Based on the results of a state system of monitoring of tuberculosis and other respiratory diseases of non-specific etiology, a retrospective comparative analysis of these diseases prevalence on the territory of the Amur region and their regional peculiarities was done. The significance and experience of the application of the state activities to protection of citizens health and the improvement of medical care quality based on the perfection of normative and legal base within phthisiology and pulmonology were shown. With the help of the methods of epidemiological screening and medical-social analysis, regional features of chronic respiratory diseases prevalence and risk factors were identified. Within the development of the information system of population respiratory health monitoring, the program of clinical and epidemiological studies of population respiratory health on the territory of the Amur region for 2010-2012 was elaborated at the Far-Eastern Scientific Center of Physiology and Pathology of Respiration SB RAMS. To fulfill the main concepts of the Worldwide Health Organization aimed at the improvement of the quality and effectiveness of treatment-diagnosing and preventive activities in the field of population respiratory health protection, a regional program recommended by the Committee of the experts of the Russian Respiratory Society to implement into the practice of the regional health care institutions was developed.

The features of the development of professional dust lung disease have been studied clinically and experimentally. Metabolic changes have been identified in miners at the stage of chronic manifestations of anthracosilicosis: hypercholesterolemia, dyslipidemia, and immune disorders. In the rats under the experiment the inhaling of coal and rock dust is accompanied by the increased synthesis of protective proteins in the lungs: HIF-1α, HSP₇₂, HSP₇₃ and HOx-2. In the biochemical profile of the lung tissue of rats there was a reduction in total protein, magnesium, and an increase of aminotransferases activity. Histological studies of lung tissue showed that even at the early stages of the impact of coal and rock dust effect a structural reorganization of the respiratory tract has been registered. These results indicate the need for preventive organoprotective support for the body from the moment of coal and rock dust exposure, which should include anti-inflammatory drugs and an adequate protein diet.

The aim of the research was to characterize the spectrum of cytokines and to evaluate their participation in the formation of thyroidal insufficiency profile in patients with bronchial asthma. The serum levels of thyrotropic hormone (TTH), general thyroxin (Т₄), general triiodothyronine (Т₃), free fractions of hormones (сТ₄ and сТ₃), interleukins 4 and 2 (IL-4, IL-2) and interferon-γ (IFN-γ) were determined at one time in 124 patients with uncontrolled bronchial asthma (Asthma Control Test >10 and ≤19 grades) and without evident pathology of thyroid gland with the help of immune-enzyme analysis. Depending on the basal level of TTH the patients with bronchial asthma were divided into three groups: the first group consisted of 58 (47%) patients with TTH level from 2.5 till 4.5 mUnits/l (I degree of thyroid insufficiency development), 22 (19%) patients with TTH level from 4.0 till 10 mUnits/l (II degree of thyroid insufficiency development) were included in the second group, the third group had 42 (34%) patients with TTH level lower than 2.5 mUnits/l (no thyroid insufficiency development). The mixed asthma was diagnosed in 79 (64%) patients, allergic asthma – in 45 (36%) patients. The obtained results were compared with the parameters of serum dehydroepiandrosterone-sulfate (DHEA-S) and basal cortisol. At the examination it was found out that steroids of adrenal cortex, cortisol (at the domination of atopic asthma criteria) and DHEA-S (at the mixed form of a disease) affect significantly the change of thyroid gland activity at bronchial asthma and control the proliferation and secretory activity of almost all immune-competent cells. The patients with uncontrolled asthma were revealed to have the variability of polarization levels of the immune response by Th1and Th2 types and the development of functional insufficiency of the thyroid gland of I-II degrees, which is associated with the 2.5-4 times domination of proinflammatory cytokines products (IL-2 and IFN-γ) over the synthesis of immunosuppressive ones (IL-4).

Research objective: to study the features of realization of apoptosis of lymphocytes in the peripheral blood in patients with bronchial asthma of different severity in the period of exacerbation and out of it. 136 patients were divided into 2 groups depending on the severity of the disease. In the first group 67 patients with moderate bronchial asthma were included; the second group consisted of 69 patients with severe bronchial asthma among whom 31 patients constantly took systemic glucocorticosteroids. Spontaneous and Dexamethasone-induced apoptosis of lymphocytes in peripheral blood as well as the influence of the blocker of calcium channels on the modulator-induced programmable cellular death in the period of exacerbation of the disease and out of it were studied. It was found out that at bronchial asthma Dexamethasone-induced apoptosis has some features. The intensification of modulator-induced apoptosis at bronchial asthma of different severity in the conditions in vitro was revealed. But the serious course of the disease is characterized by the depression of apoptotic activity in lymphocytes, which proves an inflammation persistence in respiratory tracts and the intensification of immunocompetent cells survival. Thus, the existence of long existing immunocompetent cells in respiratory tracts is caused not only by their increased migration in the tissue, but also by the retardation of cells elimination owing to the disturbance of the processes of programmable cellular death, which is more accurately traced with the disease severity. It was found out that the suppression of the mechanism of calcium entering the cells via calcium channels of L-type of lymphocytes cytoplasmatic membrane has no impact on apoptosis-inducing effect of in vitro Dexamethasone. It was established that anti-apoptotic action of calcium channels blocker is completely lost in the period of bronchial asthma exacerbation.

The composition of fatty acids of erythrocyte membranes in patients with chronic non-obstructive bronchitis (CNB) and chronic obstructive pulmonary disease (COPD) in remission was studied. A total of 40 people, including 15 patients with CNB and 15 patients with COPD of a mild stable course were examined. The control group included 10 healthy people. The activity of the inflammatory process was studied as non-specific immunity, cytokine status. The fatty acid composition of erythrocyte membranes was studied by gas-liquid chromatography. In both groups of examined patients with bronchopulmonary pathology a significant accumulation of saturated fatty acids (14:0, 15:0, 18:0) was found out. In patients with CNB there was an increase of the content of arachidonic acid (20:4n6) by 15% (p<0.05), in patients with COPD it was by 41% (p<0.001) compared to healthy people. High levels of polyunsaturated fatty acids of n6 family in the membrane of red blood cells in patients with chronic lung diseases indicates an increase in the substrate for the formation of inflammatory mediators (leukotriene B4), and bronchospasm (prostaglandin D2). The level of eicosapentaenoic acid (20:5n3) was reduced by 24% (p <0.05) in patients with CNB, in patients with COPD it was twice as low as the initial one (p<0.001). The observed increase in the ratio 20:4n6/20: 5n3 that was 1.5 times higher (p<0.001) in patients with CNB and 3 times higher in patients with COPD may be a specific marker of poor prognosis of bronchopulmonary pathology and chronic inflammation development. Thus, the development of chronic respiratory diseases is accompanied by a disturbance of fatty acid composition of erythrocyte membranes, and the imbalance between the substrates for synthesis of pro- and anti-inflammatory eicosanoids.

The purpose of this study was to evaluate the hemodynamics of central and lung hemodynamics in patients with chronic obstructive pulmonary disease (COPD) with the method of computer-aided polyrheocardiography. The study involved 51 patients with COPD of mild to moderate severity in remission and without a concomitant cardiovascular disease. In the first group there were 22 patients with mild COPD; the second one comprised 29 patients with COPD of moderate severity. COPD diagnosis was carried out in accordance with the GOLD 2011. The control group consisted of 20 healthy non-smoking volunteers. The study of central hemodynamics in both groups showed the prevalence of hypokinetic type in 63% of cases; the normokinetic type was detected in 26% and hyperkinetic type in 11% of cases. Hemodynamic changes in the lung circulation were characterized by the increase of systolic pulmonary artery pressure by 40% in patients with mild COPD, and it was twice as much (p<0.01) in patients with moderate COPD compared with the control group, and by the increase of final diastolic blood pressure in the pulmonary artery in 65% and 4.5 times as much (p<0.01), respectively. Thus, the method of computer-aided polyrheocardiography allows to diagnose pulmonary hypertension in patients with COPD even before the development of intensive bronchoobstructive changes.

The aim of the research is to study the influence of intrasinusoidal electrophoresis of Talay mineral water on the state of the local immunity and to estimate the clinical effectiveness of this method at the treatment of patients with acute maxillary sinusitis. 68 patients were examined and 38 patients after the lavage of maxillary sinusitis went through intrasinusoidal electrophoresis with nitrogen low-mineral chloride hydrocarbonate-sodium water with a big quantity of silicic acid and fluorine. The lavage and the introduction of aqueous solution of antibiotics of the second generation Cefazolinum group were done to 30 patients (the control group) into maxillary sinuses. All the patients got the standard antibacterial and antihistaminic therapy. The parameters of the local immunity of the nose mucous tunic were studied in the lavages from the maxillary sinuses of all the participants of the study with the immune-enzyme analysis. It was found out that the patients of the main group had an earlier statistically reliable (р<0.05) positive dynamics of clinical symptoms and roentgenologic signs of the disease; a bed day also decreases (р<0.05). The differences in the local immune system responsiveness of the patients of the main and control groups were defined. In the lavage from the maxillary sinuses the patients of the main group were found to have the decrease of secretory sIgA in comparison with the initial values by 48.7%, of IgE by 75.7%, whereas the patients of the control group had the decrease by 21.3 and 32.2%, respectively, which proves a more adequate reduction of the local inflammation under the application of electrophoresis of mineral water. In the main group the number of disrupt phagocytes decreased in comparison with the initial values by 50.4% and the number of neutrophils by 11.3%, at the same time in the control group it was by 10.1 and 2.4%, respectively. So, the complex treatment of patients with the acute sinusitis with the application of intrasinusoid electrophoresis of mineral water leads to an early reduction of clinical symptoms and an intensive and anti-edema, anti-inflammatory and immune-modulating effect, which allows to improve the treatment of the patients with acute purulent maxillary sinusitis and contributes to a faster sanation of purulent inflammation.

The study of local non-specific protection and cellular immunity at influenza A(H1N1) swl in 50 women of childbearing age was done. 20 patients were diagnosed to have a community-acquired pneumonia (the main group), 30 women at the moment of examination did not have any acute infectious diseases and the exacerbation of chronic somatic and gynecological pathology (the control group). The verification of influenza virus A(H1N1) swl was conducted in the paired blood sera obtained from the patients at the moment of their getting into the in-patients hospital and in 10 days after that at the four-times growth of antibodies titer to the pathogen in the reaction of hemagglutination inhibition. The study of secretory immunoglobulin A (slgA) content in the blood serum was carried out with the immune-enzyme analysis, the percentage of populations and subpopulations of lymphocytes was done with the flow cytofluorimetry method. It was found out that the influenza A(H1N1) swl complicated with community-acquired pneumonia is characterized with the intensive intoxication syndrome which determines the changes of immunologic resistance of a female organism. The patients of the main group in comparison with the control group were registered to have the fall of sIgA level (2.6±0.29 and 4.8±0/.58 mg//l, respectively, р<0.001), which proved a lower level of the local immune protection of their upper airways and the tracheobronchial tree. In the main group there was a decrease of a relative quantity of T-lymphocytes (CD3+) till 65.6±1.57% (in the control group it was till 71.2±1.63%, р<0.05) predominantly due to Т- suppressors (СD8+) it was till 18.1±1.05% (in the control group it was till 23.7±0.66%, p<0.01) at the absence of a reliable change of a number of natural killers (CD16+56+), which may reduce the effectiveness of antiviral immunity. At the same time the women from the main group in comparison with the women from the control group had an increase of B-lymphocytes (CD19+) till 18.8±0.68% (in the control group it was till 14.6±0.73%, р<0.001) which participate in the humoral immune response of the female organism to the virus aggression against intensive intoxication syndrome.

The article shows the data which reflect the state of the carbohydrate metabolism initiated by hexokinase of glucose phosphorylation and the causes of its dysfunction in placenta and erythrocytes of the peripheral blood of women in the third trimester of gestation with active cytomegalovirus infection. After the histochemical study of 75 placentas of women who suffered the recurrence of cytomegalovirus infection in the third trimester of gestation (the main group), a reliable decrease of reaction intensiveness to hexokinase in comparison with the control group of 30 seronegative pregnant women (79.8±1.9 and 209.8±12.1 standard units, р<0.001) was revealed. One of the main causes which leads to the breakage of energetic production can be antigen-mediate hypersecretion of cortisol by adrenal cortex and its output in big quantities into peripheral blood (1467.47.4±8.23 nmole/l in the main group and 730.41±9.04 nmole/l in the control group, p<0.001), which provoked the development of lipid peroxidation processes and the formation of free-radical products contributing to the modification of membrane and cytosolic protein components in placenta. In the peripheral blood of pregnant women from the main group there was an intensification of lipid peroxidation processes which cause the growth of malonic dialdehyde till 1.65±0.09 mcmole/ml (in the control group it was till 0.74±0.05 mcmole/ml, p<0.001) and inactivating antioxidant properties of superoxide dismutase (the decrease till 243.85±7.71 Units/gНb, in the control group it was till 386.77±13.12 Units/gНb, p<0.001) and oleic acid (the drop till 15.22±0.15%, in the control group it was till 20.51±0.21%, p<0.01). At the same time in the main group there was the decrease of ATP pool in erythrocytes till 0.46±0.015 mcmole/ml (in the control group it was till 0.85±1.0 mcmole/ml, р<0.001), which determined the drop of discocytes circulation and the increase of a number of transformed and degenerative cellular forms. The obtained results prove the role of cytomegalovirus infection in the development of oxidative stress which disturbs the regulation of hexokinase ATP-D-glucose-transferring enzyme process, which results in a significant drop of ATP in placenta and erythrocytes of the peripheral blood of pregnant women.

The work shows the experimental data about the influence of low temperatures on the structure of myofibrils of rabbits cardiomyocytes. The animals were cooled during 5, 15 and 30 days at the temperature of -30ºС daily for three hours. Electronic-microscopic and biophysical study of the structure and the functional activity of myocardium was done. The damages of morphofunctional state of cardiomyocytes myofibrillar apparatus were found out; the square of their damage was defined with the use of «Bio Vision» software depending on the density of myofibrils spots; the calculation of the percentage to the studied mass of myofibrils was done. After 5-day cooling, the square of the damaged spots of cardiomyocytes myofibrils was 1842.19 Sqr micr or 1.73% from the general square of myofibrils. The further cooling led to a more severe myocardial damage. At the 15^th day of cooling the damaged spots were 1961.631 Sqr micr or 11.59% from the general square of myofibrils and by the 30^th day the zone of the damage enlarged till 2042.56 Sqr micr or 15% from the general square of myofibrils. The obtained results suggest that a long cooling of the body is a severe damaging factor which affects cardio-vascular system. It influences metabolic processes in cardiomyocytes particularly negatively and causes the damage of myofibrillar apparatus of cells. The body being under cooling for a long time may get into unfavorable conditions for the normal heart work, which is revealed through the decrease of the functional myocardial working efficiency.

Morphological and morphometric characteristics of epithelium cells of white rats tracheal mucosa under cooling and overheating of the body were studied. 18 groups of laboratory animals underwent the exposure to low (-15°C) and high (+40°C) temperatures during three hours a day for 7, 14 and 21 days. Alongside with the temperature exposure the animals in the corresponding groups were administered with medications of phytoadaptogens per os ( Hypericum perforatum and Rhodiola rosea ). It was done to study the pharmacological possibilities to contribute to the adaptation of airways to different temperatures. After the experiment the medications from the trachea tissue were made; with the method of light microscopy the comparison of the height of the epithelial layer in the material of the experimental and intact animals was done. It was found out that the longer the cooling of the body was (from 7 till 14 days) the less the height of epithelium was (from 33% till 51% from the normal value). After that the epithelium height increases till 31% due to adaptive hypertrophy. Under the continuous thermal exposure the height of epithelium consistently grows by 18, 28 and 34%. The administration into the animals’ body of Hypericum perforatum under the cold exposure does not influence the height of epithelium changes subject to the period of exposure. Under the administration of Rhodiola rosea the maximal height of epithelium was registered at the 14^th day of cooling. The animals administered with Hypericum perforatum and being under heat exposure have a modification of epithelium height changes subject to the period of exposure with the maximum height of epithelium at the 7^th day. Under Rhodiola rosea administration the maximal height of epithelium was registered at the 7^th day of the exposure to the heat. Phytoadaptogens Hypericum perforatum and Rhodiola rosea contribute to the compensation of changes of tracheal mucosa epithelium caused by the wide range of temperatures.

The aim of the research was to study histochemical characteristics of Na⁺ ions localization in the lungs of rats under the influence of dihydroquercetin and experimental cold stress. White outbred rats were the object of the study. They were divided into three groups with 10 animals in each one. The first group included intact rats which were kept in the standard conditions of vivarium; the animals of the second group were exposed to low environmental temperatures of -15ºС during an hour a day for three months; the animals of the third group being exposed to cold temperatures also had a daily administration of per os dihydroquercetin in 50 mg per 1 kg of body weight with the help of probe. Na⁺ ions in the lungs of rats were revealed with histochemical reactions with antimonates on the frozen sections. At histochemical analysis there was found a high concentration of Na⁺ ions on the surface of pulmonary bronchial mucosa; the adventitious membrane is dyed with azure 2. In the intact animals of the first group the thickness of positively responsive to antimonite material in the epithelial tissue of pulmonary bronchi mucosa is 8.5±0.3 µm. In the second group under the exposure to cold it has increased till 15.0±0.7 µm (р<0.001 in comparison with the first group). With the administration of dihydroquercetin in the third group Na⁺ ions reaction intensiveness with antimonite drops till 9.3±0.3 µm and almost gets to the normal one. Granularly dyed with antimonite and alizarin red cellular elements are found in the places of moderate hyperemia of the respiratory part of the lungs. The thickness of interalveolar septum in intact animals was 5.7±0.77 µm; as a result of hyperemia of the respiratory part of the lungs that occurs due to the cooling of the animals’ body it increases till 11.0±0.9 µm (р<001) in the animals of the second group. Under the correction with dihydroquercetin the thickness of interalveolar septum decreases till 6.0±0.61 µm (р<0.01 in comparison with the second group). The results of the research prove the effectiveness of dihydroquercetin at its administration in a dose of 50 mg/kg for the correction of the total supercooling of the body.

The increase of adaptation capabilities of a person to the damaging effect of cold 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. The animals were divided into three groups and each of them had 15 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; and the experimental group in which before cooling animals had a daily oral intake of the tincture made of birch, nettle and plantain leaves 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 20%), of diene conjugate (by 29%), and of malonic dialdehyde (by 21.5%) against the decrease of antioxidant system activity in the blood of intact animals. The introduction of the tincture to rats in the conditions of cold exposure contributes to the reliable decrease in the blood of lipid hydroperoxides by 19%, of diene conjugates by 13%, of malonic dialdehyde by 18% 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 reliably higher by 22%, of vitamin E by 19%, of catalase by 18% in comparison with the same parameters of the rats of the control group. So, the application of the mentioned tincture in the conditions of long cold exposure of the organism of experimental animals leads to the stabilization of the processes of peroxidation against the increase of antioxidant system activity.

Fatty acids composition of Penicillium canescens Sopp. and Aspergillus fumigatus Fresen. isolated from the soils of Blagoveshchensk (the Amur region, Russian Far East) was studied. Linoleic, oleic and palmitic acids are the main fatty acids for both strains. Linoleic acid is the major one (41.1%) in Aspergillus fumigatus micelium, the content of linoleic and oleic acids is almost equal (35.4 and 31.2% respectively) in Penicillium canescens . The percentage of nonsaturated fatty acids (olein, linoleic, linolenoic and others) in a mycelium of Aspergillus fumigatus reached 71.3%, in Penicillium canescens mycelium – 72%. Palmitic and stearic acids were the main ones among saturated fatty acids in the fungi biomass. Penicillium canescens possessed a big variety of minor and trace fatty acids. The results are of interest for the study of fungi adaptive strategy in technogenic ecosystems, and can be used for micromycetes identification.

The morphology of bacteria and microscopic fungi in the snow that falls on Blagoveshchensk in the windless weather was studied. It was found out that during a snowfall in the snow flakes there are typical rod-shaped bacteria, yeast-like fungi, mycelian fragments of fungi, cultivated with difficulty elementary bodies of L-form bacteria and separate fines. The surface of the mold mycelium is covered with fine particles which are separated from each other by some distance, which allows to assume they have some relations with the receptors of the cell wall. Microscopic and submicroscopic forms identified in snowflakes can be the centers of ice formation, but mycelian fragments can be the nuclei of only large snowflakes.

The literature review shows the results of the studies of a great number of authors. They concern the optimization of anti-inflammatory therapy of chronic obstructive pulmonary disease (COPD). COPD is a progressive disease characterized by systemic manifestations and often combined with the concomitant pathology which defines the forecast, the severity course, the treatment tactics and the rehabilitation program. Pulmonary and extrapulmonary manifestations of COPD are associated with the pathologic inflammatory process which is already revealed at the pre-clinical stages and its intensiveness increases alongside with the severity of the disease. The main cells of inflammation are neutrophils, T-lymphocytes and macrophages which are accumulated with the release of huge quantities of biologically active substances and induce a number of inflammatory reactions leading to the restriction of air flow and bronchial obstruction. Taking into account the fact that the chronic inflammation is a major cause of COPD, the treatment should include a powerful anti-inflammatory therapy. A promising trend is the use of a new class of drugs - inhibitors PDE-4, a representative of which is the roflumilast. Inhibitors of PDE-4 slow down the destruction of cAMP; this reduces the emission of biologically active substances involved in the main phases of inflammation by anti-inflammatory cells. Clinical effectiveness of the roflumilast in patients with moderate and severe COPD was studied in a series of large randomized placebo-controlled studies – Record (M2-107), Opus, Ratio (M-112), EOS (M2-107), HELIOS (M2-128), AURA (M-124), HERMES (M-125), the results of which confirm the fact that the roflumilast therapy is accompanied by the improvement of the pulmonary function, the reduction of exacerbations risks and the improvement of the patients’ quality of life.

In the review the information on the use of synanthropic plants of the Amur region in medicine and the prospects for their practical use are given. The particular attention is paid to pharmacological effects that drugs and compounds derived from these plants possess. Of 118 species of all adventive plants and weeds growing in the Amur region, 48 adventive species may be considered to be medicinal plants. There are no published data on the use of 34 species in medicine, and for 23 species there are no data on the chemical composition.

Morphologic substance and mechanisms of amblyopia have not been studied enough, which hampers the development of effective methods of treatment. The elimination of sensory deprivation is vital in amblyopia treatment. In medical practice different ways of treatment directed to stimulate the reserve functional abilities of the amblyopic eye are used. The review covers the modern methods of amblyopia treatment based on the pleoptical, laser, physiotherapeutic, medication, surgical and complex stimulating influence on the amblyopic eye function. The direct occlusion and penalization notwithstanding their simplicity have to be used for a long time. Pleoptic influence is not always effective. The drawback of laser stimulation is its failure regarding light radiation and the probability of the negative effect on photoreceptors of the retina. Effective stimulating action of physiotherapeutic procedures demands a wide range of specific devices, which is no always possible within out-patient reception hours. The intake of different medications has a positive effect in all cases of amblyopia treatment, but it does not eliminate the causes of this pathology. Surgical methods successfully deal with the causes of refraction, anisometropia and obscure origin amblyopia and must be used at the earliest. With their benefits and drawbacks each of the known modern methods of amblyopia treatment affects only one side of the pathological process. The complex application of different methods has a many-sided influence on the visual analyzer and contributes to a higher effect of disinhibition and the stimulation of amblyopic eye function. The analysis of literature upon this question shows that this problem is of high interest and the optimal ways of its solution have not been found yet.