The article deals with the questions connected with the delegation of power about the organization of medical aid from municipal level to the level of subjects of Russian Federation according to new regulatory legal acts: the Federal Law from November, 29th, 2010 №313-FL «About amendments in separate acts of Russian Federation in connection with the passing of the Federal Law "About obligatory medical insurance in Russian Federation"» and the Federal Law from November, 21st, 2011 №323-FL «About bases of health protection of citizens in Russian Federation», and realization of the Federal Law from May 8, 2010 №83-FL «About amendments to certain legislative acts of Russian Federation in connection with the improvement of the legal status of state (municipal) institutions». Possible risks of administrative decisions made in the subjects about realization of laws are analyzed. A more preferable variant of the decision is offered, namely, to transfer the state powers about the organization of primary medical aid to the municipal level, having given the necessary finance for that to regional budgets. It will allow, on the one hand, to enhance the responsibility of the subject of the Russian Federation, and, on the other hand, it will provide a more effective execution of transferred powers by municipalities.

The analysis of organizational and methodical facilities of medical aid to patients with chronic bronchitis and COPD in the health and care institutions of Khabarovsk Krai was done. Based on the analysis of modern problems of diagnosis and prevention of chronic bronchitis and COPD the suggestions (optimization of specialized net of treatment and prevention institutions and their staff potential, supplying the institutions of health and care with diagnostic medical facilities, fulfilling the standards of diagnosis and treatment) were made. Their implementation will allow to improve the efficiency of treatment, diagnosis and preventions activities done to pulmonological patients at the regional level.

Sharp daily and seasonal changes of temperature and humidity of air, atmospheric pressure, the speed of wind and other factors have an important physiological impact on a person. It reveals itself through the change of metabolic processes in cells and the formation of response in the change of immune and metabolic indicators of blood. Statistically reliable dependence of pulmonary diseases growth on the degree of air pollution which reduces the resistance of the organism is known. The aim of this work was to study the response of immune and metabolic blood indicators of Vladivostok populace to the influence of climate and air pollution. It is established that the level of air pollution of Vladivostok city is determined by climatic features. The reaction of immune and metabolic blood indicators to the influence of monsoonal climate exceeds the pathogenic reaction to anthropogenic pollution, which in combination is hazardous to the health of the city populace.

In this article the authors describe the results of sociological research on the problem of smoking among health professionals. The aim of this study was to analyze the prevalence of smoking among medical staff in Yekaterinburg. An anonymous questionnaire about smoking and health professionals' attitude to it was prepared. This study involved 1100 people. Smokers accounted for 28.5% of respondents. The highest percentage of smokers was among the lower staff (36.2%), the lowest one was among physicians (26.3%). Among doctors the age of initiation to smoking falls on a period of training in medical school. This points to the need of prevention of smoking among medical students. 75.6% of surveyed doctors recommend that patients stop smoking. But at the same time among experts there is a low level of awareness of quit smoking methods, which diminishes the quality of their recommendations. The findings show that smoking doctors in contrast to non smokers recommend their patients to stop smoking more rarely.

The aim of the research was to increase the efficiency of sports and health-improving activity for female students of senior years of the university off-hour time. The state of health of 100 students during the study at the Amur State University including the parameters of their physical state was studied, negative factors accompanying the studies of senior female students were identified, the attitude of female students to sports and health-improving activities at the university and to sports and health-improving classes at university's «Center of Health» was found out, the motivation of senior female students to sports and health-improving classes off-hour was studied. At the experimental research the most effective combinations of sports and recreation facilities were found. The application of these facilities led to the improvement of physical state of female students, of their health, their progress in studies, motion activity and motivation to sports and health-improving classes.

The aim of the research is to study the features of clinical course and prevention of complications in patients with bronchial asthma with mixed pathology. During 10 years, the clinical symptoms and the dynamics of spirometry parameters were estimated in the newly arrived to the North suffering from bronchial asthma with arterial hypertension. The patients were divided into 2 groups: the main one (47 people) and the control one (50 people). The patients of the main group regularly took budesonide/formoterol, tiotropium bromide; in the cold period of the year complex pulmonary rehabilitation was done to them to prevent the complications of bronchial asthma. The patients of the control group took beclometasone, fenoterol; the prevention of complications of bronchial asthma was carried out according to the standard program in the conditions of polyclinic. It was established that among newly arrived citizens of the North the combination of bronchial asthma with arterial hypertension was found out in 72% of women and 28% of men, arterial hypertension develops in them in 5-9 years. Mixed pathology leads to worsening of both diseases clinical course. In 10 years the progressing increase in the degree of bronchial obstruction in patients of the control group was revealed. The patients of the main group had a stabilization of spirography indicators, 78% of patients had bronchial asthma under control, whereas in the patients of the control group against the decrease of parameters of ventilation lungs function there was a whole or partial control of bronchial asthma only in 28% of patients. Antiasthmatic drug therapy brings adequate positive effect in the prevention of complications in patients with bronchial asthma and with arterial hypertension only in combination with complex rehabilitation program.

The aim of the work is to define the character and intensity of mutually mediated influence of steroids on the functional activity of hypophysial-thyroidal system in patients with bronchial asthma. 54 patients with uncontrolled bronchial asthma and 12 healthy people without clinical and ultrasonic manifestations of thyroid gland pathology took part in the research. The examination was held 24 hours later after standard cold bronchoprovocation test. The concentration of thyroid stimulating hormone, total thyroxin, total triiodothyronine, free fractions of these hormones, cortisol, dehydroepiandrosterone-sulfate was fixed in the blood serum by immune-enzyme analysis. It is established that 72% of patients with uncontrolled bronchial asthma as a response to cold stimulus had a drop of total and free thyroxin, a fall of free triiodothyronine level which is associated with bronchi responsiveness and which is independent from thyroid stimulating hormone quantity. Identified features of thyroid gland functional activity are closely connected with a high stress-induced level of glucocorticosteroids and a low effect of dehydroepiandrosterone-sulfate which limits stress-responsiveness.

Over 98 patients with chronic obstructive pulmonary disease (COPD) were examined at different stages of chronic pulmonary heart development. The evaluation of the status of the main arteries of the head and cerebral hemodynamics depending on the severity of the disease was done. The results suggest that the progression of COPD against respiratory insufficiency and chronic hypoxia in these patients leads to the development of vascular remodeling processes in the brain. COPD patients without pulmonary hypertension at rest had the increase of indices reflecting peripheral resistance at the extracranial level. As the chronic pulmonary heart forms there is the growth of thickness of the complex «intima-media» of common carotid arteries, and the reduction of regional and total cerebral blood flow. It was revealed that with the growth of the degree of bronchial obstruction, gas composition and rheological properties of blood correlate with indicators of cerebral hemodynamics. Slowing the rate of cerebral blood flow, arterial hypoxemia and hypercapnia in patients with COPD lead to the development of dyscirculatory encephalopathy which affects the quality of life and prognosis of the disease.

To study the spread, risk factors and clinical and functional characteristics of chronic nonspecific pulmonary diseases in correlation with concomitant pathology in the military personnel, single-step representative research of 605 military personnel and reserve officers of Chelyabinsk garrison at the age from 25 till 75 years was done with the help of random sampling, including questioning, also with fluorography of lungs, laboratory analyses and spirography with the subsequent statistical processing of the received data. In 28.9% of the examined patients chronic nonspecific pulmonary diseases were revealed; among them there were 25.1% of people with chronic bronchitis, 2.4% with bronchial asthma, and 1.5% with chronic obstructive pulmonary disease. Chronic pulmonary diseases were accompanied by chronic diseases of gastrointestinal tract (in 25.2%), cardiovascular diseases (in 18.3%), top respiratory tract diseases (in 22.3%), and diabetes mellitus of the second type (in 2.3%). Incidence rate of chronic pulmonary diseases depends on age, the experience of service, frequency of trainings in the field, the contact with the sources of ionizing radiation, vibration, toxic chemicals, and industrial aerosols. Smoking is the prime risk factor of chronic pulmonary diseases development and concomitant pathology. It intensifies the influence of professional factors. Nicotine dependence and concomitant pathology increase the frequency and intensity of chronic non-specific pulmonary diseases and decrease indices of FEV₁and FEV₁/FVC.

The role of endogen cannabioid system in regulation of the immune response is discussed widely nowadays. So the expression of endocannabinoid receptor СВ₂ on immunocompetent cells with stimulation of immune system in vivo was studied. The expression of endocannabinoid receptor СВ₂ was performed by flow cytofluorometric method on flow cytometer using antibodies. The intracorporal irradiation of blood and the enrichment of blood with the ozone-oxygen mix were used for stimulation of the immune system. The immunostimulating effect of these physical methods is used for increasing of functional activity of immunocompetent cells through the activation of synthesis of cytokines and phagocytosis processes. This cytometric analysis of mononuclear leukocytes of healthy donors (28) demonstrated that the percentage of cells expressing the differentiating antigen to CB₂ receptor on their surface was more than 90% of all studied cells. Stimulation of immune system in vivo after intracorporal irradiation of blood leads to the suppression of quantity of immune cells which express CB₂ receptors on their surface for 30% (less than 60% of general quantity of immunocompetent cells). The amount of CB₂ receptor containing cells was not bigger than 70% after intravenous injection of ozone-oxygen mix. The obtained results of the study demonstrate that endocannabioid system is involved in the regulation of the immune response and can be used for direct influence on the inflammatory reaction of organism through CB₂ receptor.

The aim of the work is the study of arginindehydrogenase activity effect on the level of histamine in the peripheral blood of pregnant women with herpes-virus infection. 25 pregnant women who suffered an exacerbation of herpes virus infection in the third trimester of gestation and 10 healthy mothers were examined. A new histochemical methodology of arginindehydrogenase identification was developed. The activity of the enzyme in syncitiotrophoblast was calculated with the computer cytophotometry. It was established that in the syncitiotrophoblast of placental villi of the pregnant woman, who was under the influence of toxic products of exacerbating herpes virus infection with antibody titer growth of G class to herpes virus 1:12800, there was an increase of arginindehydrogenase activity identified by histochemical method till 48.7±2.9 standard units. At the same time in the peripheral blood a sharp growth of histamine content till 1.44±0.09 mkmole/l (in the control group it was 0.612±0.01 mkmole/l, р<0.001) was found out by biochemical method. The increase of histamine in the peripheral blood contributes to the development of fetoplacental insufficiency in pregnant women.

The features of alpha-linolenic acid metabolism in the peripheral blood of pregnant women of III trimester and in the homogenate of placentas of parturient women with the exacerbation of herpes-virus infection depending on IgG antibodies titer to the virus of simple herpes of 1 type have been studied in this work. It was found out that pregnant women who suffered from the exacerbation of herpes-virus infection during gestation had a decrease of alpha-linolenic acid concentration in plasma of the peripheral blood by 35% and in membranes of erythrocytes by 42%. At the same time in the homogenate of placentas of the parturient women who suffered from the exacerbation of herpes-virus infection during pregnancy there was a decrease of alpha-linolenic acid content. The most significant changes were observed at IgG antibodies titer to the virus of simple herpes of 1 type 1:12800. The revealed dysbolism of alpha-linolenic acid in herpes-virus infection may lead to a poor production of protective eicosanoids synthesized from acids of omega-3 family.

The aim of the research is to study cortisol content in placenta in exacerbation of herpes virus infection at early pregnancy and to identify the reasons for its change. 98 samples of abortion material of 5-10 weeks of development taken from almost healthy women and women with herpes virus infection exacerbation were examined. The study was done with the help of biochemical identification of cortisol concentration and histochemical analysis of the 11β-hydroxysteroid dehydrogenase of I and II types. At exacerbation of herpes virus infection a significant increase of cortisol content (more than two times) in villous chorions at early stages of pregnancy was found out. The revealed changes were the result of the hormone metabolism disturbance: low activity of 11β-hydroxysteroid dehydrogenase of II type and high activity of 11β-hydroxysteroid dehydrogenase of I type in placenta, as well as inadequacy of reactions regulatory mechanisms.

The article describes the data obtained at the studying of eicosanoic acids of С₂₀ by the method of gas-liquid chromatography in the homogenate of placentas of parturient women who suffered from the exacerbation of high intensive herpes-virus infection during pregnancy (the rise of IgG antibody titer to the virus of simple herpes of 1^st type is 1:12800). It was found out that the exacerbation of herpes-virus infection during pregnancy results in the change of eicosenoic acids of С₂₀ content, which is revealed through the rise of the precursor of proinflammatory eicosanoids of ω-6 arachidonic acid by 28% at the simultaneous decrease of ω-3 family eicosapentaenoic acid inhibiting the given process by 20%. As a result the synthesis of eicosanoids at herpes-virus infection in the greater degree will be done from arachidonic acid, which can be the factor of trouble as the optimal balance of the ratio ω-6/ω-3 polyunsaturated fatty acids during pregnancy and neonatal period is essentially important for the subsequent functioning of the organism.

The blood flow in uterine arteries, ultrasound picture of chorion, biochemical and hormonal parameters of 135 women in the first trimester of pregnancy at influenza А(Н3N2) in the period of the disease epidemic were studied. It was established that patients with antibody titer to the pathogen 1:32-1:128 in comparison with the titer 1:8-1:32 had a statistically reliable increase of the resistance in uterine arteries, the visualization frequency growth of uterus hyper tonus till 29.4%, of thinning of chorion till 26.5%, of its thickening till 58.8%, of retoplacental hematoma till 22.1%, of deformation of the fetal egg till 25% at the rise of mean-molecular peptides till 0.25±0.002 units of opt. dens. (р<0.001) and seromucoid till 0.12±0.002 units of opt. dens. (p<0.01). There was an activation of lipid peroxidation with the increase of malonic dialdehyde concentration and the drop of ά-tocopherol level. The oppression of hormonopoiesis in the mother's organism and in the chorion was revealed through the concentration drop of chorionic gonadotropin, placental lactogen, progesterone, estriol, dehydroepiandrosterone against the growth of serotonin and cortisol. It was found out that the increase of aggressiveness of influenza А(Н3N2), endotoxemia, activation of lipid peroxidation and serotoninemia play an important role in the pathogenesis of blood flow and echostructure of chorion changes and they condition the damage of the wall of blood vessels of a mother and chorion villi.

The aim of the research is to study in experimental conditions the character of changes of acid-base balance and bioenergetic processes in erythrocytes of the peripheral blood of rabbits at general cooling of the organism. It is established that as a result of daily cooling (from 15 till 30 days) of animals under experiment during three hours at temperature -30ºС pH of rabbits blood falls to 7.34±0.013 by the 30^th day of the experiment, and the quantity of pCO₂ in blood increases to 49.5 mm of mercury. The quantity of adenosinetriphosphoric acid in erythrocytes of the peripheral blood decreases to 0.34±0.06 mkmole/ml (control - 0.65±0.07 mkmole/ml), and the concentration of 2.3-biphosglycerate increases to 6.9 mkmole/ml. There is a drop of hemoglobin erythrocytes oxygenation to 96.0±3.2% (control - 99.5±3.0%), which leads to hypoxia in the organism of animals under experiment. Thus, the cooling of the organism suppresses energetic processes in erythrocytes of the peripheral blood and causes metabolic acidosis.

The increase of adaptation capabilities of a person to the damaging effect of ultraviolet radiation with the help of pharmacological medicine is important at prophylaxis of different diseases and pathologies development. In experimental conditions the possibility to correct free radical lipid oxidation of rats' organism membranes was studied with the oral introduction of the tincture made of birch, nettle and plantain leaves. It is established that daily ultraviolet radiation during three minutes contributes to the decrease of rats' organism stability to physical activities, to the increase of lipid hydroperoxides level, of diene conjugate and of malonic dialdehyde in the blood and liver homogenate of animals under experiment. The introduction of the tincture to rats in the conditions of ultraviolet radiation in 7 days of the experiment results in the reliable increase of the duration of rats swimming by 27.5% in comparison with the rats of the control group (which were exposed only to ultraviolet radiation), and by the end of the experiment in 28 days the increase was by 28%. While analyzing the effect of the tincture on the intensity of lipid peroxidation of biological membranes of rats' organism it was shown that the level of lipid hydroperoxides in the blood and liver homogenate of animals was lower than analogous indicator in rats of the control group by 32%, of diene conjugates and malonic dialdehyde by 23 and 21%, respectively. So, the application of the mentioned tincture in the conditions of long influence of ultraviolet radiation on the organism of animals under experiment leads to the growth of organism stability to physical activity against the increase of antioxidant system activity.

Free fatty acids take an active part in the thermogenesis of the organism. It is known that three-hour cooling of man's organism leads to the growth of free fatty acids in blood plasma by 30 %. The aim of the research is to determine the character of phospholipids and fatty acids metabolism in the peripheral blood of experimental animals at general cooling of the organism. It is established that at cooling of rabbits during three hours at temperature -30ºС there is a significant increase of lysophosphatidylcholine in the peripheral blood till 3.0±0.2% (control - 0.4±0.05%). The quantity of fatty acids at animals cooling increases till 5.5±1.2% during three hours, and by the 30^th day of the experiment till 6.6±1.3%. The quantity of arachidonic acid in the peripheral blood of rabbits by the 30^th day of the experiment increases till 6.3±1.4% (control - 2.5±0.3%). So, long cooling of the organism at temperature -30ºС results in the disturbance of lipid metabolism which is accompanied by the growth of eicosanoids, lysophosphatidylcholine and arachidonic acid in the peripheral blood.

The aim of the study is the optimization of the treatment of patients with combined and multiple disintegrating fractures of the pelvic ring by adding antioxidants to the basic therapy. In the traumatology department the examination and treatment of 56 patients with combined and multiple disintegrating fracture of the pelvic ring was done; standard therapy was prescribed to 30 patients, and 26 patients also got antioxidants in the form of reamberin. It was found out that reamberin added into the complex therapy is accompanied by the antioxidant effect which by the end of the treatment reveals itself through statistically reliable decrease of diene conjugates content, lipid hydroperoxides and malonic dialdehyde in the blood plasma and through the increase of ceruloplasmin and E vitamin. The dynamics of clinical and laboratory indicators in patients against complex therapy with reamberin reflects a more fast stabilization of the patient already by the fourth day of treatment (in 2.4 and 3.9 times faster by APACHE II and SAPS II scales, respectively), in comparison with the patients who had standard therapy and had stabilization of their state only by the 10^th day of treatment. The application of reamberin in complex treatment of patients with severe combined and multiple fractures of the pelvic reliably decreases the dates of preoperative preparation, in-patient treatment and patients rehabilitation and also contributes to the lowering of the total number of somatic complications and reduction of their combination.

At the study of saliva and blood serum crystallogenic properties of 23 patients with ulcer disease coordinating its changes were shown. Biological fluids of crystallogenic and initiated activity by vizuametric technology, including the use of number of special criteria estimation were studied. The control group included 35 healthy people. Gastric Helicobacter pylori contamination was detected by immunological and morphological methods. Progressive «metabolic signal» damping at its translation from one functional system (gastrointestinal tract) to the other (blood) was illustrated. This becomes apparent in reduction of crystallogenesis changes module from control. It was stated that gastric Helicobacter pylori contamination increases crystallogenic activity in samples of saliva and blood serum. In facias of these biological fluids crystallozability rate and structurization index were higher than in samples of healthy people. Dynamics of facias destruction indicates pathological essence of these transformations. These associated changes of biological fluids crystallogenesis indirectly confirm systemic character of metabolic disorders presented at gastric ulcer disease. This forms pathogenetic preconditions for sero- and salivacrystallodiagnostics of investigated pathology.

The study shows the dynamics of overall incidence of eye and its appendages in the Amur region in the urban and rural population in various age groups over past 12 years. From 1999 to 2010 the incidence of ophthalmopathology of population rose by 64% (from 68.1 to 111.4‰). On average the index under study increased by 5.5% a year with an apparent tendency for further growth. The ophthalmopathology incidence rate among urban population of the Amur region increased from 1999 to 2010 by 51% (from 94.1 to 142.4 ‰). Among rural population the general incidence during this period increased by 138% (from 20.6 to 49.0 ‰).

Because of the serious situation concerning tuberculosis morbidity and high death rate caused by the disease the problem of improving preventive measures is urgent. For the last 7 years in TB prophylactic centers of Khabarovsk Krai the program of the international society of the Red Cross and Red Crescent of World Health Organization about the struggle against tuberculosis has been implemented. One of the conditions of the given program is the creation of a complex of epidemiological, clinical and sanitary-and-hygienic measures directed to the prevention of the infectious disease spread and the complex program of infectious control. The program of infectious control includes 3 levels of control: administrative, engineering and personal. Authors describe the ways of realization of infectious control at all levels and give an opinion on the necessity of similar approaches applications in the institutions of the general medical network, especially in out-patient polyclinics.

The review covers the data about the character of thyroid gland diseases (autoimmune thyroiditis, thyrotoxicosis, hypothyroidism) influence on bronchial asthma clinical course whose worsening is caused by thyroid gland hormones effect on oxidation-reduction reactions of organism, adenylate cyclase synthesis, quantity regulation and function of beta-adrenoreceptors, the state of the immune system and lipid peroxidation. It also reflects modern conceptions about the disturbance of hormonal status depending on the severity degree of bronchial asthma which is revealed thorough desynchronization of diurnal rhythms of thyroid hormones and organic changes of thyroid gland by the X-ray study data. At pathologic changes of structure and function of the thyroid gland the clinical course of bronchial asthma becomes severe, bronchospasmodic syndrome gets more intensive; on the other hand asthma causes the development of transient hyperthyroidism, transient and clinical hypothyroidism. The question about the correlation of thyroid gland diseases and bronchopulmonary diseases is still an urgent problem of modern medicine.

The morphofunctional state of mesothelium allows to evaluate its regenerative ability. Mesothelial cells and extracellular matrix play a regulatory role in the compensatory-adaptive reactions of the pleural cavity. Mesothelial cells at pleural injury lose their inter-cell connections, are separated, take the morphology of fibroblasts and cover the surface of pleura. Mesotheliocytes create numerous factors and cytokines mobilizing the movement of inflammatory cells into the pleural cavity. The inflammation of the pleura can take a chronic course: there happens granulation scarring, fibrinogenous layers are subject to organization on the surface of the lung and on the parietal pleura. In the end, there is a thick, rigid wall of the residual cavity created, scarry walls, pneumosclerosis and pneumocirrhosis of the adjacent part of the lung are formed. The reaction of pleura mesothelium after the injury is a multiple-factor process under which there can be coagulation, the formation of adhesions with the development of fibrosis and a subsequent obliteration of the pleural cavity.

The article deals with the questions of cytomegalovirus infection symptoms in pregnant women at different stages of gestation. The danger to infect pregnant women was analyzed. It was shown that the most dangerous period for cytomegalovirus infection to affect the fetus is the first weeks of gestation, which may lead to spontaneous miscarriage. The features of serologic methods of infection study were discussed. It was proven that during pregnancy it is necessary to control the dynamics of IgM antibody dynamics to cytomegalovirus infection in the blood by the method of immune-enzyme analysis. The mechanism of cytomegalovirus penetration into the cell was studied. The evidence of inducing influence of cytomegalovirus infection on apoptosis was given. The recommendation about the necessity to examine the pregnant woman upon the presence of cytomegalovirus infection is given as it may lead to newborn infecting during the labour and cause cytomegalic infectious process with the damaging of central nervous system, eyes, lungs and liver.

Marfan Syndrome (MS) is a hereditary system disease of conjunctive tissue with a wide range of clinical manifestations. At this disease osseous, cardiovascular, respiratory, central nervous systems and eyes are affected. The frequency of respiratory disturbances at MS is from 10 till 25 %. The most frequent pulmonary complication is pneumatothorax conditioned by bullous emphysema. Intensive system and stromal conjunctive tissue changes in the pulmonary tissue, which are revealed through structural and functional rearrangement of lungs parts with ineffective ventilation and perfusion, serve a favorable environment for non-specific and specific (tuberculosis) infection development. Among obtained editions which quite fully describe different aspects of MS there are almost no woks about the correlation between MS and pulmonary tuberculosis. This is probably because of the fact that the staff of TB dispensaries are not informed enough about MS which is potentially dangerous both for tuberculosis development and as the one able to complicate its clinical course.
The personal clinical observation of tuberculosis pulmonary damage against MS has been given. Modern high technologies methods have been applied for X-ray diagnostics. The dynamics of tuberculosis course has been studied.