The production of vaccines requires constant improvement of methods and tools, revision and modernization of the current technology with the aim to improve quality of the product made for the benefit of public health. The purposяe of this work was to improve the process of production of polysaccharide polyribosyl ribitol phosphate (PRP), which is the active agent of Haemophilus influenzae type b (Hib) vaccines. We investigated how PRP yield depends on the following factors: concentration of dissolved oxygen in the culture liquid, glucose concentration control method applied in cultivation, source of protein for the producer microorganism, stability of the polysaccharide at the culture liquid inactivation stage. As a result, we managed to increase the PRP yield in the culture liquid by 10%, ensured a 25% boost of the biomass accumulation rate during cultivation in the fermenter and reduced the cultivation time by 6.5 hours. The PRP loss rate at the culture liquid inactivation stage was reduced by 80%. Relying on the patented composition, we invented a new composition of the nutrient medium that meets the current regulatory requirements.

Nasal breathing is of great importance for professional athletes because of the peculiarities of carbon dioxide metabolism in the body. Problems with nasal breathing caused by post-traumatic deformities of the nose can be successfully corrected with the help of rhinoseptoplasty, but the possibility of performing this surgery on patients under 18 years of age is a discussed matter. This study aimed to analyze the results of the effect functional rhinoseptoplasty has on nasal breathing, consider rhinoseptoplasty as the preferred method of treatment for adolescents with post-traumatic deformities of the structures of the nose. The study involved 15 professional athletes aged 15–18 years with post-traumatic deformities of the external nose and troubled nasal breathing. Five of them (33.3%) were female, 10 (66.7%) were male; all underwent open rhinoseptoplasty.  The NOSE and SCHNOS questionnaires were used to assess the symptoms of nasal obstruction before and after surgery. Post-surgery, all patients subjectively noted that their nasal breathing improved, which was confirmed by the filled questionnaires. There were no significant complications registered during the follow-up period.  Functional rhinoseptoplasty is a viable surgical option for adolescents under 18 years of age. 

Increasing use of ionizing radiation sources in different spheres of human life dictates the need for investigating the effects of low-dose radiation on mortality and morbidity. The aim of this study was to compare mortality from the most common non-communicable diseases in the cities of Severodvinsk and Arkhangelsk. We analyzed the rates of age- and sex-specific mortality from circulatory system diseases (CSD), malignancies, digestive system disorders, respiratory system diseases, and external causes. CSD-related mortality among men and women past working age was higher in Severodvinsk than in Arkhangelsk (median (Q₁; Q₃): 3,349 (3,271; 3,458) vs 2,651 (2,618; 2,756), p < 0.012; 1,947 (1,890; 2,022) vs 1,753 (1,727; 1,809), p < 0.012; 292 (281; 342) vs 265 (253; 274), p < 0.025, respectively). For other causes of death, mortality rates in Severodvinsk did not exceed those in Arkhangelsk.  Increased mortality from CSD in Severodvinsk cannot be linked to socioeconomic conditions or chemical air pollution because the standard of living is higher in Severodvinsk than in Arkhangelsk, whereas the level of chemical pollution is lower. At the same time, the presence of the nuclear shipyard and radioactive waste repository in Severodvinsk could cause chronic exposure to low-dose radiation. It is important to expand preventive measures aimed at early detection of vascular damage in nuclear workers and general groups of population residing in the vicinity of hazardous radiation sites.

The current measures for protection of the gas processing plant employees cannot fully prevent the impact of pollutants. Evaluation of the immune system is one of the methods for monitoring of the employees' health, and testing the system of measures used to improve the working conditions. The study was aimed to identify alterations in the immune status of the employees at the gas processing and high hydrogen sulfide content condensate processing facility depending on their working experience. The working environment and the employees' immune system were evaluated by standard methods. Pollutants were detected with the Bruel & Kjaer 1302 Multi-Gas Monitor, and the Tsvet-550 gas chromatographer. A total of 160 employees and 81 controls (blood donors of the regional blood transfusion station) were surveyed. The immune system was evaluated using the System 9000 Plus hematological analyser, Cyto FLEX LX flow cytometer,  UNICO 2100UV specrophotometer, and KFK-3-03-ZОМЗ photometer. It was concluded that the existing complex of occupational and industrial hazards affects the immune status of the main production unit employees, which is reflected in the decreased CD20 levels and increased CD8 levels along with the constant levels of CD4. Correlations were revealed between the immuniglobuline level alterations, decrease in the phagocytic index and phagocytic number, as well in lysozyme activity, and the working experience. Pollutant exposure results in altered immunity of the employees, which could be considered the adaptation mechanism.

The statistically significant long-term results of the implant survival and the effectiveness of prostheses are inadequately represented in scientific literature. The study was aimed to assess the effectiveness of prosthetics with fixed structures on the intraosseous dental implants for the replacement of partially absent dentition in the dynamics of the 20-year follow-up. A total of 671 patients with partially missing teeth were examined at the Clinical Center of Dentistry of the FMBA of Russia, who were fitted with 1,700 intraosseous titanium dental implants with the terms from the moment of completion of prosthetics on implants of 5, 10, 15 or 20 years. The criteria for clinical and radiological evaluation of the implant condition were as follows: no complications affecting the condition of periimplant tissues (normal), mucositis, periimplantitis with bone resorption at 1/3 or 1/2 of the implant height, implant removal. Based on 20 years of experience, prosthetics with fixed structures on implants is highly effective in replacing the partial defects of dentition. In total, 62.2% of implants remain functional for 20 years. The average life of implant-supported fixed prostheses is 15 years for bridges, and 20 years for single and combined implant-supported crowns. The most effective are single implant-supported crowns, and the least effective are prostheses supported by implants and teeth. The significantly preserved implant-supported prostheses make it possible to support the concept of the long-term implant installation with respect to the implant-supported non-removable prostheses. The view is thus confirmed that the effectiveness of the implant-supported prosthetics is reduced with the inclusion of teeth in the bridge support, along with implants. 

Prospects of using oncolytic viruses in breast cancer therapy

Breast cancer (BC) is a cancer with a high prevalence and mortality among women worldwide.  With the current diagnostics methods, BC may remain undetected at its early stages, and the therapies developed for the disease are associated with severe side effects. Oncolytic viruses can be the basis of the new, effective BC treatment approaches. The viruses destroy tumor cells directly and launch the antitumor immune response; this dual action supports their efficacy. It is possible to make the oncolytic virus therapy more effective by designing genetically modified viruses that can target BC cells better and/or induce a stronger antitumor immune response. This review outlines the directions of development of oncolytic viruses in BC treatment, covers the optimal ways of delivering viruses to the tumor and the efficacy of their use in combination with other therapeutic agents (methods) and presents the prospects of using oncolytic viruses in antitumor vaccines.

The problem of optimizing the functional state of an athlete, who often travels to the training venues and competition sites, is an integral part of the system for ensuring the maximum efficiency of his professional activity. An athlete, who lives and trains in central Russia, the next day may find himself at the competition halfway around the world, in any climatic zone or time zone. This review details the stages and terms of the adaptation of athletes; criteria of the athlete's adaptation to the new climatic conditions and geographical settings are provided. The existing adaptation models are presented, together with the recommended method for diagnosis and control of climatic and geographic adaptation in athletes.

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide. It is characterized by hepatic steatosis and stetohepatitis and in some cases can progress to cirrhosis with or without hepatic failure and hepatocellular carcinoma. At present, NAFLD is deemed a predictor of cardiovascular risk. Besides, it can aggravate pre-existing cardiovascular conditions. Structural and functional changes in the heart, liver and blood vessels are interdependent and mutually aggravating. Metabolic factors (dyslipidemia, hyperglycemia and insulin resistance) contribute to hepatic, cardiac and vascular damage, and NAFLD and comorbid cardiovascular disorders together can activate fibrogenesis in the heart, blood vessels and liver.

Today, medical rehabilitation is undergoing significant transformation. The new system built around the biopsychosocial model includes assessment of physical constraints and rehabilitation diagnosis, determination of rehabilitation potential, formulation of goals and objectives of individual interventions, development of rehabilitation plans, and progress evaluation. All of these rehabilitation components can be implemented using a personalized, problem-oriented, multidisciplinary approach, which is now being actively introduced into clinical practice. The current pandemic of the novel coronavirus infection has demonstrated that medical rehabilitation is crucial for convalescents. However, its principles and techniques have not been fully elaborated yet. This review describes the current state of medical rehabilitation of children with or after infectious diseases and identifies its avenues and prospects.

Currently, there is no cure for pediatric diffuse brain stem (BS) tumors. Radiotherapy, including proton therapy, is an important component of combination treatment for this cancer, especially in children with a complicated medical history. The article addresses the issues of therapy for pediatric BS tumors and reports the use of proton re-irradiation in a 9-year-old boy with unverified diffuse BS tumor. Proton re-irradiation is an effective treatment option that can sustain and improve the quality of life and prolong survival in children with diffuse BS tumors.

Many patients with traumatic brain injury develop complications in the postoperative period. The article describes a case of revision surgery in a female patient with cerebrospinal fluid rhinorrhea following a severe car accident. During one surgery, the skull base and the frontal bone defect were repaired and a lumboperitoneal shunt was placed. The skull base was repaired using an autologous musculoaponeurotic graft. For a better cosmetic effect, the implant was designed using CADCAM technologies. The patient had a relapse of the leak in the postoperative period, which required revision surgery (multilayer reconstruction using a fibrin-thrombin sponge). The patient was followed up for 2 years, with no relapse. The desired clinical and cosmetic effects were successfully achieved.