Prediction of cardiac function deviations (ECG data) in the course of permanent cosmonaut's monitoring starting from selection till return to earth after short-duration space flight]

Analyzed were deviations in cardiac function in 29 cosmonauts with previous aviation and other occupations ranging of 29 to 61 y.o. who made 8- to 30-day space flights (totai number of flights = 34) between 1982 and 2006. The deviations were identified in ECG records collected during clinical selection, clinical physiological examination (CPE) before flight, insertion and deorbit in transport vehicles, and post-flight CPE. Based on the analysis, the cosmonauts were distributed into three groups. The first group (55.2% of the cosmonauts) did not exhibit noticeable shifts and unfavorable trends in ECG at any time of the period of observation. The second group (34.5%) showed some deviations during selection and pre-flight CPE that became more apparent in the period of deorbit and were still present in post-flight ECG records. The third group (10.3%) displayed health-threatening deviations in cardiac function during deorbit. These findings give start to important investigations with the purpose to define permissible medical risks and ensuing establishment and perfection of medical criteria for candidates to cosmonauts with certain health problems.     

Soviet space flight: the human element

Building on past experience and knowledge, the Soviet manned space flight effort has become broad, comprehensive, and forward-looking. Their long-running space station program has provided the capabilities to investigate long-term effects of microgravity on human physiology and behavior, and test various countermeasures against microgravity-induced physiological deconditioning. Since the beginning of Soviet manned space flight, the biomedical training and preparation of cosmonauts has evolved from a process that increased human tolerance to space flight factors, to a system of interrelated measures to prepare cosmonauts physically and psychologically to live and work in space. Currently, the Soviet Union is constructing a multimodular space station, the Mir. With the emergence of dedicated laboratory modules, the Soviets have begun the transition from small-scale experimental research to large-scale production activities and specialized scientific work in space. In the future, additional laboratory modules will be added, including one dedicated to biomedical research, called the "Medilab." The longest manned space flight to date (326 d) has been completed by the Soviets. The biomedical effects of previous long-duration flights, and perhaps those of still greater length, may contribute important insight into the possibility of extended missions beyond Earth, such as a voyage to Mars.     

Biorhythmic selection of cosmonauts]

The paper describes some features of modern and future interplanetary space missions which may influence the stability of the circadian system of the human body. It presents requirements for biorhythmological selection of cosmonauts. The paper discusses the biorhythmological types of humans: biorhythmologically labile, biorhythmologically inert and intermediate. The time schedule specified by the flight program dictates the selection of the cosmonauts of a certain type for the given mission. The paper suggests methods for the biorhythmological selection of cosmonauts: 1) on the basis of adaptation to the concrete type of "space day" in the flight; 2) on the basis of the biorhythmological type; 3) on the basis of the length of the natural circadian period; 4) on the basis of typological features of the nervous system.     

空间飞行对免疫功能影响的研究进展

目的 综述空间飞行对免疫功能影响的研究进展. 资料来源与选择该领域的相关研究论文与综述. 资料引用国内外公开发表的论文和综述44篇. 资料综述分析和综述了通过空间飞行和地面模拟实验研究宇航员和动物的免疫系统及免疫细胞的功能变化情况的研究进展. 结论 空间飞行对宇航员、实验动物及免疫细胞的免疫功能变化均具有重要影响,主要表现为免疫功能受抑制.     

Psychophysiological selection: status and prospects

The major stages in the development of psychophysiological selection of cosmonauts in the USSR are discussed. The psychophysiological selection was originally based on the data of psychoneurological expertise of the flight personnel and achievements of aviation psychology in the USSR. This was followed by the development of psychophysiological research, using instrumentation and simulation flights. Further complication of flight programs and participation of non-pilot cosmonauts (engineers, scientists) necessitated detailed study of personality properties and application of personality tests. At the present stage in the development of psychophysiological selection great importance is attached to the biorhythmological selection and methods for studying man's capabilities to control his own emotional, behavioral and autonomic reactions as well as environmental parameters. The review also discusses in detail methods of group selection and problems of rational selection of space crews.     

Peculiar physiological reactions to +Gx loads of nonprofessional members of short-term missions to the ISS]

Physiological reactions to +Gx loads of 10 nonprofessional members of 8 to 12-d. missions to the ISS some of whom had partial health defciency were compared with data about space station MIR cosmonauts (n=10) who participated in flights of similar duration but were qualified as essentially healthy. Age of the ISS visitors varied between 29 and 60 years, whereas the MIR cosmonauts were 31 to 49 years old. Based on analysis of objective information, the ISS visitors were distinguished by much more pronounced sinus tachycardia and tachypnea during insertion and re-entry. There were several instances of pre-launch extrasystole arrhythmias that persisted during insertion and were, as a rule, more serious during re-entry. Also, descent from orbit caused more frequent cardiac rhythm disturbances, polymorphism and severity in these space flyers in comparison with the MIR cosmonauts. Particularly grave ECG deviations were observed in two 60-y.o. crew members. However, all these disturbances were episodic by character. These results suggest that development of individual programs of medical risk mitigation for nonprofessional flyers to the ISS should give regard for the status of cardiac rhythm regulation as re-entry g-loads may affect ECG dramatically. Besides, the analysis highlighted the necessity of more rigorous selection of aged candidates for ISS missions with partial health deficiency     

Psychosocial support for cosmonauts

Based on a meeting with members of the Psychological Support Group for cosmonauts, along with several referenced documents, the author summarizes the Soviet experience in dealing with psychological and interpersonal factors related to long-duration space missions. Cosmonaut selection and training procedures following the principle of "neuropsychological resistance" formulated by F.D. Gorbov. Inflight monitoring uses the macroanalysis of crew speech characteristics as an indicator of psychological state. Psychosocial problems include "asthenia" and interpersonal tension. Support efforts focus on enhancing behavioral and autonomic adaptation, planning flexible work/rest schedules, improving the space station environment, arranging relevant free time activities, and helping crews readjust to Earth postflight. Attention is paid to changes in cosmonaut preferences and sensitivities as the mission progresses. The use of support activities is believed to be positively associated with the health and performance of cosmonaut space crews.     

民用救捞船上加改装医疗救护模块的研究

目的 研究执行航天员海上救援任务的民用救捞船上加改装医疗救护模块的技术与方法.方法 根据任务的需要,对2型6艘民用救捞船船型,采用3种不同的加改装设计方案.依据快速救护性、布局合理性和经济实用性3个主要性能指标,对3种方案作出评估.结果 实践证明,3种加改装方案都明显提高救捞船的海上医疗救护能力,其中方案2最佳.结论 根据载人航天任务海上应急医疗救护的需要,经加改装实践和海上3次载人航天任务的检验,此加改装技术与方法科学合理,能满足性能要求,对完成航天员海上救援任务具有重要意义.     

International Space Station medical standards and certification for space flight participants

INTRODUCTION: The medical community of the International Space Station (ISS) has developed joint medical standards and evaluation requirements for Space Flight Participants ("space tourists") which are used by the ISS medical certification board to determine medical eligibility of individuals other than professional astronauts (cosmonauts) for short-duration space flight to the ISS. These individuals are generally fare-paying passengers without operational responsibilities. MATERIAL AND CONTEXT: By means of this publication, the medical standards and evaluation requirements for the ISS Space Flight Participants are offered to the aerospace medicine and commercial spaceflight communities for reference purposes. It is emphasized that the criteria applied to the ISS spaceflight participant candidates are substantially less stringent than those for professional astronauts and/or crewmembers of visiting and long-duration missions to the ISS. CONCLUSIONS: These medical standards are released by the government space agencies to facilitate the development of robust medical screening and medical risk assessment approaches in the context of the evolving commercial human spaceflight industry.     

宇宙飞行对航天员免疫系统的影响

目的概述近年来有关宇宙飞行影响航天员免疫系统功能的研究进展。资料来源与选择国内外相关文献35篇。资料综合论述了宇宙飞行对航天员免疫系统功能的影响及其可能机制。结论宇宙飞行可影响航天员免疫系统功能，导致细胞免疫功能减低，但是，体液免疫功能变化不明显。目前，对于宇宙飞行导致航天员免疫系统功能改变的可能机制，主要集中于太空复合因素以及由其引起的神经一内分泌系统改变对免疫系统的直接和间接影响。由于太空实验的数量有限且重复性差，所以，目前的研究结论都是初步性的，对于宇宙飞行对航天员免疫系统的确切影响还有待进一步研究。     

Correlation of the cosmonauts' physiological reactions to +Gx loads during deorbit with the hemodynamic shifts in the period of short-term microgravity]

Physiological reactions of four cosmonauts to +Gx during the descent after short-term (less than 30 d) space flights were correlated with the hemodynamic shifts developed previously during the LBNP test and occlusive plethysmography in microgravity. The cosmonauts who had exhibited a sharp decrease in cerebral circulation during the in-flight LBNP tests showed signs of deteriorated cerebral blood flow (vertigo, weakness, hyperhydration) at the attempt to assume the vertical posture and to climb out of the landing module. Also, the cosmonauts found to have the arterial and venous tone significantly dropped in microgravity, suffered petechial hemorrhages in the back integument during the exposure to +Gx. These data suggest a correlation between the physiological reactions of cosmonauts to +Gx at the end of short-term space flight and the shifts in hemodynamics earlier in microgravity.     

Results of medical research carried out in 1985 on prolonged space flights

This paper presents medical results obtained during the fourth expedition of five cosmonauts onboard orbital complexes Salyut-7--Soyuz-T-13 and Salyut-7--Soyuz-T-14. The cardiovascular system was examined using 36 resting and provocative tests. They were performed by means of electrocardiography, tetrapolar rheography, arteriovenous pulsography and tachooscillography. In addition, body mass and leg volume were measured. The above parameters showed typical variations as well as individual changes related to the preflight circulation level and environmental effects. The use of modified regimens of provocative tests demonstrated their applicability to the assessment of the cardiovascular function in space flight.     

State of the pituitary-adrenal system of cosmonauts after orbital flights of different duration

In order to assess the hypophyseal-adrenal system and glucocorticoid activity, excretion of total 17-hydroxycorticosteroids (17-HOCS) was measured before and at R + 1 day after a standard water load (20 ml/kg). Twenty-six cosmonauts were examined after flights of 2--140 days. Although the cosmonauts spent different time in weightlessness, the content and rate of glucocorticoid excretion in the urine during postflight water loads was 1.5--2 times higher than during preflight loads. This increased excretion of 17-HOCS was associated with their decreased reabsorption and/or increased glomerular secretion. The latter may be a manifestation of extrarenal action of ACTH due to its hyperproduction immediately postflight.     

Analysis of polymorphism of bone metabolism genes and evaluation of the risk of osteopenia in cosmonauts

Densitometry of cosmonauts following long-duration missions shows reduction of bone mineral density (BMD). On the average, post-flight BMD remains within the normal range and the broad variability of individual BMD values sometimes is qualified as local osteopenia. Individual reactions are typed by similarity of amount and rate of BMD loss. At present, analysis of functionally significant polymorphism of bone metabolism genes is the most effective instrument for diagnostics of susceptibility to osteopenia and osteoporosis. The investigation was aimed to analyze polymorphism of genes of vitamin-D and (VDR) and calcitonin (CALCR) receptors, and of collagen-1 alpha-1-chain (Col1a-1) in candidate cosmonauts and cosmonauts returned from 5 to 7-mo. missions. According to the results of analysis, in the majority of cosmonauts rapid BMD loss correlated with TT genotype by VDR gene but not with genotypes Tt and tt and associated with carriage of incomplete s-allele in the Col1a1 gene. Yet, in several instances high BMD loss rates were personified with carriers of VDR gene alleles (homo- and heterozygote states--tt and Tt) and heterozygote by Col1a1 gene (Ss).     

In-flight medical incidents in the NASA-Mir program

This paper summarizes medical experience during the six NASA-Mir flights from March 14, 1995, to June 4, 1998. There were 7 U.S. astronauts who were part of 6 Mir space crews and worked jointly with 12 Russian cosmonauts. Advances in space medicine have created a safer environment; however, experience shows that crewmembers experience traumatic injuries and illnesses of diverse etiologies during spaceflight. During these joint flights both Russian and U.S. medical kits were available to crewmembers who could access either medical kit as appropriate. The Russian medical team had primary responsibility for monitoring and care of all crewmembers and analyzing medical results. When medical incidents occurred, the appropriate Russian or U.S. medical team determined the plan for diagnosis and treatment. Each team kept the other informed regarding medical situations during the flights and strictly observed the principles of medical confidentiality. A summary of medical incidents by programmatic element is described as experienced by the crewmembers and the ground support medical teams. The most frequent medical cases were small traumatic injuries to the skin and mucous membranes and fluctuations in the cardiovascular system, manifesting primarily in the form of cardiac dysrhythmias. The ability to use both the Russian medical aids and the U.S. medical kit significantly increased the effectiveness and reliability of therapeutic and prophylactic care. The degree of medical care and cooperation established precedents for integrating these systems for the medical support of expeditions on the International Space Station.     

From the flight of Iu. A. Gagarin to the contemporary piloted space flights and exploration missions

The first human flight to space made by Yu. A. Gagarin on April 12, 1961 was a crucial event in the history of cosmonautics that had a tremendous effect on further progress of the human civilization. Gagarin's flight had been prefaced by long and purposeful biomedical researches with the use of diverse bio-objects flown aboard rockets and artificial satellites. Data of these researches drove to the conclusion on the possibility in principle for humans to fly to space. After a series of early flights and improvements in the medical support system space missions to the Salyut and Mir station gradually extended to record durations. The foundations of this extension were laid by systemic researches in the fields of space biomedicine and allied sciences. The current ISS system of crew medical care has been successful in maintaining health and performance of cosmonauts as well as in providing the conditions for implementation of flight duties and operations with a broad variety of payloads. The ISS abounds in opportunities of realistic trial of concepts and technologies in preparation for crewed exploration missions. At the same, ground-based simulation of a mission to Mars is a venue for realization of scientific and technological experiments in space biomedicine.     

Cytogenetic analysis of cosmonaut's blood lymphocytes exposed to low space radiation doses and its place in clinical-physiological health monitoring

The article discusses the informative significance and pertinence of cytogenetic analysis of peripheral blood lymphocytes to the clinical-physiological investigations of cosmonauts conducted before and after space missions (SM) of varying duration. The authors point out high sensitivity of the technique, relative simplicity and affordability of the analysis of instable chromosomal aberrations including such radiation effect markers as dicentrics and centric rings. Cytogenetic investigation of cosmonauts could be used to estimate ionizing radiation dose, and to predict delayed effects.     

Crewmember communication in space: a survey of astronauts and cosmonauts.

A total of 54 astronauts and cosmonauts returned questionnaires which addressed various aspects of crewmember communication in space. All respondents believed that crewmembers should be fluent in one shared common language, but American and Soviet space travelers were less tolerant of dialect differences than their international counterparts. Sensory activities (Watching and Listening) were rated as significantly increasing in space, whereas more complex communicative activities (Reading, Gesturing, and Writing) were judged to significantly decrease. Cosmonauts scored higher than astronauts in all verbal and nonverbal activities, possibly reflecting more responsiveness to the space environment. Several factors were rated as significantly helping intracrew communication: Shared Experience, Excitement of Space Flight, Close Quarters, and Isolation from Earth. Other factors were judged to significantly hinder communication: Facial Swelling, Spacecraft Ambient Noise, and Space Sickness. These findings have important operational and scientific implications involving future manned space missions.     

On medical screening of civilian candidates for cosmonauts by exposure to the head-to-pelvis acceleration profiles]

The subject of analysis was the data on +3 and +5 Gz tolerance of 130 civilian non-pilot applicants for cosmonauts (men and women, aged 23 to 55) gathered over the past 30 years. Length of the centrifuge arm was 7.25 meters and the total number of primary centrifuge runs was 309. For nearly every second of the applicants (46.7%) acceleration at +5 Gz was an ordeal causing distinct vascular or coronary decompensation. Thus, 29.7% exhibited various combinations of brief visual disturbances, tachycardia, tachypnea, and systolic arterial pressure in the shoulders; in 17%, visual disturbances and/or their precursors were combined with exaggerated cardio-vascular functional parameters, arrhythmia, and serious vegetative disorders. Most of those who had failed to endure the first centrifugation were unable to improve G tolerance during next runs; indeed, they showed negative G-tolerance dynamics. G intolerance grew in significance or was exacerbated by new disorders and their combinations. These results testify against exposure of non-pilot applicants for cosmonauts to +5 G, during the primary medical screening.     

中美空军飞行学员医学选拔对照实证研究--男性生殖系统

目的：对比分析中美空军飞行学员男性生殖系统医学选拔标准对选拔结果的影响,为我军飞行学员医学选拔标准的修订提供相关支持。方法对比分析2012—2015年招飞定选数据,并对男性生殖系统医学选拔结果分别按照中、美飞行学员医学选拔标准进行对比分析。结果男性生殖系统医学选拔不合格人数23例,综评合格16例。不合格及综评合格项目主要包括精索静脉曲张、睾丸鞘膜积液以及睾丸不等大等。结论中美飞行学员男性生殖系统医学选拔标准有一定差异,但对招飞结果影响有限,我军标准中部分项目可适当精简。