratio for rational antibacterial therapy was lower than for empiric one (2889 and 4480 rubles for 1 treated patient correspondingly). The use of the rules of rational antibacterial therapy in practice leads to proved saving of economic costs.