Systemic inflammation is an integral pathophysiological component of many critical illnesses. The systemic inflammatory response is based on a cascade of interactions leading to hypercytokinemia and, as a consequence, multiple organ failure, which is one of the main causes of mortality in intensive care units.Aim of the study. To evaluate the activity of the negative regulation system of T-cell response by determining the plasma levels of PD-1, PD-L1 and PD-L2 molecules in pneumonia patients with influenza A (H1N1).Materials and methods. 85 patients with pneumonia and underlying influenza A (H1N1) were examined. Among them there were 30 patients with severe pneumonia, and 55 patients with non-severe pneumonia. Plasma levels of PD-1, PD-L1, PD-L2 molecules was determined by flow cytofluorometry method.Results. In patients with severe pneumonia and underlying influenza A (H1N1), the plasma level of PD-1 receptor increased 4.6-fold, while the concentration of its ligands PD-L1 and PD-L2 increased 10.6 and 2.2-fold, respectively.Conclusion. Significant increase in levels of PD-1 and its ligands PD-L1 and PD-L2 in patients with pneumonia and underlying influenza A (H1N1) indicates the involvement of negative regulation system of T-cell response in the cascade of immunological reactions and is associated with the severe disease. Possible correction of immune reactions realized through PD-1/PD-L1/PD-L2 complex in critically ill patients is a promising research avenue.

The objective: To determine the level of satisfaction with their work and degree of burnout among anesthesiologists and emergency physicians working in the red zone of a COVID-19 hospital.Subjects and methods. A prospective study was conducted as an anonymous survey of physicians performing their duties in intensive care units of the red zone. 65 specialists were interviewed: Group 1 (52.3%) – trainee physicians, Group 2 (47.7%) – anesthesiologists and emergency physicians.Results. The majority of respondents in both groups noted relatively high satisfaction with their current work. At the same time, the majority of respondents (70.9%) in the group of anesthesiologists and emergency physicians would prefer the previous working conditions to current ones. Also, it was noted that both groups were highly emotionally exhausted.

Актуальность. Системный про- и противовоспалительный каскад реакций является одним из патофизиологических компонентов развития критического состояния различного генеза. Поиск биологических маркёров и патогенетических механизмов влияния на макроорганизм систем рецепторов, участвующих в реализации реакций врожденного и адаптивного иммунитета, вследствие повреждения или инфекции, остается актуальным научным направлением. Цель исследования. Оценить активность системы рецепторов TNFRSF7 и TNFRSF9, определив их плазменную концентрацию у больных пневмониями на фоне гриппа A/H1N1. Материалы и методы. Обследовали 85 больных пневмонией на фоне гриппа A/H1N1. Из них 30 пациентов с тяжёлой пневмонией, 55 - с нетяжёлой пневмонией. Методом проточной цитофлуометрии определяли плазменную концентрацию молекул TNFRSF7 и TNFRSF9. Результаты. Установили, что что у больных тяжёлой пневмонией на фоне гриппа A/H1N1 плазменная концентрация рецепторов TNFRSF7 и TNFRSF9 увеличивалась в 1,8 и в 2,3 раза соответственно. Заключение. Увеличение концентрации TNFRSF7 и TNFRSF9 у больных пневмониями на фоне гриппа A/H1N1 свидетельствует о вовлечении в реализацию реакций врожденного и адаптивного иммунитета суперсемейства рецепторов TNF и ассоциировано с тяжестью состояния. Background. Systemic pro- and anti-inflammatory cascades of reactions are pathophysiological components of various critical states. It remains relevant to search for biological markers and pathogenetic mechanisms of effects on the macro-organism of receptor systems involved in innate and adaptive immunity induced by damage or infection. Aim of the study. To evaluate the activity of the TNFRSF7 and TNFRSF9 receptor systems by determining their plasma concentrations in pneumonia patients with influenza A (H1N1). Materials and methods. 85 patients with pneumonia associated with influenza A (H1N1) were examined. Among them, 30 patients had severe pneumonia, and 55 patients had non-severe pneumonia. Plasma levels of TNFRSF7 and TNFRSF9 were measured by flow cytometry. Results. In patients with severe pneumonia and underlying influenza A (H1N1), the plasma concentrations of TNFRSF7 and TNFRSF9 receptors increased 1.8-fold and 2.3-fold, respectively. Conclusion. The significant increase in plasma TNFRSF7 and TNFRSF9 receptors in patients with pneumonia associated with influenza A (H1N1) indicates the involvement of the TNF receptor superfamily in innate and adaptive immunity reactions and is related with severity of the disease.

В статье приведены особенности организации медицинской помощи и интенсивной терапии больным с осложненны ми формами гриппа А/H1N1/09 и сезонного гриппа в Забайкальском крае осенью 2009 года. Ключевые слова: грипп A/H1N1/09, пневмония, интенсивная терапия. The paper describes the way medical and intensive cares are organized to patients with complicated forms of A/H1N1 and seasonal influenzas in the Trans Baikal Territory in the fall of 2009.