In modern conditions, the possibilities of using 3D printing in medicine are expanding, and it occupies about 11% of the global additive manufacturing market. At the Kirov Military Medical Academy and the ERA Military Innovation Technopolis, 3D printing is used for training, preoperative planning, the creation of splints, the manufacture of non-invasive functional products, and the creation of COVID-19 prevention aids. In order to determine the prospects for development, foreign experience in the use of 3D printing in medicine has been studied over the past 5 years. It is established that a register of clinical data on 3D printing is being created for training, 3D models are being printed to simulate tissue resistance during surgery. With the help of preoperative planning, Siamese twins are separated, doctors are trained in surgical operations on 3D models of elastic resin feet, cardiological models are used to predict the risk of complications during transcatheter implantation of an artificial aortic valve, as well as rehearsals of operations with congenital heart anomalies. Individual implants are manufactured for the lumbar and cervical spine, replacement of the damaged area of the chest and rib, finger phalanges, hip and knee replacements. As auxiliary products, individual surgical instruments for operations with low trauma, orthopedic insoles, elastic stents for the urethra and mesh stents of the trachea are created. New materials made of polyamide (PA11), polyesteresterketone, titanium alloys, absorbable polymer and biocompatible resin are offered for 3D printing. There are new 3D printing software and updates of existing ones. Personalized braces and aligners are printed in dentistry. With the help of 3D printing, individual multi-layered polytablets, smart tablets that release medicinal substances on command from a smartphone, childrens chewing tablets are created. For research purposes, the following devices have been printed: simulating cardiac tissue with sensors to track the effects of drugs and toxins; predicting the individual response of the biopsy tumor material to treatment; diagnosing some infectious diseases using a smartphone and a silicon microfluidic chip. The use of 3D printing in medicine individualizes and improves the quality of medical care.

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The purpose of the study is experimental testing of Russian medical devices for the elimination of tension and open pneumothorax.Objectives of the research. Perform an analysis of the volume of therapeutic measures in the wounded and injured with open and tension pneumothorax. Conduct experimental testing of Russian samples to eliminate tension and open pneumothorax.Materials and methods. A retrospective analysis of the medical histories of 232 patients with polytrauma admitted for treatment at the war surgery department of the Kirov Military Medical Academy in the period from 2015 to 2019. An experimental study was carried out on large biological objects (pigs) to evaluate the effectiveness of eliminating open and tension pneumothorax using products from the UD-02f (paramedic) kit.Results. A retrospective analysis of the medical histories of 232 patients with polytrauma admitted for treatment at the clinic in the period from 2015 to 2019 was carried out. The incidence of tension pneumothorax was 11.6%. In 44.4% of cases, it was eliminated; in 55.6% of the ambulance teams, tension pneumothorax was not eliminated. Open pneumothorax was diagnosed in 21.1% of those admitted at the prehospital stage. In all cases, the elimination of open pneumothorax was carried out by applying an improvised sealing bandage to the chest. An experimental study of the effectiveness of the UD-02f set showed that the use of products included in this set allows to effectively eliminate the life-threatening consequences of wounds and chest injuries.Conclusion. Open and tension pneumothorax are severe life-threatening consequences of chest injuries with a development rate of up to 12.1% and 11.6%, respectively. The inclusion of a set for eliminating tension and open pneumothorax disposable, sterile (paramedical) UD-02f, in the complete equipment and training of medical personnel in the procedure for its use, will allow timely and effective elimination of tension or open pneumothorax at the prehospital stage of emergency medical care.

AIM: To assess the psychometric qualities of the methodology for identifying signs of deviant behavior in military personnel developed at the S.M. Kirov Military Medical Academy. MATERIALS AND METHODS: The ISADA method is a screening questionnaire for assessing the presence of a propensity for deviant forms of behavior in military personnel. The questionnaire was developed at the S.M. Kirov Military Medical Academy. The abbreviation ISADA was used as a name for the methodology, consisting of the names of its main scales Avoidance, Suicidality, Aggressiveness, Delinquency and Addictiveness. The questionnaire consists of 60 questions directly related to well-being, behavior or character, to which the subject must answer only yes or no. Also, the Dynamic Observation Questionnaire and the Questionnaire for Evaluating the Professionally Important Qualities of a Serviceman were used to determine the success of the military professional activities of servicemen. RESULTS: According to the results of the assessment of the psychometric qualities of the technique for identifying signs of deviant behavior in military personnel, the majority (from 75 to 95%) did not reveal a tendency to deviant (deviant) forms of behavior. The scales of the ISADA questionnaire generally comply with the requirements of the Guidelines for the development, examination, implementation and use of professional psychological selection methods in the Armed Forces of the Russian Federation. CONCLUSION: The ISADA method has a high social significance, since its application will allow diagnosing the propensity of military personnel to deviant (deviant) forms of behavior. This technique can be recommended for use. In the course of the practical use of the ISADA methodology, it is advisable to continue work on assessing its predictive validity.

В в е д е н и е. Высокий удельный вес травм жиз-ненно важных областей тела (голова -16,5-21,0 %, грудь -18,0-50,4 %, живот -6,5-31,3 %, таз -14,2-29,1 %, позвоночник -5,0-11,4 %) определяет медико-социальную и экономическую значимость проблемы лечения сочетанных повреждений и ве-дет к значительному уровню показателей смертно-сти и инвалидизации. Причем в общей структуре травм доля повреждений этих областей тела еще больше: головы -40,0-56,8 %, груди -14,4-34,4 %, живота -22,1-35,2 %, таза -20,3-29,1 %, позво-ночника -4,3-11,4 % [1-4].Актуальность изучения возможностей био-метрического анализа результатов диагностики и комплексного многоэтапного хирургического лечения сочетанных ранений и травм, характери-зуется рядом недостаточно решенных вопросов. До последнего времени не сформулированы объек-тивные диагностические критерии к применению методов многоэтапного хирургического лечения сочетанных травм, не определена последователь-ность выполнения диагностических мероприя-тий. Практически не разработаны вопросы алго-ритма диагностических и лечебных мероприятий в медицине катастроф при лечении пострадавших с множественными и сочетанными травмами. По мнению ряда авторов, доля множественных и со-четанных повреждений достигает 80 % [3,5].Цель работы -определение оптимальной так-тики лечения сочетанной травмы с применением