Exercise-induced bronchoconstriction (EIB) in patients with asthma is associated with the severity and low control of the disease and supported with the activation of airway inflammation. The aim of the work was to study the influence of eosinophilic component of cellular inflammation and the level of formation of products of lipid peroxidation (LP) in bronchi of asthma patients at the formation of airway reaction in response to dosed exercise load (DEL). 57 asthma patients were assessed upon the level of asthma control by the ACT questionnaire (Asthma Control Test), baseline lung function (FEV₁), airway response (∆FEV₁) to DEL, the contents of LP products in the exhaled breath condensate, the cellular composition, the activity of myeloperoxidase (MPO), cytomorphologic parameters of the induced sputum (IS). The group of control was consist of 20 healthy people. According to the airway response to DEL, asthma patients were divided into 2 groups: the 1^st group included patients with EIB (n=24), the 2^nd group had the patients with negative airway response to DEL (n=33). It was found out that in the patients with an excessive response to DEL the contents of eosinophils in IS (23.2±4.3%) was significantly higher than in people who did not have response to DEL (16.1±2.9; р<0.001) and in healthy people (0.1±0.08%; р<0.001). The patients with EIB had a tendency to increase the activity of MPO and had a more expressed secretion of enzymes in comparison with other patients. Besides, in the patients of the 1^st group in the exhaled breath condensate there was found a higher level of unoxidized lipids (Е206 nm) and their oxidized derivatives (Е233 nm, Е278 nm) in comparison with the patients who did not have a response to DEL and healthy people. In the patients with positive response to DEL there was found a close correlation between the number of eosinophils in IS and ACT (r=-0.58; р=0.049), as well as the correlation between the basic concentration of Е206, Е233/Е206, Е278/Е206, index of intensiveness of eosinophils cytolysis in IS and bronchial response (ΔFEV₁) to DEL (r=-0.39, р<0.01; r=-0.46, р<0.01; r=-0.34, р<0.01; r=-0.83, р<0.01, respectively). The parameters of eosinophilic component of inflammation and LP can be viewed as biomarkers of EIB formation in asthma patients.

The research objective is to justify the use of low-frequency impulsive magnetic fields in complex rehabilitation of patients with partially controlled asthma. There was done the comparative analysis of efficiency of treatment between the groups of the patients receiving basic medicamental therapy (33 people) and patients who received the complex treatment including similar basic drug therapy in combination with low-frequency magnetic therapy (30 people). The efficiency of the rehabilitation was estimated in a month; the data of clinical observation, the results of the questionnaire upon the control of symptoms of asthma (ACQ-5 test), the indicators of lung function, cellular immunity and the level of cytokines in the blood serum were taken into account. The received results of the research showed pathogenetic validity of the controller therapy application together with low-frequency magnetic therapy at rehabilitation of patients with partially controlled asthma. The combined influence of constant and impulsive magnetic field against the background of drug therapy allowed to increase the efficiency of treatment and to achieve control over disease symptoms without increasing the drug loading. The efficiency of the treatment gets higher due to the mild stimulation of proliferation of lymphoid cells and production of cytokines which regulate all the stages of inflammatory reaction in organs and the immune response of the organism in general. The use of medical technology will allow to minimize the risk of exacerbations and to increase the quality of life of patients with asthma.

To assess the influence of hyperosmotic airway hyperresponsiveness on the health-related quality of life in patients with asthma, there were examined 76 patients divided into two groups: with and without increased bronchial response to inhalation with the hypertonic solution of sodium chloride. The quality of life was assessed with the help of SF-36 and AQLQ, the state of emotional sphere with the help of Hospital Anxiety and Depression Scale. The level of asthma control was found by ACT questionnaire. The lung function was assessed with spirometry. As a result of the study it was found out that the asthma patients with hyperosmotic airway hyperresponsiveness have a low level of general and specific quality of life, worse asthma control and unfavorable psychoemotional state that influences both the asthma control and the assessment of the general and specific quality of life. Regression models for the prediction of osmotic airway hyperresponsiveness degree and the level of asthma control in patients by the parameters of the quality of life have been suggested.

The aim of the work was to determine the clinical and functional characteristics of asthma during pregnancy in comparison with indicators of the state of intracardiac, renal hemodynamics and neonatal health. There were analyzed the clinical and functional characteristics of the clinical course, the outcomes of pregnancy, childbirth and neonatal status in 46 patients with asthma and 20 healthy pregnant women. Clinical and medical history, integrated monitoring of clinical syndromes, assessment of diastolic function of the right heart using a tissue Doppler imaging, the study of blood flow in the renal vessels and uterine-placental hemodynamics were used in the research. Mild asthma was observed in 29 (63%) patients, a moderate one in 14 (30.5%) and a severe one in 3 (6.5%). In assessing the diastolic function of the left heart in pregnant women with asthma the flow of early diastolic filling velocity (Em) and Em/Am ratio were lower than in healthy subjects (p<0.05), which indicates a violation of relaxation processes due to the high rigidity of the myocardium. At ultrasound diagnostics of changes of utero-placental hemodynamics there was revealed a difference in the condition of the vascular resistance in the basin of the uterine arteries in terms of 20-24 weeks of gestation. The intensity of the blood flow was lower in the group of patients with asthma, which was reflected in the increase of the resistance index values. The majority of patients were observed to have the development of gestational complications. The following diseases diagnosed in newborns from mothers with asthma prevailed: cerebral ischemia, intrauterine infection, violation of the adaptation period, intrauterine growth retardation and the syndrome of motor disorders.

Medical rehabilitation (MR) has become one of the important tasks of sanatorium-and-spa treatment (SST) in patients with lung diseases. The aim of the study is assessment of the effectiveness of sanatorium-and-spa MR in patients with chronic bronchitis (CB) under complex SST in view of the provisions of the "International Classification of Functioning, Disability and Health". The study included 91 CB patients treated with SST. Selection of patients for the study was carried out by a continuous sampling with simple randomization by informed consent of patients and duration of treatment of at least 18 days. Methods of investigation and treatment were applied in accordance with the features of the functional state of the patient, the individual indications and the standards of SST in lung diseases. Psychological research and evaluation of quality of life (by the tests of Reeder, Beck, Spielberger-Hanin, SF-36) were additionally conducted. The analysis of the results was carried out by methods of variation statistics. Sanatorium-and-spa MR in patients with CB in the resort of Crimean Southern Coast is characterized by high efficiency. Significant positive trends were found out for a number of domains: the sensation of pain and dizziness (b 280 and b 2401), blood pressure (b 420), immune system (b 435), fatigue (b 4552), the sensations associated with the functioning of the cardiovascular and respiratory systems (b 4601), overcoming stress and other psychological problems (d 240) and all functions controlled in general. Significant reduction of seven domain values by the end of the course of treatment indicates positive rehabilitation potential of SST in patients with CB.

The aim of the research was to give a characteristic of the inflammatory process of nose and throat at cytomegalovirus infection in women in the second trimester of pregnancy. A retrospective analysis of clinical, rhinoscopic and pharyngoscopic signs of inflammation of nose and throat mucosa in 268 women in the second trimester of pregnancy was done. The first group included 30 seronegative women with physiologic course of pregnancy (there were no antibodies of IgM to cytomegalovirus (CMV) and antibodies of IgG to CMV). The second group included 64 patients with latent course of chronic cytomegalovirus infection (CMVI) (there were no antibodies of IgG to CMV, antibodies of IgG to CMV were 1:200-1:400). The third group included 60 patients with reactivation of chronic CMVI (antibodies of IgM to CMV were 1:200-1:400, antibodies of IgG to CMV were 1:200-1:400). The fourth group had 58 women with reactivation of CMVI (antibodies of IgM to CMV were 1:200-1:400, antibodies of IgG to CMV were 1:200-1:800). The fifth group had 56 patients with reactivation of chronic CMVI (antibodies of IgM to CMV were 1:200-1:400, antibodies of IgG to CMV were 1:400-1:1600). It was found out that the patients of the third and fourth groups in comparison with the second did not have any changes in the frequency of the diseases of nose and throat. In the fifth group in comparison with the second one the signs of acute nasopharyngitis (р<0.001) and exacerbation of chronic catarrhal nasopharyngitis (р<0.001) occurred rarely. Acute tonsillopharyngitis (р<0.05), exacerbation of chronic hypertrophic nasopharyngitis (р<0.05) and chronic decompensated tonsillitis (р<0.01) were diagnosed most often. This was followed by expressed edema (p<0.01) and hyperemia (р<0.05) of nasal mucosa; edema (р<0.01) and hyperemia (р<0.05) of the back of the throat; as well as hyperemia (р<0.001) and sclerosis (р<0.01) of tonsils; frequent detection of thyroid masses on the lacunae of tonsils (р<0.01), sub mandibular (р<0.05) and front cervical lymphadenitis (р<0.01).

There was done an examination of anti- and pro-inflammatory cytokines in the blood serum in 98 women in the second trimester of gestation. The first group included 30 women with physiological course of pregnancy (control). 68 patients with exacerbation of chronic simple bronchitis of influenza etiology were divided and included the second group with 24 patients with antibody titers 1:16-1:64; the third group that had 23 patients with antibody titers 1:32-1:128; the fourth group with 21 women with antibody titers 1:64-1:256. It was found out that pregnant women of the second group in comparison with the first one had the increase of the contents of IL-4 till 27.8±2.31 pg/mL, of TNF-α till 59.3±4.24 pg/mL and of IFN-γ till 55.4±4.16 pg/mL (in the control it was 14.7±1.32 pg/mL, р<0.001; 38.4±3.62 pg/mL, р<0.001 and 32.4±2.03 pg/mL, р<0.001, respectively). At the comparison of values of IL-4 and IFN-γ in the second and third groups there were not revealed any changes of the level of these cytokines, at the same time the concentration of TNF-α grew by 29.7% (р<0.05). The patients of the fourth group in comparison with the third one had the increase of concentration of IL-4 by 12.5% (р<0.05), of TNF-α by 22.8% (р<0.001) and IFN-γ by 17.5% (р<0.05). This suggest an important pathogenetic meaning of the growth of anti-influenza antibodies in the stimulation of the system inflammatory response inducing the development of endothelial pathology and placental insufficiency at the exacerbation of chronic simple bronchitis in women in the second trimester of pregnancy.

By gas chromatography the quantitative contents of myristic, palmitic and stearic fatty acids were studied in the erythrocyte membrane in pregnant women with reactivation of chronic cytomegalovirus infection in different periods of gestation. The main group consisted of 96 pregnant women with reactivation of chronic cytomegalovirus infection (titer of IgG antibodies to cytomegalovirus was 1:1600) in I, II and III trimesters of gestation (32 women in each). The control group included 96 healthy pregnant women whose age and date coincided with the main group. It was found out that the reactivation of chronic cytomegalovirus infection in pregnant women is accompanied by the increase in myristic acid concentration in the erythrocyte membrane by 55% (p<0.001) in the I trimester, by 66% (p<0.001) in II trimester and by 63% (p<0.001) by the end of gestation. Palmitic acid concentration increased in women of the main group in the erythrocyte membrane by 58% (p<0.001) in I trimester, by 62% (p<0.001) in II trimester and by 57% (p<0.001) in III trimester. Stearic acid content in the erythrocyte membrane of pregnant women with cytomegalovirus infection was revealed to be higher than in the control group during the whole period of pregnancy. The increase of the contents of saturated fatty acids in pregnant women with cytomegalovirus infection can have a dual character: on the one hand, it meets the needs of the developing fetus energy substrates and structural components of cells; on the other hand, it increases the relative microviscosity of erythrocyte membrane, which may be one of the causes of hypoxia of a fetus and a born child. The findings suggest the feasibility of a differential approach to therapeutic treatment of pregnant women with cytomegalovirus infection and the use of drugs that stabilize the lipid metabolism.

The natives of Russian North-East region have a long exposure of organism to low air temperatures. Already at the early age (15-20) many citizens of Chukotka have the signs of inflammatory processes in airways that lead to long inflammation and later result in severe asthma. In November-January period 1985-1986, 320 Chukotka citizens were examined. The values of bronchoscopy and bronchobiopsy of bronchial mucosa were studied. It was found out that the low temperature of the inhaled air damages adenylatcyclase receptors on the cilia of ciliary cells, which leads to the suppression of cAMP activity. Mast cells, macrophages, eosinophils and neutrophils drawn to the bronchial mucosa lead to the damage of blood circulation in the mucosa as well as to the disturbance of energetic processes in epithelial cells and their differentiation under the suppression of the activity of APUD-system. Ciliary cells and the whole of epithelial layer of the mucosa die at the time of hyperplasia of muscular elements, bronchial spasm and bronchial obstruction development with impaired conductance of the distal airways. All these factors lead to the development of severe asthma.

The aim of the research is to estimate the changes in the process of regeneration of airway epithelial lining of rats of different age under general cooling of the body. The research was done on 60 white outbread mice at the age of 6-7 months (young) and 19-20 months (old). Each group included 2 subgroups: the first one had intact animals; the second one consisted of animals which were subject to general cooling during 14 days by 3 hours daily at the temperature of -15ºС. Cranial and caudal parts of trachea mucosa and the wall of intralobular bronchus (of a small calibre) were the object of the research. It was found out that with the general cooling of the body in the epithelium of the cranial and caudal trachea in old animals compared with young rats there was indicated a significant reduction in the number of basal and especially intermediate cells, and the increase in the number of goblet ones. The increase in the number of epithelial cells, primarily of intermediate ones in the state of extrusion, was found out. In small bronchi in old rats the number of ciliated cells decrease whereas their destructive changes increase and the number of Clara cells in the elimination of the state grow. The effect of low temperatures leads to the activation of lipid peroxidation reactions against the decrease of the contents of vitamin E in the lungs of rats, especially the older animals.

The purpose of the research is to study the impact of the course of inhalation with propolis, royal jelly and their mixture in "Apingalin" medication on some indicators of energy metabolism in experimental pulmonary edema in rats. Blood plasma of 90 white male rats weighing 0.15-0.2 kg was studied. The animals were divided into groups: intact animals; control animals to which adrenal pulmonary edema (epinephrine was administered intraperitoneally at a dose of 0.5 mg/kg) was introduced; propolis, royal jelly, Apingalin animals with pulmonary edema, which then had a course of inhalation with propolis, royal jelly and Apingalin (10 days by 10 minutes), respectively. The collection of biological material was carried out at the 11th day after the start of the experiment. The intensity of energy processes was evaluated by the level of glucose, lactate, creatinine, LDH activity, phosphorous compounds quantity in blood plasma of experimental animals. It was found out that in experimental pulmonary edema in rats anaerobic glycolysis is enhanced alongside with the collapse of creatine phosphate, which causes corresponding changes in biochemical homeostasis, n.e. the increase of concentration of lactate, creatinine, and the reduction of blood glucose concentrations. Inhalations with royal jelly and Apingalin allow to eliminate the consequences of the violation of energy metabolism after experimental pharmacological shock most effectively, inhalations with propolis do it less effectively.

Numerous studies conducted in recent years show that in the mechanism of environmental factors influence on a living organism at adaptation of a warm-blooded organism to cold, in particular, there is a common pathogenetic link, namely excess production of free radicals. An experimental study of the use of natural antioxidants derived from medicinal plants of the Amur region seems to be quite perspective. In experimental conditions the possibility to correct free radical lipid oxidation of rats’ organism membranes was studied with the oral introduction of the tincture of herb convolvulus that contains the complex of natural antioxidants. The animals were divided into 3 groups and each of them had 30 rats: intact animals which were held in standard conditions of vivarium; the control group in which rats were exposed to cold during three hours daily; the experimental group in which before cooling animals had a daily oral intake of the tincture in a dose of 5 ml/kg. It was found out that in the blood of experimental animals a daily cold exposure during three hours contributes to the increase of lipid hydroperoxides level (by 19-20%), of diene conjugate (by 16-21%), and of malonic dialdehyde (by 41-50%) against the decrease of antioxidant system activity in the blood of intact animals. The introduction of the tincture to rats in the conditions of oxidative stress contributes to the reliable decrease in the blood of lipid hydroperoxides by 9-16%, of diene conjugates by 8-17%, malonic dialdehyde by 21-28% in comparison with the rats of the control group. While analyzing the effect of the tincture on the activity of the components of antioxidant system it was shown that the level of ceruloplasmin in the blood of animals was significantly higher by 10-26%, of vitamin E by 18-23%, of catalase by 10-28% in comparison with the same parameters of the rats of the control group. So, the application of the mentioned tincture in the conditions of oxidative stress induced by the influence of cold leads to the stabilization of the processes of peroxidation against the increase of antioxidant system activity.

At present in the clinical practice compounds of succinic acid which have antioxidant and cytoprotective properties are used as pharmacologically active substances with a wide range of biological activity. In experimental conditions the possibility to correct free radical lipid oxidation of rats’ organism membranes was studied with the administration of the succinate containing drug called Remaxol^® (Polysan, St. Petersburg). The animals were divided into 4 groups and each of them had 20 rats: the group with intact animals which were held in standard conditions of vivarium; the control group in which rats were given carbon tetrachloride during 3 days daily; the experimental group in which before the introduction of carbon tetrachloride animals had a daily intra-abdominal intake of Remaxol in a dose of 50 mg/kg; the experimental group in which before the introduction of carbon tetrachloride animals had a daily intra-abdominal intake of the Remaxol in a dose of 100 mg/kg. It was found out that in the blood of experimental animals the administration of carbon tetrachloride during 3 days contributes to the increase of lipid hydroperoxides level (by 20-24%), of diene conjugate (by 17-19%), and of malonic dialdehyde (by 51-59%) against the decrease of antioxidant system activity in the blood of intact animals. The administration of the succinate containing drug to rats in the conditions of oxidative stress contributes to decrease in the blood of lipid hydroperoxides by 7-12%, of diene conjugates by 7-11%, and of malonic dialdehyde by 13-24% in comparison with the rats of the control group. While analyzing the effect of the succinate containing drug on the activity of the components of antioxidant system it was shown that the level of ceruloplasmin in the blood of animals was significantly higher by 9-24%, of vitamin E by 12-21%, of catalase by 13-24% in comparison with the same parameters of the rats of the control group. So, the application of the succinate containing drug called Remaxol in the conditions of administration of carbon tetrachloride into the organism of animals under experiment leads to the stabilization of the processes of peroxidation against the increase of antioxidant system activity.

In the experiment the effect of adaptogenic herbal blend of Hypericum perforatum and Rhodiola rosea on the parameters of the search activity of laboratory rats against the background of high and low temperatures was investigated. The experiment was performed in the tool installation (N.R.Grigoriev, 1998), which is the universal problematic camera, with application of the mixture of herbal adaptogens from Hypericum perforatum and Rhodiola rosea in a dose of 30 mg/kg; 150 mg/kg; 300 mg/kg in rats exposed to prolonged heat and cold stress. The tests were carried out on 100 white mongrel male rats weighing 180-200 g. The following indicators of the search activity were subject to registration: 1) motivation-energy parameters (search time and search intensity - the number of targeted paces of rats from the camera for 60 seconds); 2) the parameters of the cognitive sphere (the cognitive index and the coefficient of the erroneous strategy of paces). It was found out that the mental capacity of animals is reduced under the effect of the temperature factor on the body. Powdery mixture of plant adaptogens of Hypericum perforatum and Rhodiola rosea in doses of 150-300 mg/kg significantly improved the cognitive characteristics of the search activity in the conditions of cold and heat stress on the body.

This article features the issues concerning the impact of chemical elements in drinking water on the human health in the rural areas located in the south of the Amur Region. Ground waters from the Zeya-Bureya artesian basin used for the domestic and drinking purposes are the main source of water supply in these areas and, thus, are selected as the object of the study. For this purpose the content of chemical elements in water samples collected from 361 wells located in 167 settlements has been studied. Health risk factors assessment from chemical elements was carried out. The main scenario of penetration of these substances into the human organism was selected a peroral way, i.e. when consuming water for drinking. Toxic and cancerogenic risk to health was assessed. It was established that within the major part of the study area the values of the individual hazard quotients (HQi) for chemical elements in drinking water at the geochemical background level do not exceed the upper limit of the safe level. The values of individual cancerogenic risks of chemical elements in drinking water do not exceed those for the permissible risks (ranging from 1·10^-6 - 1·10^-5) for the populated areas in Russia. At the same time, in the villages located within the limited area of the narrow riverside strip about 10 km wide along the left bank of the Amur river and the right bank of the Zeya river there was observed a high probability of toxic effects from arsenic contained in drinking water (HQi from 0.4 to 3.8). The values of individual cancerogenic risks from arsenic exposure (CRi from 0.1·10^-3 to 0.7·10^-3) calculated for these villages exceeded the permissible value. Thus, on the main territory of the rural areas of the Amur Region south there is no potential risk for development of both toxic and cancerogenic effects from environmental chemical elements contained in drinking water. But, within the riverside areas of the Amur and Zeya rivers there are some zones of hydrochemical arsenic anomaly where the toxic and cancerogenic risk due to its higher concentrations is regarded as quite alarming.

A brief review of the literature devoted to the etiology, pathogenesis, clinical features and diagnosis of congenital hemorrhagic telangiectasia (Rendu-Osler disease) was done. There is also demonstrated a rare case of the personal experience of the authors, namely the observation of the patient with Rendu-Osler disease with local telangiectasia on the lower lip and the mucosa of the nasal cavity and in the bronchi; and in their absence, on the exposed parts of the body, which in its turn created significant difficulties in diagnosis. There were defined the following clinical features of this case: the debut of the disease at the age of 15 years old in the form of recurrent nasal bleeding; despite repeated surveys the causes of bleeding were not identified and there was only the treatment of anemia; the deteriorating course of the disease was associated with stressful situations in the family, a viral infection, exposure to mercury as a result of the person’s occupation, which led to pulmonary hemoptysis and bleeding of up to 200 ml per day; difficulties in diagnosis were due to the lack of typical telangiectasia on the open for examination parts of the body; the diagnosis was suspected clinically by careful examination of the lower lip mucosa where multiple telangiectasia were found. The diagnose was subsequently re-confirmed by bronchoscopy. So, if a patient has nasal or bronchopulmonary unspecified bleeding, hemoptysis, we recommend to have a targeted research on congenital hemorrhagic telangiectasia on the available to visual examination parts of the body to eliminate the local forms of the Rendu-Osler disease.

Pulmonary Langerhans cell histiocytosis (PLCH) is in the group of diseases of unclear etiology. This disease is also known as histiocytosis X or eosinophilic granuloma which is the most non-malignant form of this disease. More than 90% of adult patients with this pathology are smokers. The mean age of the patients is 32 years old. Typical symptoms of this disease are cough and apnoea. Pneumothorax was identified in approximately 20% of patients. Under our observation during 10 years there were 7 patients with PLCH, 2/3 of them were men. Their age was from 5 till 45 years old. 5 patients were smokers, and children were non-smokers. In 5 patients the diagnose was verified by biopsy of lungs or bony tissue. In 2 patients the diagnose was confirmed by typical X-ray pattern during a long-term observation. 4 patients had only pulmonary forms of the disease, and 3 patients had a combination of pulmonary changes with bonny damages. Granulomatous sites of damage (dissemination), aerocysts, and as sequela, pneumothorax became the basic patterns on roentgenograms and computed tomography. This disease should be distinguished from many other diffuse and disseminated processes in lungs, and, first of all, from sarcoidosis basically of III and IV stages. The most important differential-diagnostic criteria are presented.

In the review of the literature the causes of bronchopulmonary dysplasia and modern methods of radiation diagnosis of this pathology are discussed in detail. The data on advantages of the spiral computed tomography in diagnostics and differential diagnostics of bronchopulmonary dysplasia in children are presented. The questions of the assessment of options and the severity of the course of the disease are revealed. The analysis of opportunities of radiology diagnosis of bronchopulmonary dysplasia outcomes is carried out.