We consider the epidemiological data on the health status of participants of liquidation of consequences of the Chernobyl accident, provide information on the experience of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia in the diagnosis, treatment and rehabilitation of participants of liquidation of consequences of the accident at the Chernobyl nuclear power plant and current (former) residents of the contaminated areas. It is shown that in the last few years (2007–2016) within the Russia-Belarus Union State program for joint activities to overcome the consequences of the Chernobyl disaster, the Center provided specialist and high-tech health care for more than 5,000 liquidators of the Chernobyl accident and current (former) residents of the contaminated territories of Russia.

Much of the work to eliminate the most severe consequences of the accident with IV reactor of the Chernobyl NPP (April 27, 1986) was assigned by the Government of the USSR primarily to the country’s Armed Forces. The Military Medical Service had to solve responsible and fundamentally new problems to prevent medical and biological effects of radioactive contamination, with the Central Military Medical Directorate of the Ministry of Defence closely cooperating with the Ministry of Health of the USSR. Within a few days 95 thousand people were taken of the 30-kilometer accident area. Thanks to this, acute radiation sickness was prevented in the majority of local residents. Simultaneously, military doctors successfully provided a comprehensive medical support to troops and the «liquidators» operating in the area of the accident. More than 239 thousand
soldiers underwent radiation monitoring. Acceptable radiation dose of 25 rem received 99 % of them.

The study included 31 patient liquidators of the Chernobyl accident aftermath with a body mass index over 35.0 kg/m2. From the combination of clinical data, results of laboratory and instrumental studies the patients were diagnosed with nonalcoholic fatty disease of the pancreas. All the patients had signs of impaired lipid and carbohydrate metabolism, increased activity of amylase and lipase, exocrine pancreatic function disorder. Ultrasound and computer tomography data showed signs of fibro-lipomatous lesions of the pancreas. The data obtained resulted in developing a point system to diagnose nonalcoholic.

Due to the Chernobyl accident, a lot of persons were exposed to «low»-dose radiation followed by various neuropsychiatric and psychosomatic disorders in the long term. Further, disability and mortality rates in them increased. The article describes mental effects of radiation disaster, stages of formation and clinical manifestations of radiation psychosomatic illness, its diagnosis, treatment and prevention.

The relationship between cardiovascular disease rates in military liquidators of the Chernobyl NPP accident aftermath over years, their radiation exposures and age at the time of recovery activities. During the first 15 years after the accident, cardiovascular disease incidence in military liquidators increased 6-fold (from 25 to 145 ‰), predominantly due to arterial hypertension and ischemic heart disease. Over the subsequent years, incidence decreased to 60–75 ‰. Incidence depended on the age of arrival for recovery activities at the Chernobyl NPP: the younger the liquidators were the earlier and quicker the circulatory pathology appeared and progressed. There was no relationship between cardiovascular disease incidence and the absorbed dose of radiation.

To study the role of metabolic syndrome in the pathogenesis of cerebrovascular disease, 60 Chernobyl accident recovery workers have undergone instrumental and laboratory examination. In addition to the parameters of glucose and lipid metabolism, metabolic syndrome markers, i. e. insulin with the calculation of HOMA index, leptin, adiponectin, plasminogen activator inhibitor 1 were assessed in recovery workers with chronic cerebrovascular disease. The excretion of the main melatonin metabolite – 6-sulfatoximelatonin in three urine samples (day, evening and night) was also assessed. As a result, diagnostically relevant laboratory parameters were selected for evaluating the role of metabolic syndrome in the development of chronic cerebrovascular disease and the effectiveness of the pathogenetic therapy. For the accident recovery workers with metabolic syndrome and chronic cerebrovascular disease it is reasonable, together with a standard examination, to define markers of plasma hemostasis activation, parameters of insulin and leptin resistance as well as excretion of melatonin metabolites. The introduction of the additional diagnostic tests will facilitate the timely detection of metabolic syndrome in recovery workers. Understanding the real causes of metabolic syndrome and pathogenetic mechanisms of insulin resistance will help to develop more effective ways of prevention and correction of this metabolism disorder and eventually reduce the risk of cardiovascular disease and mortality in these patients.

The aim of the study was to evaluate the effect of radiation from the 1986 Chernobyl disaster for the Voronezh region situated at a distance of more than 600 km from the epicenter. Data from the radiological laboratory of Center for Hygiene and Epidemiology in the Voronezh region were used. Characteristics of the soil surface contamination with cesium-137 and strontium-90 (Ci/km2), the overall average annual effective dose (mZv/year), the dose of gamma radiation (mZv/h) were selected to assess the impact of the Chernobyl accident on the Voronezh region. It was found that for the Voronezh region areas of radioactive contamination from the Chernobyl disaster, maximum surface contamination of soils with cesium-137 reduced from 3.15 to 1.66 Ci/km2, strontium-90 from 0,063 to 0.0033 Ci/km2 over 30 years. Maximum territorial average annual effective dose of external radiation decreased from 1.70 to 0.08 mZv/year. Based on the research the current radiation situation in the Voronezh region can be considered satisfactory (secure). Radiation indicators comply with safety regulations. The average annual effective dose from «Chernobyl rain» for residents of the settlements subjected to radioactive exposure, in 2010–2015 did not exceed 0.16 mZv/year. In the structure of the collective radiation dose of the population of the Voronezh region, doses from natural sources of ionizing radiation dominate each year (from 74.96 to 76.68 %; average for Russia in 2014 – 86.81 %); followed by medical sources of ionizing radiation, their annual contribution to the collective dose varies from 20.04 to 24.78 % (in Russia in 2014 – 12.91 %), technologically modified radiation background, including global fallout and the Chernobyl accident – from 0.18 to 0.20 % (in Russia in 2014 – 0.23 %), radiation from enterprises that use sources of ionizing radiation – 0.07–0.08 % (in Russia in 2014 – 0.05 %). According to the analysis of cancer incidence over the past five years (total malignant neoplasms, including the thyroid gland, lymphatic and hematopoietic tissue), there were no significant differences between areas with varying radioactive contamination after the Chernobyl accident. Therefore, it can be concluded that the density of radioactive pollution in the Voronezh region is currently not associated with malignancy rates.

Results of mass spectrometry analysis of microbial markers in whole blood of 129 liquidators of the accident at the Chernobyl nuclear power plant are presented to study the wall (blood samples) and luminal (feces) intestinal microbiota. The method provides a new version of molecular microbiological study due to possible simultaneous quantitative determination of more than hundreds of microbial markers directly in biological samples without culturing the microorganisms, biochemical test materials or genetic primers. The study of blood and feces microbiota via gas chromatography-mass spectrometry of microbial markers suggests that examined liquidators of the accident at the Chernobyl nuclear power station have expressed intestinal dysbiosis: the total number of microbial markers are increased in the blood and decreased in the feces; in blood, the microbial markers of Propionibacterium / Clostridium subterminale are two-fold increased with decreased Lactobacillus markers, and in feces microbial markers Eubacterium / Clostridium coccoides are increased with decreased Lactobacillus markers; increased microbial markers of opportunistic microbiota in blood and feces). These individual profiles of microbiome served as the basis for targeted correction.

Clinical and laboratory indicators of the neuroendocrine system were analyzed along with the phenomenon of premature aging and androgen status in 68 male liquidators of the accident at the Chernobyl nuclear power plant aged (48.0 ± 1.2) 18 years after the accident and 56 liquidators aged (67.2 ± 8.8) 28 years after the accident with a fixed radiation dose from 20 to 125 cGy as per accounting cards. Biological age was defined via the method of the Institute of Gerontology, Academy of Medical Sciences of the USSR, based on clinical and instrumental examinations. The control group consisted of 19 men without history of radiation exposure and other occupational hazards. According to assessments, subgroups with the biological age of 60 years and over 60 years were identified. By passport age, these subgroups did not differ significantly. With increasing biological age and index of premature aging, hormonal imbalance (decreased testosterone, free androgen index, prolactin, DHEAS, increased cortisol, disrupted negative feedback) typical for physiologic were revealed in Chernobyl cleanup workers. In 28 years after the accident, these changes became more pronounced.

White outbred male rats (270 animals) at the age of 4 months, were irradiated with gamma-rays 60Co at doses of 10; 20; 50 and 100 cGy with a dose rate of 0,5 Gy/h. Fragments of the brain were taken on day 1 and at months 6, 12, and 24 of post-radiation period. Following standard histological processing, tinctorial changes of neurons were assessed along with their morphometric parameters, total protein content and nucleic acids. It was found that by the end of the follow-up period the number of normochromic neurons reduced and the number of hyper- and hypochromic cells and their destructive forms increased. Nerve Cell index decreased over time, indicating the death of the neurons, but without statistically significant reduction in their number in the area. In the post-radiation period, phase changes in size of the cytoplasm, nucleus and nucleolus as well as content of nucleic acids (RNA in the cytoplasm and nucleoli, DNA in the nuclei) were observed. In irradiated animals, these were more pronounced and not always the unidirectional with age-related changes nature. This creates a certain instability in the structural and functional organization of neurons, which, with predisposing factors, may induce functional disorders of the central nervous system.

In experiments on mice exposed to acute external gamma radiation, hemostimulating activity mechanisms of glutathione disulfide organic salt and inosine – the medicament molixan — were studied. Molixan was administered intraperitoneally at a dose of 30 mg / kg 1 time a day for 10 days after irradiation. It was found that irradiation at a dose of 3.5 Gy caused the death of 30 % of the mice, and molixan reduced mortality in irradiated animals to 10 %. The ability of molixan to accelerate post-radiation recovery of bone marrow hematopoiesis by stimulating myelocytic and megakaryocytic cell lines was demonstrated, with resulting increase in the number of white blood cells and platelets in the peripheral blood. Hemostimulating activity of molixan can be mediated by increased production of hematopoietic cytokines– interleukin-1, interleukin-2, interleukin-6, granulocyte-macrophage and granulocyte colony-stimulating factors – by splenocytes.

Results of the assessment of life safety culture in inhabitants of radioactive contaminated and clear areas of Russia are presented. Research was conducted in 2013–2014 in the Kaluga, Bryansk, Tula and Oryol regions. Residents of radioactive contaminated areas of these regions were included in the control sample. Monitoring made it possible to assess the level of life safety culture in the population of radioactive areas with (n = 782) and without (n = 324) radioactive contamination and expression of its basic psychological components. The article also presents procedure for forming public health and safety culture in the contaminated areas.

The article analyzes levels of subjective control and its relationship with stress-coping behavior in employees of EMERCOM of Russia with different levels of adaptation (high, medium, low). Criteria are defined for distribution of employees into different groups of adaptation. Stress-coping strategies and internality were compared within groups of employees with high, medium and low levels of adaptation. According to the study results, adaptation is related to levels of subjective control and key stress-coping strategies in employees of EMERCOM of Russia.

According to the Russian Science Citation Index (http://elibrary.ru/), as of 01.02.2016 there were 278 publications on art therapy with children issued in Russian over 2004–2015. They cover features of the art therapeutic method, its main directions and objectives, capabilities and benefits of art therapy for counseling and work with children in crisis and emergency situations. The techniques of art therapy organically fit into the play activity of children, do not create additional stress for children in emergency situations. They distract children from significant experiences, provide vivid physical sensations blocked as a result of trauma, do not cause fatigue since are based on pre-existing skills. Throughout art therapy classes, good performance and activity are maintained in children at a sufficient level. In addition, creative activities contribute to stress relief and optimization of the repertoire of protective and adaptive reactions.

Abstract. Information search in the electronic database of the Scientific Electronic Library gave an array of 515 scientific papers published in Russia in 2005–2015 on medical-biological and psychological problems of the liquidators of the Chernobyl accident aftermath and population of the contaminated areas. Annually, (53 ± 6) articles were published. A polynomial trend at a low coefficient of determination looks like an inverted U-curve with the highest rates in 2009–2011. The main scientometric indices of the array of articles calculated in the Russian Science Citation Index are provided. The average number of citations per article was 1.4, 38.1 % of the articles cited at least once, Hirsch index was 11. The distribution of citations by cited papers years showed that the median citation history was about 6 years. A scientometric analysis was performed on a selection of articles of leading magazines and organizations. In 50.2 % of the articles, studies were devoted to the liquidators of the Chernobyl accident, in 13.6 % – to children and adolescents, 12 % to the population living in the radiation contaminated areas. Problems of physico-chemical biology were studied in 16.4 %, general biology – in 5 %, clinical medicine – 38.2 %, preventive medicine – 22.1 %, life sciences – 8.7 %, psychological sciences – 6 3 % of the articles.