The results of the research about the estimation of epidemiologic features of the spread of chronic respiratory diseases and risk factors of their development on the territory of the Amur region held within the realization of the international WHO project – GARD (Global Alliance against Respiratory Diseases) in Russian Federation are presented. To solve this task in Blagoveshchenck a research center was founded on the basis of Far-Eastern Scientific Center of Physiology and Respiration Pathology SB RAMS. The main methods of the study were interviewing (filling in the validated WHO – GARD questionnaire) and the study of the external breathing function (spirometry) in the urban and rural population of the Amur region. Epidemiologic analysis of respiratory health of population, carried out with the help of validated tools of estimation, allowed to reveal a high frequency of basic symptoms of chronic respiratory diseases (cough, phlegm, wheezing, short breath) and to establish the main correlation between the level of their spread and risk factors (professional engagement in the polluted air, smoking, the use of the open fire for building heating and cooking). The results of the research prove that the urgent attention of the health protection system and the society in general should be paid to the problems of respiratory health. These results can be used at the state level at the development and realization of federal and regional programs of monitoring and chronic respiratory diseases prophylaxis.

The aim of the research was to define pathognomonic changes of hormonal profile of the system «hypothesis-thyroid gland» for the development of thyroid insufficiency in patients with uncontrolled bronchial asthma and the estimation of their role in the formation and realization of cold bronchospasm. 124 patients with bronchial asthma without evident pathology of thyroid gland and 25 practically healthy people simultaneously were examined upon the primary serum levels of thyroid stimulating hormone (TSH), general thyroxin (Т₄), general triiodothyronine (Т₃) and free fractions of these hormones (сТ₄ и сТ₃), and in 60 minutes after bronchoprovocation challenge with cold air. Most patients (73%) had the changes of the functional state of the thyroid gland which in 48% were revealed through the decrease of Т₄ products in the range of «highly normal» values of TSH in the blood: from 2.5 till 4.0 mUn/l, and in 25% from 4.0 till 10 mUn/l in the form of «light» hypothyroidism of I and II degree respectively; the values increased alongside with the growth of cold hyperresponsiveness of bronchi. At the same time there was an initiating influence of cold hyperresponsiveness of bronchi on the compensatory growth of thyrotropin and acceleration of the conversion of thyroid hormones into the most active forms of hormones – Т₃ и сТ₃. The realization of this phenomenon was more characteristic for the patients with bronchial asthma with the TSH value levels in the range from 2.5 till 4.0 mUn/l (I degree of thyropathy) than in patients with the level of TSH from 4.0 till 10.0 mUn/l (II degree of thyropathy).

The phenomenon of cold bronchial hyperresponsiveness represents an urgent clinical problem because of its high prevalence in asthmatics living in cold climate conditions and ability to promote the development of fluctuating bronchial obstruction. However, often its early diagnostics by cold bronchoprovocation challenge is not possible due to the technical limitations or the presence of medical contraindications. In this case indirect methods based on the detection of biomarkers associated with the development of cold bronchoconstriction may be useful. The aim of the present study was to examine the role of disturbance in glucocorticoid homeostasis and functional activity of β₂-adrenergic receptor complex as the predictors of cold bronchial hyperresponsiveness in patients with bronchial asthma. Using logistic regression analysis we invented three mathematical models allowing to perform the forecast with the accuracy up to 83%. Detailed comparative characteristic of the diagnostic values has been provided for all the proposed methods.

The correlation between the motivation peculiarities and attitude to the disease in patients with bronchial asthma depending on the disease severity degree was studied. 119 patients with bronchial asthma of a different severity degree at the age from 19 till 69 were examined. The test-questionnaire MSF (A.A.Rhean), the test «The motivation to success» by T.Ehlers, the methodology for diagnostics of the degree of readiness to risk by G.Schubert, and the methodology for psychological diagnosis of types of attitude to the disease were used. It was found out that types of attitude to the disease in patients with bronchial asthma are conditioned by the motivational features: the motivation to success and the tendency to being cautious are predominantly observed, they correlate in a reverse manner with the types of attitude to the disease and treatment (ergopathic, anosognostic and harmonic). The consideration of the correlation of types of attitude to the disease and the features of motivation are necessary for the right organization of psychological help to the patients with bronchial asthma and the actions directed to achieve the total control over the disease.

The aim of the research is the analysis of the structure of indirect expenses at the treatment of patients with bronchial asthma with uncontrolled clinical course. 306 outpatients’ cards and disease histories of patients who were at the outpatient’s treatment in the Far-Eastern Scientific Center of Physiology and Pathology of Respiration of the Siberian Branch of Russian Academy of Medical Sciences from 2007 till 2010 were studied. It was found out that the quantity of days of patients’ incapacity for work depends on the basis therapy. The use of Seretide^® medication in the complex therapy leads to the largest decrease of the period of temporary incapacity for work in comparison with other analogous medications, which results in the lowering of temporal incapacity medical certificates expenses and as a consequence to the decrease of the loss of gross regional product.

The purpose of the study was to determine the clinical and functional characteristics of mild persistent asthma at different periods of pregnancy. The features of clinical course of the disease were identified in 180 patients at different periods of pregnancy. The frequency of family history (65.5%), duration of asthma over 5 years (79.4%), extrapulmonary diseases of atopic range (73.8%), related extra-genital diseases (2.2 diseases in one pregnancy), asthma exacerbations (68.8%), mainly in the 1^st and 2^nd trimesters, were found out. The dynamics of the disease (improvement in 21.7%, the stability of the course in 34.4%, deterioration in 43.9%) and predictors of its complication: the presence of allergic rhinitis (41.1%), chronic nasal disease (54.4%), acute respiratory infections (36.7%) were revealed. The correlation of uncontrolled bronchial asthma with gestational complications (early toxicity, preeclampsia, threatened miscarriage, placental insufficiency, intrauterine infection of the fetus, chronic intrauterine fetal hypoxia), diseases of the newborn (with multifarious lesions in 71%) and the drop of adaptive capabilities of pregnant women was proved.

Specific humoral immunity to influenza virus А(Н3N2) and to viruses of the respiratory group, the concentration of serum secretory immunoglobulin А (sIgA), as well as pro- and anti-inflammatory cytokines (TNF-a, IFN-γ) were studied in 86 women with chronic bronchitis in the I trimester of gestation. It was found out that in the stage of remission pregnant women with chronic obstructive bronchitis in comparison with the patients with chronic non-obstructive bronchitis had in the blood serum influenza virus А(Н3N2) with antibody titer 1:64-1:64 (in 45 and 4%, respectively, р<0.05) and parainfluenza of the 1-3 types with antibody titer 1:128-1:128 (in 40 and 4%, respectively, р<0.05). Pregnant women with the exacerbation of chronic obstructive bronchitis in comparison with patients with exacerbation of non-obstructive bronchitis had influenza А(Н3N2) 4 times oftener and parainfluenza of the 1-3 types 10 times oftener; they also had a lower level of sIgA (5.5±0.15 and 6.5±0.32 pg/ml, respectively, р<0.05), as well as high content of TNF-a (58.1±3.9 and 45.4± 4.2 pg/ml, respectively, р<0.05) and IFN-γ (49.7±2.7 and 37.9±3.8 pg/ml, respectively, р<0.05). The obtained data shows the role of viruses of the respiratory group in the suppression of local specific protection as well as in more intensified systematic inflammatory reaction at the aexacerbation of chronic obstructive bronchitis in women in the I trimester of pregnancy.

The state of cerebral blood flow in 44 children of the early neonatal age with the cerebral ischemia of the first degree born from mothers who had an acute form of chronic bronchitis of a virus genesis in the second trimester of pregnancy was studied. All babies were divided into two groups: the first group included 21 newborns whose mothers suffered the acute form of chronic non-obstructive bronchitis, and the second group consisted of 23 babies whose mothers had an acute form of chronic obstructive bronchitis. A complex serological, biochemical, functional and clinical research was done. It was found out that newborns of the second group in comparison with those from the first group oftener had an intrauterine infecting with А(Н3N2) influenza virus that plays a significant role in endotoxemia and brain blood vessels affection. Against the antenatal respiratory virus infection in babies of the second group in comparison with those from the second group higher indicators of mean molecular peptides (0.30±0.005 and 0.28±0.005 units of optical density, respectively, р<0.01) were registered in blood plasma. While studying the vascular resistance, the resistance index of mean brain artery in babies of the second group exceeded the values of those from the first group (0.76±0.015 and 0.71±0.013 standard units, respectively, р<0.05). More intensive clinical syndromes of hyperexcitability and motional dysfunctions were registered in the newborns of the second group.

The features of endobronchial microhemocirculation in 60 patients with chronic lymphocytic leukemia at different stages of tumor progression were studied. The bronchoscopy with endobronchial laser Doppler flowmetry was done to all patients. It was found out that the indicators of endobronchial microhemocirculation considerably decrease in process of chronic lymphocytic leukemia progressing. The most important reasons of microhemocirculation violation are hyperleucocytosis in the peripheral blood and the anemic syndrome. After the cytostatic therapy the endobronchial microhemocirculation indicators become better, but they don’t acquire a normal state because of multifactoring of microcirculating channel violations. The microhemocirculation pathology leads to the tissue violations and the local metabolism, tissue hypoxia, which can lead to violation of drain function of bronchi and development of inflammation.

To study morphologic and functional features of bronchopulmonary system, a сomplex examination of 30 patients with chronic myeloleukemia (CML) at the initial diagnosis of hemoblastosis in chronic phase and in 1.5 years after imatinib treatment was done. It was found out that in patients with CML in the chronic phase there were specific manifestations of the bronchopulmonary system, namely: leukostasis in microcirculation channel vessels, violation of endobronchial microhemocirculation, the decrease of the diaphragm volume caused by the enlarged liver and spleen compression. A number of patients had a moderate increase of mean pulmonary artery pressure. The incidence of bronchopulmonary infections in CML chronic phase is not high. After achieving complete clinical and hematologic, cytogenetic and major molecular responses, the rates of endobronchial microhemocirculation and functional capacity of the diaphragm return to the normal ones. The analysis of autopsy reports of 20 patients with CML who died in blast crisis stage was done. Leukemic infiltration of the lung tissue, bronchial tubes, pleura and diaphragm, mediastinal lymphonodus hyperplasia, leukostasis in the vessels, compression by enlarged liver and spleen of diaphragm and lower parts of the lungs with the formation of atelectasis, pleurisy, the presence of inflammatory infiltrates in the lung were diagnosed in these patients.

The analysis of infectious complications in 574 cancer patients receiving chemotherapy in soft hematology department of the Amur Regional Hospital was conducted in 2002-2011. In patients with acute lymphoblastic leukemia infectious complications were reported in 88% of cases at the time of induction of remission; during the re-induction of remission and consolidation they were in 40%; in patients with acute non lymphoblastic leukemia they were in 90% of cases at the time of induction of remission, in 80% during the consolidation of remission, and in 10% of cases during maintenance therapy; in patients with chronic lymphocytic leukemia they were in 85%; in patients with multiple myeloma they were in 40%, and at non-Hodgkin’s lymphomas they were in 50%. The most frequent complication of hemoblastosis is febrile neutropenia, mucositis, and pneumonia. The most severe complications are pneumonia, sepsis and necrotizing enteropathy. The features of the course and prognosis of these diseases were analyzed. At the appropriate sanitary and hygienic conditions, modern antibacterial medications, granulocytic and colony-stimulating medications and other therapies, the prognosis of the infectious complications of hemoblastosis at the absence of uncontrolled tumor growth is in most cases favorable.

The aim of the research was to present the histochemical characteristic of carbohydrate compounds in the airway of rats lungs under exposure to cold. The experiment was conducted over 100 white male rats whose cooling was done in the climatic camera at the temperature -15ºС once and during 15 and 30 days for three hours daily. It was found out that during cold exposure the activity of mucin secretion by goblet cells of epithelium dramatically increases and to a lesser extent it increases by glands of trachea and bronchial tubes submocosa, which leads to the disruption of fibrillar structure of the mucus gel layer on the surface of the lungs airway. With prolonged exposure to cold a complex of specific changes of mucopolysaccharide exchange develops in lungs dominated by acidic mucopolysaccharides and glycosaminoglycans in those parts of the mucous membrane where there are changes in the structure of epithelium. This is due to the active implementation of cell elements, migrating from the connective tissue, into the structure of the basement membrane. The accumulation of glycosaminoglycans in the intercellular substance of loose connective tissue and blood vessel wall serves as an inductor providing the formation of fibrous structures. With long-term cooling, followed by an excess of connective tissue catabolism, collagen and cells destruction, their degradation products stimulate the activation of anabolic processes of all its components. Thus, prolonged exposure of lungs airway to cold results in the development of a complex of carbohydrate metabolism disorders causing prolonged inflammation in trachea and bronchi mucous tunic and leading to the development of sclerotic changes in the connective tissue.

The aim of the research is the study of the ways of excretion and accumulation of staphylococcal alpha toxin from the lung abscess combined with purulent bronchitis. The methods of reproduction of these inflammations were developed during the experiment over 29 rabbits. As the source of purulent-necrotic process in lungs and bronchi in animals the mixture of Staphylococcus aureus meal (Wood-46 strain) was used in the combination with the stabilizer (Freund's adjuvant complete, USA), which was introduced into the lung tissue through the chest. To study the ways of the spread of bacterial toxin from purulent-necrotic nidi of lungs and bronchi, purified staphylococcal α-toxin tagged with I¹²⁵ was introduced into the animals by the same method. It was found out that staphylococcal α-toxin tagged with I¹²⁵ has the main ways of elimination into lymph and blood. Its maximal accumulation occurred in the lymph of the right lymphatic duct (23.9±1.5 units of relative specific activity) and it was twice as much as in the lymph of the chest lymphatic duct. The concentration of staphylococcal α-toxin in the blood was 10 times less than in the lymph. Staphylococcal α-toxin accumulates in big quantities in some vital organs: kidneys, lungs, liver, heart.

The influence of the aqueous extract of Japanese Dodder (Cuscuta japonica) on the velocity of Mycobacterium tuberculosis growth has been shown. To accelerate the growth of Myc. tuberculosis, dry culture media of FAST-3L and of Lowenstein Jensen were mixed with the aqueous extract of Cuscuta japonica . It was found out that the complex chemical composition of the aqueous extract made of dry seeds or dry vegetative stems of the plant parasite Cuscuta japonica has a biological effect on Myc. tuberculosis. At mixing of standard culture media of FAST-3L and of Lowenstein Jensen with the aqueous extract of Cuscuta japonica , Myc. tuberculosis grow much faster preserving typical R-forms colonies. The mycobacterium in the first medium grow at the fifth day (2.8 times faster than in the standard culture medium), and in the second medium they grow at the 18^th day (1.5 times faster than in the standard culture medium). The mechanism of Myc. tuberculosis growth acceleration demands a further study. The most probable is the fact that chemical substances of the aqueous extract of Cuscuta japonica directly or indirectly affect either the synthesis of cell wall components (peptidoglycan) or change its chemical composition. This leads to the access enhancement into the cell of trophic resources.

Morphotypes of resting bacteria forms in the ecosystems of Blagoveshchenck were visualized with the help of direct electronic microscopy. It was found out that resting forms externally corresponding to elementary bodies and their microcolonies of L-forms unidentified bacteria are in the water of the Amur river, drinking running water and in the soil of the town. The revealed resting forms have been found both in a free state and in biofilm, which may hinder the identification of pathogenic and conditionally pathogenic bacteria by routine bacteriologic methods. These elementary bodies together with their microcolonies may cause different diseases in people with a low immune-biologic resistance. It is difficult to identify the source of infecting in such a case.

Statistical retrospective analysis of 44004 requests for emergency medical care from 2008 till 2010 was done to identify the structure of emergency medical care appealability by patients with respiratory diseases. It was found out that there was a high emergency medical care appealability among men in all nosologic groups of respiratory diseases with the exception of bronchial asthma. The structure of diseases is reliably different in age groups, which allows to identify age risks of the disease development and its transition into a chronic pathology. The highest pace of emergency medical care appealability growth was found in the able-bodied age. The identified morbidity changes depending on the age tell about the necessity of a higher attention to people of the infant and able-bodied age as in this very period there is an active accumulation of risks and the beginning of the chronic pathology development. Children oftener apply for the emergency medical care because of acute states and bronchitis, able-bodied population because of pneumonia, people older than 65 because of pneumonias and chronic pulmonary diseases. The decrease of the level of emergency medical care appealability among adult population leads to the development of the chronic state and severity of the disease. The appealability depending on the season was also revealed: the lowest rate is observed in summer months, the highest rate is observed in autumn and winter period (October, November, December) because of pneumonias and bronchial asthmas.

The aim of this work is to analyze the proportion of the overall and primary age cataract incidence among the rural and urban citizens of the Amur region from 1999 till 2010. It was found out that age cataract plays an important role in the structure of ophthalmic pathology among adults. During the study period the proportion of the overall cataract incidence in the Amur region ranged from 18.4 to 22.7%, while the share of primary disease was from 12.5 to 18.3%, which may indicate the deterioration of the epidemiological situation of this nosology. The differences in the proportion of the overall cataract incidence among the urban and rural population were minimal and similar in terms of dynamics. However, we observed a more dynamic growth in the share of primary disease of the rural population (73%), which may be the result of both the absence of surgical care and the deterioration of the epidemiological situation of this nosology.

A brief review of methods for analysis of products of free-radical polyunsaturated fatty acids peroxidation which are of some interest for medical and biological studies of the states which are accompanied by oxidative stress is presented. Lipid peroxidation (LPO) is the consequence of oxidative stress and results in the formation of numerous products which differ in structure, life time, toxicity and biological activity. LPO significantly accelerates at different diseases. Analysis of LPO products is of interest for the estimation of oxidative stress, for the research of toxic, metabolic and signaling effects of the products on an organism, and for diagnosis of different diseases. Multiple methods for analysis of LPO products have been developed. They vary in specificity, sensitivity, complexity of procedure and equipment. In clinical studies, less complicated and specific methods for analysis of stable LPO products are preferred, though increasing application of more advanced techniques like mass spectrometry gives opportunity for the analysis of wide spectrum of LPO products. Development of highly specific antibodies makes ELISA a common tool of analysis of minor and otherwise difficult-to-determine LPO products. Reliability and precision of analysis depend highly on precautions taken on sample handling, preparation and storage, which are to avoid degradation or further formation of LPO products.

The literature review shows modern conceptions about the role of airway hyperresponsiveness in the development of non-specific pulmonary diseases in children who frequently get ill. The increased airway hyperresponsiveness being an unfavorable factor occurs in the one third of healthy children and can be revealed with the help of bronchoprovocation challenge with different pharmacological agents and non-specific physical stimuli. The application of bronchoprovocation challenge in healthy children allows to identify people with the high airway hyperresponsiveness, who constitute the risk group of bronchial asthma. Those children who frequently get ill may have the acute inflammation and edema of mucous tunic as a result of micro vessels dilation and exudation from the lumen. These factors in the combination with the inadequate airway response to external influence can provoke the development of bronchial obstruction connected with the spasm of bronchial musculature as well as bronchial asthma. The correlation between the bronchoconstrictor response and the state of microcirculation makes it necessary to develop preventive actions at respiratory diseases epidemic periods and search for the ways of airway hyperresponsiveness correction.

Sarcoidosis incidence and its prevalence are the subject of a big number of studies whose results are very controversial due to the absence of standard diagnostic criteria, variability of identification methods, low sensitivity and specificity of diagnostic tests. Recently identified cases of the disease are most often registered in able-bodied population from 25 till 40 years old. At present there are some drawbacks in the organization of radiodiagnostics. There is no uniform system of the standard of radiation studies at the outpatient and polyclinic stage, the outdated equipment is still in use, radiation studies performed in outpatient conditions as a rule are duplicated in hospital. At the consultation policlinic of Far Eastern Scientific Center of Physiology and Pathology of Respiration SB RAMS from 2008 till 2012 437 computer tomographic (CT) examinations were done to 345 patients with respiratory sarcoidosis. Most of the patents were examined repeatedly with the help of CT to study the dynamics of the process. Morphological verification was done to 88% of patients. The diagnosis in other patients was based on typical symptom complexes at clinical and roentgenologic researches and dynamic observations. As a result of CT-examinations new data about the features of sarcoid lymphadenopathy were obtained with the use of modern diagnostic technologies. The development of diagnosis algorithm and roentgen semiotics of this category of patients was conditioned by the fact that bronchopulmonary and mediastinal lymphadenopathy is a key diagnostic link of sarcoidosis. In clinical practice there are a number of diagnostic mistakes as well as unsolved problems.