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The article summarizes the results of developing countermeasures by the team of winners of the USSR state prize under the leadership of academician O.G. Gazenko, and ensuing investigations at the Institute for Biomedical Problems. The system of countermeasures against the debilitating developments in cosmonaut's organism first developed in Russia ensured successful completion of long-term SF (64 to 438 days) aboard the Salyut and Mir orbital stations. The system incorporates exercises on the treadmill and veloergometer, axial body loading in suit Pinguin, application of negative pressure on the lower part of the body vacuum suit Chibis and several others. The system proved high efficiency in preventing or smoothing over the negative effects of microgravity in the course and after long-term space flight.

The article includes excerpts from The Bioethic Rules of Research With Humans and Animals that have established on analysis of national and international bioethic guidelines for biomedical research with the use of humans and animals and are a part of the ISS human use guidelines.

The arguments characterizing the poor theoretical validity and low profitability of the concept of "weightlessness disease" developed during recent few years by its authors are advanced. The morphofunctional rearrangements occurred in the body during space flights are considered as the result of adaptation-disadaptation rearrangements directed towards supporting the equilibrium with a set of reduced environmental requirements. Understanding the mechanisms of adaptation rearrangements creates the real but not forced basis for developing the measures for cosmonauts health stabilization and spaceflight safety.

The basic goal of medical investigations during and after the 366-day mission was to accumulate data about physiological responses to such a long exposure to microgravity. In flight, cardiovascular and other systems were examined in detail and the efficacy of countermeasures used was assessed. After flight, physiological systems were also followed very carefully. According to the preliminary data, the medical results obtained during and after flight give evidence that man can well adapt to a year-long space flight, maintaining good health and adequate work capacity. The readaptation process was very similar to that observed after shorter flights (6-11 months). As compared to former flights, no new or qualitatively different changes in the vital systems of the body were seen. The observations indicate that the duration of manned space missions can be further increased.

The objective of medical investigations during and after the 366-day manned mission was to accumulate information about human responses to long-term effects of microgravity. To do this, cardiovascular and other systems were examined in detail during and after exposure. The results gave evidence that the crewmembers well adapted to the long-term flight effects. Their good health condition and high work capacity were supported by adequate medical procedures. Postflight readaptation developed similarly to what was seen after previous flights of shorter duration (6-11 months). No qualitatively new changes in the physiological systems were detected during or after this mission.

Comparison of the specific features of the environment and human activities in aviation and space flights allows us to distinguish the major relations in the system man--vehicle--environment as related to their medical support. It is concluded that in the aviation flight the man-vehicle interaction plays the leading role while in the space flight the man-environment interaction comes to the foreground. Having in view these differences, medical and professional selection, prediction, medical monitoring and medical support of pilots and cosmonauts are discussed.

In 12 series of short-term (4.5 hour) experiments the exposures that influenced the blood distribution relative to the long axis of the body (postural changes, lower body excessive pressure, lower body negative pressure, axial loads) were studied. A close correlation between the blood flow in lung capillaries, water losses and orthostatic responses was established. The correlation was dysproportional when LBEP or LBNP was applied in certain postures. This may be attributed to the effect of these exposures on vessel compliance.

In 1975 the Soviet Union performed two manned flights on board the orbital station Salyut 4. The first mission of 30 days was flown by A. A. Gubarev (Commander) and G. M. Grechko (Flight Engineer) and the second mission of 63 days by P.I. Klimuk (Commander) and V.I. Sevastyanov (Flight Engineer). The present paper gives preliminary data on the general health and cardiovascular investigations of the crew members during and after flight. The clinical and physiological examinations of the cosmonauts showed that the work-rest cycles and counter-measures used helped to maintain their good health and high performance in flight, to alleviate adverse reactions and to facilitate readaptation post-flight. Medical results of the post-flight investigations revealed no changes that may detract from further increasing the duration of manned space missions.

The paper presents the results of medical examinations of the cosmonauts B. V. Volynov, V. M. Zholobov, V. V. Gorbatko and Yu. N. Glazkov during their 49- and 18-day flights aboard the orbital station Salyut-5. During the prolonged 49-day flight the cosmonauts developed symptoms of asthenization and fatigue. The medical monitoring of the cosmonauts showed increased blood filling of the head veins, increased arterial pressure and cardiac output. No significant changes were noted in the bioelectrical or contractile function of the myocardium. By the end of the flight the 49-day crewmembers showed a 4.5--7.0 kg decrease of body weight. They displayed a decline of orthostatic tolerance. This was especially marked in V. M Zholobov. Postflight biochemical changes were as usual but in the 49-day crewmembers they were more distinct. B. V. Volynov and V. M. Zholobov had moderate counts of protein and cell elements in the urine. It is concluded that space crewmembers ought to adhere strictly to their work-rest cycle and perform actively pressigned exercises.