97 patients with bronchial asthma of different severity and 21 healthy volunteers were examined to determine the peculiarities of breathing pattern and rhythm variability depending on the presence and intensity degree of bronchoconstrictor reaction to cold air, the level of the disease control, phenotype and season of the year. The methods of spirointervalometry and bronchoprovocation test with cold air were used. A variability of volume and time parameters of the respiratory cycle and of respiratory center rhythm depending on the presence or absence of cold airway hyperresponsiveness, the level of control, severity, phenotype of bronchial asthma and season of the year was found out as the result of the study. The identified changes allowed to develop objective ways to determine the presence or absence of cold airway hyperresponsiveness in patients with bronchial asthma and to define the level of control over the disease.

The paper deals with the research on changes in the spectrum of pro- and antiinflammatory cytokines in bronchial asthma patients as related to the severity of the disease. 115 patients have been examined with 41 patients having disease of medium severity, 42 having severe forms of the disease, and 32 with steroid-dependant forms. Along with that 45 of the patients were found to have non-allergic bronchial asthma, while 70 had a mixed bronchial asthma form. All the patients were tested for proinflammatory (IL-1β, IL-6, IL-8, TNF-α) and antiinflammatory (IL-4) cytokines. As a result, it was found out that the level of proinflammatory cytokines tends to increase: IL-1β in 1.2-3.2 times, IL-6 - 2.1-2.8 times and IL-8 in 1.6-3.4 times in accord with bronchial asthma severity, which can be attributed to intensification of inflammatory process activity along with compensatory growth of antiinflammatory cytokine levels in 2.1-18.6 times. The research shows that inflammatory process develops more actively with non-allergic bronchial asthma patients as compared to the ones having a mixed bronchial asthma form, which is proved by the growth in proinflammatory cytokines rates. It has been found that in patients with severe forms of steroid-dependant bronchial asthma high levels of IL-8 persist not depending on the form or severity of the disease, which can result from the development of cell-producers' resistance to glucocorticoid hormones.

66 patients with bronchial asthma and cold airway hyperresponsiveness and 15 healthy people were examined. The dynamics of oxidative stress indicators in the exhaled breath condensate before and after the test with cold air and also after two-week standard base therapy was studied. It was established that patients with bronchial asthma with cold airway hyperresponsiveness had a much higher concentration of Н₂О₂ and diene conjugates in exhaled breath condensate than in the control group. After the test with cold air they had an increase of Н₂О_2, of diene conjugates, of ketodienes and of conjugated triens in exhaled breath condensate. After standard base therapy there was a significant drop of base Н₂О_2, and there was high bronchi responsiveness to cold air and the growth of oxidative stress indicators after the test of isocapnic hyperventilation with cold air.

The paper deals with the research on the dynamics of change in IFN status as well as interferon-producing capacity of leucocytes in vitro. 54 bronchial asthma patients with different forms of asthma had been tested before they went through cycloferon treatment, during the treatment, and after it. 16 (30%) of the tested had an allergic form of bronchial asthma, 21 (39%) had a mixed form, аnd 17 (31%) had a non-allergic form. With all the patients, the exacerbation of bronchial asthma was provoked by acute respiratory viral infections. The research showed that initially high IFN-γ (>8 pg/ml, control - 6.8±1.2 pg/ml) index in the patients' blood serum results from persistent viral and, probably, bacterial infections and causes active inflammatory process in bronchial asthma patients. Low initial indices of IFN-γ (<4 pg/ml) in blood serum and decrease in the capacity of blood leucocytes to produce IFN-α and IFN-γ point to the weakening of anti-virus body resistance, which results in the increase of the risk of acute respiratory viral infections and worsening of bronchial asthma. Introduction of cycloferon in the complex treatment of patients with different forms of bronchial asthma leads to the increase in IFN level, contributes to IFN-synthesis capacity of blood leucocytes, causes a decrease in the rates of acute respiratory viral infections and exacerbations of the basic disease.

To study the clinical, functional and morphological state of cerebral arteries in chronic obstructive pulmonary disease (COPD) at different stages of chronic pulmonary heart (HPH) 83 patients were examined. The first group included 25 patients with COPD and no pulmonary hypertension. The second group consisted of 33 patients with COPD complicated by compensated HPH. The third group included 25 patients with COPD and decompensated HPH. An autopsy material of 46 patients with COPD was investigated. It was established that the functional and morphological changes in brain arteries develop in early stages of COPD. Its severity depends on disease progression and HPH development. In group 1 the thickness of intima-media of the common carotid artery didn't differ from that of the control group, in the 2nd and 3rd groups it increased to 0.98±0.02 mm (p<0.05) and 1.14±0.05 mm (p<0.01), respectively. In patients of Group 1 there was an increase of resistive and pulsation index in the internal carotid arteries to 0.84±0.12 (p<0.01) and 1.97±0.18 (p<0.05), respectively, and in middle cerebral arteries to 0.57±0.05 (p<0.05) and 0.94±0.13 (p<0.05), respectively. The patients of Group 2 were characterized by maximum deceleration of blood flow velocity in middle cerebral artery to 86.4±4.45 cm/s (p<0.05). The patients of Group 3 showed a further decrease in blood flow velocity in intracranial arteries (p<0.01) and the maximum deceleration of blood flow velocity in the extracranial arteries to 39.16±3.28 cm/s (p<0.01). The results of morphological study of patients who died of COPD showed an increase in thickness of the intima-media complex in the Group 1 to 4.5%, in the Group 2 to 18%, in the Group 3 to 33% compared with controls. These changes can significantly limit the adaptive capacity of the vascular system of the brain, develop the progression of encephalopathy, which significantly reduces the quality of life, worsens the prognosis and dictates the need for correction therapy.

The article deals with the results of long-term prospective research of clinical and functional course of chronic obstructive pulmonary disease (COPD) associated with ischemic heart disease (IHD). 44 patients were involved in the study, 24 of them had a standardized therapy with nebivolol, cardio-selective β₁-adrenoreceptor blocking agent of the third generation, and 20 of the patients were treated without nebivolol. The observation lasted for about one year. It was found out that the combination of nebivolol with the standard therapy of COPD and IHD contributes to better control symptoms of comorbidity. It reduces the severity of dyspnea, cough, frequency of anginal attacks, heart rate and decreases the frequency of exacerbations and the severity of comorbid disease by 1.9 times. Standard therapy combined with nebivolol also during the year leads to the increase of FEV₁ by 15.2%, of FEV₁/FVC by 10.8%, of VC by 8.2% and it improves intracardiac and pulmonary hemodynamics more significantly, reduces arterial rigidity and raises physical activity tolerance.

The features of metabolic disorders in 36 patients with chronic obstructive pulmonary disease (COPD) including 16 patients with concomitant cardiac pathology (arterial hypertension, stable exertional angina) were studied. It was found out that the clinical remission in patients with COPD is characterized by impaired lipid metabolism and altered functioning of the LPO-AOD system. More severe violations of the state of peroxidation processes were found in patients with concomitant cardiac pathology during moderate hypercholesterolemia. Emerging in patients with cardiovascular disease dyslipoproteinemia influences the development of bronchopulmonary inflammation, which, in turn, induces a lipid response and complicates disorders of lipid metabolism in patients with COPD. The results of these studies confirm the needs to monitor the state of lipid metabolism in patients with COPD and concomitant cardiac pathology.

The aim of this study was to estimate the informative value of low-dose digital fluorography for diagnosis of chronic obstructive pulmonary disease exacerbations. 316 patients (179 males and 137 females at the age of 31-84 years, the mean age was 57.5±8.2 years) with COPD exacerbation of different stage were included in the research. Combined radiological examination with low-dose digital fluorography and conventional screen-film radiography was performed to all of them. Three roentgenologists assessed X-ray images by 7 major signs. The sensitivity, specificity and accuracy of the compared techniques were defined. The final stage was the construction of ROC-curves. The sensitivity of low-dose digital fluorography was 14% higher (p<0.05) than the one of conventional screen-film radiography, which was proved by computing tomography of high resolution. The rise of informative value of low-dose digital fluorography is also attested by higher position of respective ROC-curve. Low-dose digital fluorography may work as an independent technique for diagnosis of chronic obstructive pulmonary disease (COPD) exacerbations at the lowering of dose influence on the patient.

The results of clinical and functional studies of 121 workers employed in brown coal production and exposed to brown coal rock dust which exceeds maximum allowable concentration are presented in this article. 53 patients with chronic non-obstructive bronchitis who were exposed to «anthropogenic» effect of the occupational dust, 60 patients with pneumoconiosis and 8 patients with professional dust bronchitis were examined. The uniformity of the identified changes at the specified diseases of bronchopulmonary system was found out: the paucity of clinical manifestations and a low intensity of intoxication syndrome, the atrophy of the mucous membrane of the trachea and bronchi, a mixed type of lung function insufficiency with the initial lesion of medium and low lung parts, first signs of chronic cor pulmonale forming, frequent development of emphysema and the absence of pulmonary tuberculosis.

The aim of the research was to study circadian rhythms of lung function in patients with fibrous-cavernous pulmonary tuberculosis, the early identification of presence and intensity of bronchial spasm in different time of the day, and determination of chronosensitivity of the bronchial tree to bronchodilators. 30 patients with fibrous-cavernous pulmonary tuberculosis were studied. The control group consisted of 15 healthy people. The studies were conducted for 2 days at 6 a.m., 12 a.m., 6 p.m. and 12 p.m. Аt 6 a.m. and 6 p.m. inhalation bronchodilatation test with salbutamol was carried out to detect bronchospasm and bronchial tree sensitivity to bronchodilator drugs. It was revealed that patients with fibrous-cavernous pulmonary tuberculosis had pathologic circadian rhythms of lung function with sudden worsening of bronchial conductance and bronchospasm initiation at evening and night time. There was also the intensification of chronosensitivity of bronchi to pharmacological influence of inhalation bronchodilators at evening and night hours, which dictates the necessity of correction of their application time.

The study of transmitter interactions of development stages of inflammation caused by A/H1N1 was done from uncomplicated influenza to pneumonia and acute respiratory distress syndrome development. In 52 patients with various forms of influenza A/H1N1, 16 of whom developed acute respiratory distress syndrome, the content of neutrophils mediators (α-defensins, elastase, myeloperoxidase and their local inhibitors - Clara cell protein) was determined in the blood plasma. It is shown that in case of uncomplicated influenza the level of α-defensins, elastase, and myeloperoxidase increases against the unchanging amount of Clara cell protein. With the development of pneumonia, compared with uncomplicated influenza, the concentration of elastase and myeloperoxidase increases while the concentration of α-defensins decreases against the unchanging amount of Clara cell protein. With the development of acute respiratory distress syndrome the amount of Clara cell protein decreases sharply and the number of other mediators remains at the level of patients with pneumonia. Conclusions: one of the mechanisms of pneumonia development is the increased concentration of neutrophil elastase, myeloperoxidase with the formation of the relative Clara cell protein deficiency and decreased α-defensins; the decrease of Clara cell protein concentration can be one of the predictors of acute respiratory distress syndrome development.

In the structure of etiologically significant agents at pneumonias opportunistic microorganisms with acquired pathogenic properties are found in increasing frequency. Acquired factors of virulence of opportunistic microflora of lower respiratory tract in community-acquired pneumonia patients were studied. 820 microbial cultures obtained from the phlegm of patients of pulmonology department of multi profile hospital during 6 years (2005-2010) were studied. Both antibiotic and antiseptic resistance, adhesive properties and antagonism were investigated as well as biofilm formation ability and microflora. The growing level of antibiotic resistance of opportunistic microorganisms was shown in the study, the sensitivity to antiseptics being rather high. It was proved that strains studied had pronounced adhesive properties as well as antagonistic ones. The majority of bacterial cultures separated from the lower respiratory tract are able to form biofilms. The further studying of factors of acquired opportunistic microflora of lower respiratory tract will allow to understand a role of microorganisms properties in development of pyoinflammatory diseases more deeply.

To carry out a comparative evaluation of the qualtity of life of senile patients with chronic heart failure (CHF) of the II-III functional classes of ischemic genesis depending on the presence of chronic obstructive pulmonary disease (COPD) and to study the spread of depressive disturbances in subpopulation of senile patients with CHF of ischemic genesis, 158 senile patients with ischemic cardiac disease and signs of CHF of the II-III functional classes were examined. According to the results of spirography with bronchodilatation test all the patients were divided into two groups: with presence and absence of COPD. The study of quality of life with the use of specialized Minnesota Questionnaire «Living with Heart Failure Questionnaire» for patients with CHF and Questionnaire for the presence of depression CES-D (Center for Epidemiological Studies Depression Scale) was done. It was established that patients of senile age with ischemic cardiac disease and COPD disease evaluate their life quality associated with CHF both at the time of involvement into the investigation and in a year at the time of control (49.5±5.2 scores and 44.0±1.7 scores, respectively) higher than patients without COPD (52.6±2.7 scores and 52.3±3.4 scores, respectively). CHF-associated depressive symptoms of the patients with ischemic cardiac disease and COPD were less expressed (at the moment of involvement into the investigation the quantity of the patients without depressive symptoms was 59.5%, in a year at the time of control it was 56.3%) than in the patients without COPD (40.5 and 35.7%, respectively). Patients of senile age with ischemic cardiac disease and COPD are characterized by better self-evaluation of their quality of life associated with CHF and less expressed depressive symptoms associated with CHF.

The aim of the work was to estimate life quality of patients with infiltrative pulmonary tuberculosis combined with bronchial obstruction of different severity. 22 patients at the age of 20-55 years with infiltrative pulmonary tuberculosis as well as 20 healthy people were examined. To study the parameters of life quality, the questionnaire «MOS SF-36» was used. During comparative analysis of the research results it was found out that the patients with infiltration pulmonary tuberculosis had the decrease of indicators in all items of the questionnaire with a high degree of statistical significance in comparison with healthy people. The worsening of many aspects of life activity and correlation with the duration of the disease and performance of medical recommendations and presence of bronchial obstruction syndrome were revealed. Infiltrative pulmonary tuberculosis worsens physical, social and psychological components of life quality. The lowering of life quality is in direct dependence on the duration of the disease and medical recommendations performance. The intensity of bronchial obstruction syndrome significantly influences the level of life quality of patients with infiltrative pulmonary tuberculosis, that's why there should be its early diagnosis and correction in this category of patients.

The peculiarities of motivational sphere of patients with bronchial asthma depending on the severity of the disease have been studied. 133 patients with bronchial asthma and 28 healthy people at the age from 21 to 69 years were examined. The test-questionnaire «Motivation to success and failures» by A.A.Rean, the test «Motivation to success» by T.Ehlers, methods of diagnosis of the degree of readiness to risk by G.Schubert, the scale of achievement need estimation by Yu.M.Orlov, and Marlow-Crowne Social Desirability Scale were used. By the results of motivation tests the patients with bronchial asthma predominantly had a motivation to success of an average and high level, low and average values of readiness to risk, low motivations of achievement and approval. The consideration of bronchial asthma patients' motivation peculiarities can probably be a vital thing in establishing an effective communication between a doctor and a patient, and as a result, achieving a total control over the disease.

The article deals with the main approaches to coping behavior and to subjective wellbeing of a person. Subjective wellbeing is regarded as a psychic state. The results of empirical study of subjective wellbeing of patients with bronchial asthma and their coping strategy are presented; their correlation is described taking into account the complex structure of wellbeing. It is established that the more a patient is inclined to describe wellbeing as something ending very fast, something pleasant, global, associated very little with him/herself, the more he/she is inclined to have strategies of mental distraction and applying for help. The more self-evaluation of tonus at wellbeing and adequate the image of oneself, the more the patient is inclined to have a positive revaluation of the situation and coping planning, to change the situation actively, to have a good sense of humor and not to use the strategy of negation. Such constituents of the emotional and evaluation component as «active attitude to life situation», «cheerfulness», «satisfaction from life on the whole», «stability of the emotional state» negatively correlate with behavioral escape from problems and taking psychoactive substances. The constituents «relaxedness» and «calmness» are also in reverse dependence on the strategy «acceptance».

The article deals with subjective well-being of a person: its definition as a psychic state and its structure. The results of empirical study of cognitive aspects of subjective well-being of patients with bronchial asthma are presented. It was found out that patients with bronchial asthma see subjective well-being as something life-asserting, something which concerns different spheres, which is short-term and very close to confidential relationships. In comparison with respondents without a disease, bronchial asthma patients less rely on the situation as a means of well-being, they are less oriented to current life. Representing the image of subjective well-being such topics as love and wealth are reflected most often (and the topic of wealth is presented more in comparison with topics of respondents without the disease).

The aim of this work is investigation of coordination of changes of cardiovascular and respiratory systems at burn intoxication. The control group included 18 healthy people and the main group had 32 patients with skin burns (10-50% of body square). All patients were tested by electrocardiography («Polyspectrum-8», Russia) for time and spectral analysis of heart rate variability. The respiratory function was estimated by «Spirolan» device (Russia). Cardiorespiratory synchronization was verified by simultaneous use of electrocardiography and spirography, and use of special parameter of electrocardiography device - cardiorespiratory synchronization level. On the base of estimation of heart rate variability, of the respiratory function and its synchronization in patients with burn disease, two-phase response of system haemodynamics to burn trauma was shown. The first phase (for 4-6 days after burn trauma) of cardiorespiratory system reaction is reflection of non-specific stress response to burn. This reaction intensity is associated with thermal damage severity. The second phase (after 6 days of posttraumatic period) includes adaptive transformations for optimization of cardiorespiratory interaction. The role of cardiorespiratory synchronization as a sanogenetic mechanism which optimizes both systems functioning was stated.

The contents of arachidonic acid and lisophosphatidilcholine in membranes of erythrocytes of the peripheral blood of pregnant women who suffered during gestation the exacerbation of herpes-virus infection (antibody titer IgG to virus of simple herpes-1 was 1:12800) were studied with the help of methods of thin-layer and gas chromatography. The increase of arachidonic acid (in I trimester up to 3.26±0.12%, in II trimester up to 4.59±0.72% and in III up to 5.12±0.61%) and of lisophosphatidilcholine (up to 6.30±0.94% in I trimester, 7.50±0.39% in II trimester and up to 9.90±0.58% in III trimester) was found out in membranes of erythrocytes of women with the exacerbation of herpes-virus infection. Taking into account that these lipids are mediators of a wide spectrum of cellular processes of proinflammatory character and lisophosphatidilcholine is a haemolytic poison, the excess of these lipids in the peripheral blood of pregnant women at highly toxic herpes-virus infection leads to tissue inflammation, infringement of hemostasis and can be one of the causes of anemia. Thus, it is possible to believe that at the exacerbation of herpes-virus infection in the peripheral blood of pregnant women there are toxic products accumulated and they cause the disintegration of cells including erythrocytes.

The study of palmitic acid composition in peripheral blood of pregnant women who during gestation at different terms suffered from the exacerbation of chronic herpes-virus infection depending on IgG antibodies titer to virus of 1 type simple herpes was done. It is established that at activation of chronic herpes-virus infection during pregnancy there is an increase of palmitic acid in plasma (by 13% in the first trimester, by 14 % in the second trimester and by 12% in the third trimester) and in erythrocytes of peripheral blood (by 18% in the first one, by 21% in the second one and by 15% in the third one). This led to hardening of lipid bilayer of membranes, to the increase of relative microviscosity and to the decrease of fluidity influencing the transport of water and other ions. These changes were especially evident during the period when IgG antibodies titer of pregnant women was 1:12800 in the peripheral blood of pregnant women. The revealed structural disturbances of peripheral blood of pregnant women can negatively affect the forming of developing fetus and cause intrauterine hypoxia.

According to the data of both domestic and foreign literature, the morbidity of physicians exceeds that among the population of able-bodied age. An estimation of medical workers morbidity was done by studying and comparison of its various kinds: medical aid appealability, temporary disability, results of additional prophylactic medical examination, anamnestic method. Statistical retrospective analysis of registration and report medical documentation was done: a medical card of the outpatient (form №025/u), 520 in number; the form of statistical supervision №16-BN «The data about the reasons of temporal invalidity» for 2007, 2008 and 2009 years; the form №1-DD «The data about additional prophylactic medical examination of working citizens» and sociological analysis by a questionnaire method. The peculiarities of development of diseases in various age and professional groups are analyzed. The general morbidity of physicians and morbidity with temporal invalidity exceed similar indicators among adult population of the Amur Region, but are authentically below the morbidity according to self-registration. Cardiovascular, respiratory, urino-genital and gastrointestinal diseases contribute greatly to the morbidity of physicians. Higher morbidity is typical for the physicians of out-patient clinics than for the physicians of hospitals according to self-registration. The structure of diseases is authentically various depending on age and profession of physicians, which allows to establish age and professional risks of development of diseases with transition into chronic pathology. Indicators of physicians morbidity according to self-registration exceed the similar data registered in the registration-report medical documentation, which proves low activity of physicians at medical aid appealability and high risk of development of chronic form of diseases and professional diseases.

The ecologic and hygienic estimation of respiratory diseases prevalence in Primorsky Krai was done. The model «Habitat factors influence on the spread of respiratory diseases» was created with application of the system analysis and statistical multivariate methods (canonical and information-entropy analyses, Terent'ev's mathematical pleiads). It is established that in Primorsky Krai climatic conditions alongside with air pollution which only worsens the situation have a negative influence on the prevalence of respiratory diseases. Respiratory diseases in children develop under the influence of climate and technology factors relations. The level of respiratory diseases depends on the direct influence of single emissions of SO₂, NO_х into the atmosphere.

The aim of this paper is investigation of some physical and chemical factors influence on crystallogenic properties of blood serum. The peculiarities of dehydration blood serum structurization at its ozonation (ozone dose 1000 mcg/l for barbotage), oxygenation and combination of oxygenation and Darsovalization were studied. 34 samples were taken from healthy people and burned patients. Crystallogenic properties of modified blood serum were estimated by classic crystalloscopy while biological fluid initiated activity was tested by comparative teziography. The results of crystalloscopic and teziographic tests were estimated by special system of criteria. It was stated that combined exposure (oxygenation and Darsonvalization) to blood serum crystallogenic and initiated properties approximates to ozone influence on it. So, blood oxygenation leads to decreasing of biosubstrate crystallogenic activity, but ozonation and combined exposure induce its stimulation. This tendency was registered in dried samples of blood serum of burned patients too, but it was less than in facias of healthy people.

Bronchial asthma is a serious social and medical problem. This review deals with modern methods used in asthma diagnostics. In the first place it's a physical examination of patients and revealing of anamnestic characteristics as well as the study of respiratory function. Today spirometry studies are a «gold standard» for diagnostics and monitoring of asthma (spirography, peak flowmetry, body plethysmography with various provocative tests), but they don't fully reflect the multifaceted disease picture. Allergic status evaluation and identification of biological markers of asthma are necessary. There are a number of technical methods used to study disorders of regional ventilation: scintillation scanning, X-ray methods (multidetector computed tomography with three-dimensional-imaging). Modern genetic methods are one of the future trends in asthma diagnostics. It's important to note the variability of asthma and the use of integrated approach.

Our own rare clinical observation, benign leiomyoma of uterus metastasizing into lungs, is presented in the article. At histological and immunohistochemical studies there weren't any signs of malignization found either in uterus or in lungs. Bronchial asthma veiling the clinical picture is the background of the disease. In the literature this pathology is given as casuistry. The complexity of lungs leiomyomatosis diagnostics especially against bronchial asthma, possibilities of modern diagnostic technologies contributing to the choice of an adequate treatment tactic in this category of patients are demonstrated.