The parameters of cardiorespiratory system of students with different levels of resistance to transient hypoxia-hypercapnia were studied. Differences in the lung function indices, heart rate variability and central hemodynamic in young people depending on the results of Shtange’s respiratory test were identified. It was found out that students with low resistance to hypoxia had reduced ventilation indices and heart rate spectral characteristics. The variability of hemodynamic characteristics in different phases of arbitrary apnea was studied. The study found that more than a half of students aged 18 to 23 years old have a high level of resistance to transient hypoxia-hypercapnia. Lower values of adaptive reserves in young people with low tolerance to hypoxia were found. 51% of the examined students had unsatisfactory adaptation reserves, 3% demonstrated the failure of adaptation. The study established the compensatory changes in the pulmonary ventilation in patients with a low threshold of apnea. Phase dynamics of central hemodynamics parameters in patients with various degrees of resistance to transient hypoxia in the European North of Russia was studied first time. Inconsistency and disorganization of factor structure of correlations of the studied quantities in people with the low level of resistance to hypoxia reflects the imperfection of regulation mechanisms which cannot provide the necessary level of tolerance. In students with the high threshold apnea the state of modulating system, hemodynamics elements and the systems of pulmonary ventilation play the most important role.

The aim of the study was to search for the possibility of the achievement of control over bronchial asthma in patients with cold bronchial hyperresponsiveness concomitant with subclinical hypothyroidism in the regime of the step increase of the combined therapy during 24 weeks of examining. From the whole of 70 patients with uncontrolled asthma without evident pathology of the thyroid gland three groups for comparison were identified: the first group included 22 patients without cold bronchial hyperresponsiveness, the second group had 25 patients with cold bronchial hyperresponsiveness, the third group was comprised of 23 patients with cold bronchial hyperresponsiveness against subclinical hypothyroidism. At the same time the levels of thyrotropic hormone in the blood, the contents of oxidative stress products (TBA-responsive products of lipid peroxidation), antioxidant enzymes (superoxide anion scavenger) and inflammatory-cellular composition of the induced sputum were studied by the end of 24 weeks of therapy. The application of the regime of the step increase of the combined therapy by medication with budesonide/formoterol in the patients of the third group who demonstrated the highest level of oxidative stress associated with neutrophilic-eosinophilic pattern of inflammation in bronchi allowed to obtain the results of the achievement of bronchial asthma control equal to the ones obtained in the patients of the first and second groups, who had monotherapy (beclomethasone dipropionate in the regime of the step increase of the dose) and long treatment with the use of the fixed combination of budesonide/formoterol. The indices of oxidative stress in the 1 and 2 groups were less intensive and associated with eosinophils pattern of bronchial inflammation.

30 patients with bronchial asthma were examined with the aim to estimate the annual dynamics of the quality of life (QL). QL was estimated with the help of the SF-36 and AQLQ questionnaires. The cooperativity of patients was found with the help of the questionnaire specially developed for this purpose. The state of the emotional sphere was estimated with the Hospital of Anxiety and Depression Scale. The annual dynamics of QL in bronchial asthma patients receiving maintenance basic therapy, in general is characterized by insignificant dynamics which depends on the level of the patients’ cooperativity, the presence of cold airway hyperresponsiveness and anxiety-depression disorders. If bronchial asthma patients have cold airway hyperresponsiveness, the improvement of health-related QL is found only in the domain «General QL» of the questionnaire AQLQ. The cold airway hyperresponsiveness influences the achievement of control of bronchial asthma negatively. Patients who have psychoemotional problems have a constant low level of general and specific QL throughout the year and don’t have any qualitative control of the disease. The discriminant model was developed to predict the improvement of QL of bronchial asthma patients during the year by the initial level of anxiety and «Environment» scale at basic standard therapy.

The article shows the results of psychologic-psychiatric study of the features of affective sphere of patients with mild and moderate bronchial asthma. The degree of the influence of anxiety-depression symptoms on the course of asthma was studied. Psychological examination was done with the help of CES-D questionnaire (screening instrument of depression disorders identification) and the test «The Scale of Self-Esteem» (Ch.D. Spilberger, Y.L. Khanin). The identified clinical manifestations of emotional disorders were described. The study found that the more severe the degree of the disease was, the more anxiety and depression manifestations there were. High points by the scale of depression, personal and reactive anxiety correlated with the objective estimation of asthma severity and the decrease of patients compliance. Psychotherapy and/or psychopharmacotherapy are recommended under control of a psychiatrist while treating the patients with bronchial asthma concomitant with complicating affective symptoms.

The aim of the work was to estimate the disorders in lungs inflation in patients with bronchial asthma depending on the degree of control over the disease. The authors had a complex study of patients with bronchial asthma with controlled and uncontrolled course that included spirography (including the one with cold air test and bronchodilation test), bodypletismography and computer-aided tomography with zone densitometry and 3D volumetry. The results showed the reliable change in the parameters depending on the degree of the control over the disease, they were the worst in the group of patients with uncontrolled course of asthma. The patients who lost control over the disease had the increase of the degree of pulmonary ventilation maldistribution and these changes were focused in the low parts of the lungs. Using complex diagnostic possibilities, the authors did discriminant analysis, whose results allow to identify the loss of asthma control, contributing to the timely correction of the therapy.

Diseases concomitant with COPD lead to a more severe course of the disease and complicate the process of treatment. The severity of the disease itself and the use of antibiotics at COPD exacerbations result in the development of intestinal dysbacteriosis and secondary immunodeficiency. The aim of the research was to study immunologic processes in the COPD patients with identified intestinal dysbacteriosis. 60 patients with moderate COPD at exacerbation were studied. The 1^st group was comprised of COPD patients with the usual course of the disease (n=30), the 2^nd group consisted of COPD patients associated with dysbacteriosis (n=30). The parameters of cellular, humoral immunity and phagocytic activity of neutrophils were studied in the blood serum. It was found out that at COPD secondary immunodeficiency of cellular and humoral type was formed, phagocytic activity of macrophages was damaged. The contents of T-lymphocytes (CD3+) in the 2^nd group was considerably lower than in the 1^st group - 44.02±1.12 and 48.24±1.46%, respectively (р<0.05), the same situation was found at the comparative analysis of T-helpers contents (CD4+) - 30.5±1.2 and 34.8±1.4%, respectively (р<0.05). But the contents of B-lymphocytes (CD20+) in the 2^nd group was a little higher - 13.6±1.8 and 12.2±1.8%, respectively (р>0.05), the quality of activated T-lymphocytes improved as well (CD25+) - 12.4±0.84 and 9.5±0.92%, respectively (р<0.05), which we explained by higher antigen load. While studying immunoglobulins there were no any significant differences in the groups of comparison (р>0.05). The changes in phagocytic link were lower (р<0.05) in the 2^nd group in comparison with the indices in the 1^st group. Thus, the damages of the immune status are more intensive in the patients with COPD associated with intestinal dysbacteriosis. The damages in monocytic-macrophage system are the most important.

93 patients of the employable age who were admitted to be disabled because of COPD were examined in the outpatient setting with the aim to study the influence of combined medical therapy on respiratory and cardiovascular systems and the quality of life (QL). During 3 months in the 1^st group 48 patients took tiotropium bromide in the dose of 18 mkg/day, in the 2^nd group 30 patients alongside with the tiotropium bromide therapy had infusions of 1.5% solution of reamberine in a dose of 400 ml twice a day and the complex of respiratory gymnastics; in the 3d group (the control one) 15 patients were treated with salbutamol and inhalation corticosteroids. During the treatment all the patients had spirometry, Doppler cardiography, the estimation of QL with the use of MOS SF-36 and SGRQ questionnaires. The disorders of the lung function predominantly of obstructive type were initially found in all the patients; pulmonary hypertension and the disorders of diastolic function of myocardium of the right ventricle were identified in 89% of patients. The decrease of general and specific indicators of QL was identified. After the treatment in the 1^st and 2^nd groups there was significant improvement of lung function indices, but in the 2^nd group the significance of differences was higher (р<0.01). In the control group there was no statistically significant dynamics of lung function. Only in the second group there was decrease of systolic pressure indicators in the pulmonary artery (р<0.001) and improvement of diastolic function of the right ventricle (р<0.05). Besides, the patients of the second group after treatment had longer remission than the patients in all other groups (р<0.001), and the patients of the 2^nd group had statistically significant improvement of QL. This research proves significant clinical effectiveness of combined medical therapy with the use of tiotropium bromide, reamberin and the complex of respiratory gymnastics.

The aim of the research is to estimate the informative value of identification of calcium and sodium cations in cells and microorganisms in the swab of induced sputum and bronchoalveolar lavage fluid in patients with bronchial asthma. Cytochemical characteristics of cell elements in the swab of induced sputum and bronchoalveolar lavage fluid obtained from 100 patients with bronchial asthma during winter were studied. Eosinophils leukocyte s in the number from 3 till 70 in sight were found in the swab. There was very low content of goblet cells with the ratio to the cells of cylindrical bronchial epithelium 1:20. The cells granules of squamous epithelium of the oral cavity, granules of eosinophils leucocytes, nuclei and sections of cytoplasm of alveolar macrophages part, the nuclei and cytoplasm of neutrophilic leucocytes and lymphocytes were painted with saturated alcohol solution of alizarin red C (рН≤4). Alizarin paints the nuclei and apical part of cells of desquamated cylindrical epithelium intensively. At destruction of cells polymorphic cells with the diameter of 4-6 mkm are found in the swab, their cytoplasm is painted with alizarin diffusively, the cells have unpainted rare chromatin and from 2 till 5 nuclei painted with alizarin. At painting of induced sputum swab and bronchoalveolar lavage fluid with osmium antimonate there is localization of sodium cations in the region of contacts with lipid microorganisms. Alizarin red C paints the products of crystallization of bronchoalveolar lavage in cytological swab.

Morphological, morphometric and stereological characteristics of ciliated epithelial cells of the tracheal mucosa in albino rats during cooling of the body was studied. Three groups of laboratory animals were cooled for 3 hours a day at -15°C during 7, 14 and 21 days. After the experiment the stains from paraffin sections were made. With light microscopy planimetric and stereological quantities in the epithelial layer from the experimental and intact animals were measured. The measured values in the experimental groups were compared with the intact group. It was found out that at 7-day cooling epithelial height decreased by 33%; the size and roundness of ciliated cells increased against intact group by 48% and 49%, respectively. The volume density of epithelium decreased by 24%, the surface density by 12%, but the length density increased by 60%. At 14-day cooling the height was reduced by 51%, the area of ciliated cells decreased by 59%, and the roundness decreased by 25%. The volume density of epithelium decreased by 22%, the surface density by 24%; and the length density increased by 26%. Three-week cooling caused the reduction in the height of the epithelium by 34%.The area of ciliated cells was less than the control by 39%. The roundness exceeded the control by only 4%. The volume density of the epithelium decreased by 34%, the surface density by 37%; and length density increased by 13%. Among measured stereological parameters only the surface density was the most objective parameter of adapting epithelium as it has had the linear depending on the longitude of cold exposure.

The aim of the work is to analyze the influence of chronic cytomegalovirus infection during exacerbation on synthesis and transformation of steroid hormones, particularly progesterone, in placenta. The villous chorion was the material for the research. It was taken from the medical abortions of 30 pregnant women at the gestation of 11-12 weeks with chronic cytomegalovirus infection at exacerbation (the main group) and from 32 pregnant women at the same period of gestation without the pathology (the control group). The verification of cytomegalovirus, the identification of type-specific antibodies of M and G class and avidity index were carried out by immune-enzyme analysis; cytomegalovirus DNA was identified by PCR. The study of progesterone and cholesterol was done by spectrophotometric method. The analysis of cholesterol synthesis was conducted by histochemical method with the tetrazolium salts on cryostat sections. The activity of 3β-hydroxysteroid dehydrogenase and dehydrogenase of 5β-pregnen-3,20-dione was defined by histochemical method of Z.Lojda et al. with the use of 2 mM solution of Δ⁵pregnen-3β-ol-20-one and 5β-pregnen-3,20-dione. The exacerbation of cytomegalovirus infection in the first trimester of gestation led to the decrease of the cholesterol synthesis activity. As a result the decrease of the quantity of this predecessor of steroid hormones in the peripheral blood and placenta (р<0.05) was found out. Alongside the decrease of intensiveness of pregnelone transformation into progesterone was found. The decrease of hormone concentration in placenta was also identified (р<0.05). At the same time there was the lowering of the activity of 5β-pregn-3,20-dione transformation, which led to the disturbance of progesterone binding with receptors. Thus, at the exacerbation of cytomegalovirus infection there was a sharp drop of progesterone synthesis, which could create the threat to embryo death at the early stages of gestation.

In this paper we evaluated the activity of cytochrome oxidase and counted the number of apoptotic syncytiotrophoblast nuclei in 25 placentas obtained at delivery in pregnant women with 36-37 weeks gestation period who had been diagnosed with recurrent cytomegalovirus infection at 30-34 weeks. A statistically significant reduction has been found in the amount of reaction products for cytochrome oxidase in the presence of increased number of apoptotic nuclei of syncytiotrophoblast with a peak at 1:1600 titer of IgG antibodies to cytomegalovirus (p<0.05). During intersystem analysis of mutually dependent variables, an inverse relationship has been established between the number of apoptotic nuclei of syncytiotrophoblast and parameters of cytochrome oxidase activity in recurrent cytomegalovirus infection during pregnancy. The results suggest the involvement of mitochondrial factors - cytochrome oxidase and its deficiency in the development of metabolic dysfunction, including dysfunction at DNA level that increase appearance of apoptotic changes in the nuclei of placental syncytiotrophoblast. On the one hand, this fact is a probable reflection of tissue hypoxia, on the other - it indicates the initiation of intracellular enzymatic mechanisms of apoptosis, causing the development of placental insufficiency.

The results of electron microscopic studies of 35 umbilical cords obtained at birth from women undergoing cytomegalovirus infection in the third trimester of gestation (titer of IgG antibodies to cytomegalovirus 1:1600) - the main group (n=24) and from healthy pregnant women, the control group (n=11). It was found out that major violations evolved in the endothelial monolayer of umbilical vessels. In vessels there was the pattern of exudative and proliferative stages of diffuse endothelial inflammation. The signs of infectious and toxic damage associated with viremia, which is proved by dystrophic, apoptotic, necrobiotic and necrotic changes in endothelial cells and their desquamation were revealed. At the same time there was the destruction of the extracellular matrix and the basement membrane of blood vessels, the reduction of contacts between endothelial cells, as well as adhesion, transmigration and activation of leukocytes to the vascular wall, thereby remodeling the umbilical vessels and disrupting their function. Revealed changes in the endothelium may lead to disorders in dyscirculatory vessels and initiate the development of umbilical artery spasm and obstruction of the venous blood flow, which may be the cause of fetal hypoxia, resulting in intrauterine growth retardation and premature termination of pregnancy.

The study investigates the role of ω-6 polyunsaturated arachidonic acid in the umbilical artery endothelial injury in 30 newborns from mothers with acute exacerbation of cytomegalovirus infection (IgG antibody titer to cytomegalovirus 1:1600) in the 3^rd trimester. Analysis of the results shows that the increase in the content of arachidonic acid in pregnant women with exacerbation of cytomegalovirus infection is a pathogenic factor in the development of vascular endothelial damage, which is confirmed by presence of histochemical reaction products of fatty acid peroxide formed in the oxidation process of this acid. At the same time characteristic structural changes of the umbilical artery endothelium are: the increase of the heterogeneity of endothelial cells, the reduction of their order arranged in the monolayer, the increase of the number of cells in the state of apoptosis, high shedding of cellular elements in the vessel lumen. Revealed changes in the endothelium of the umbilical artery with cytomegalovirus infection can cause violations of the elastic properties of blood vessels, congestion and thrombosis, and therefore blood flow disturbance between mother and fetus, which further can become a factor in the development of fetal hypoxia. In such circumstances, it is advisable to add in food and prescribe ω-3 polyunsaturated fatty acids for women, whose pregnancy occurs against the background of exacerbation of cytomegalovirus infection. The expected outcome of this will not only the activity of lipid peroxidation decrease and, consequently, improve the functional activity of cells, but will also help to improve blood circulation in the mother-placenta-fetus, improve blood rheology, and reduce perinatal complications.

This paper presents a new approach to the assessment of blood oxygen transport function by the degree of erythrocytes affinity to oxygen in pregnant women with cytomegalovirus infection, which is based on the use of oxygen absorbing reagent followed by photometry and calculation of the coefficient of oxygenation of erythrocytes. 60 antibody-positive to cytomegalovirus pregnant women at 9-12, 18-22 and 30-34 weeks of gestation (the main group) and 60 antibody-negative pregnant women (the control group) were studied in dynamics. The study found the increase of the coefficient for erythrocyte affinity to oxygen was due to activity of cytomegalovirus infection during gestation. At the relapse of cytomegalovirus infection at 9-12 weeks the coefficient for erythrocytes affinity to oxygen was 5.62±0.03 relative units (the control - 3.05±0.05 relative units, p<0.05), at the persistence of the disease at 18-22 weeks it was 4.51±0.03 relative units (control - 3.11±0.07 relative units, p <0.05), and when there was latent infection during the gestation of 30-34 weeks it was 4.27±0.2 relative units (control - 3.32±0.3 relative units, p<0.05). The results suggest the influence of active cytomegalovirus infection on the increase of erythrocytes affinity to oxygen, which constitutes a violation of oxygenation processes and can cause the development of hemic hypoxia in pregnant women, which endangers the general metabolism in the «mother-placenta-fetus» system.

The state of blood flow in the right and left uterine arteries, umbilical cord artery and the medial cerebral artery of the fetus was studied in 171 women in the third trimester of gestation with the latent course and reactivation of chronic cytomegalovirus infection (CMVI) against the latent chronic herpetic infection. Doppler parameters in 30 women with physiological course of pregnancy were used as the control ones. It was found out that the patients with latent CMVI (the absence of IgM antibody to cytomegalovirus, the presence of IgG antibody to cytomegalovirus in the titer 1:400 and IgG avidity index to cytomegalovirus 68-75%) had the increase of vessels resistance in the right uterine artery till 2.45±0.07 (in the control it was 2.23±0.06, р<0.05) and in the umbilical cord artery till 3.24±0.13 (in the control it was 2.75±0.06, p<0.01). At reactivation of chronic CMVI in women (IgM antibody to cytomegalovirus 1:200-1:400, IgG antibody to cytomegalovirus 1:400-1:1600 and IgG avidity index to cytomegalovirus 56-70%) in comparison with the patients who had in their blood serum IgM antibody in the titer 1:200-1:400, IgG antibody to cytomegalovirus 1:400-1:800 and IgG avidity index to cytomegalovirus of 56-70% there was a more significant increase of the right uterine artery tonus (3.16±0.11 and 2.56±0.11, respectively, р<0.05), uterine artery (4.31±0.10 and 3.80±0.14, respectively, р<0.05) against the drop of the vessels resistance in the medial cerebral artery (3.95±0.13 and 4.41±012, respectively, р<0.05). These suggested significant hemodynamic disorders in the «mother-placenta-fetus» system and more intensive antenatal hypoxia as a result of antibody formation stimulation and the change of specific humoral antivirus immunity in pregnant women.

The results of the research of coal dust from the atmospheric suspensions contained in the snow and collected from 11 points around Karakansky mining cluster (Kuzbass) in the winter of 2011-2012 are presented. The mineral component of coal dust of light (La, Ce, Nd) and heavy (Y, Gd, Dy, Yb) rare earth elements was found out. Rare earth elements are presented in the form of phosphates (turnerite, xenotime), and also in the form of silicates (ortite). The increased toxicity of atmospheric suspensions of Karakansky Coal Mine of Kuzbass in the view of their high «contamination» with rare earth elements both in mineral and not mineral forms is anticipated.

Lymphangioleiomyomatosis (LAM) is a rare polysystem disease which appears predominantly in women of reproductive age (18-50 years old). LAM is conditioned by disseminated pathologic process which is characterized by tumor-like lesion of pathologic smooth muscle-like cells (LAM cells) around small bronchi, bronchioles, the walls of blood and lymphatic vessels of lungs with further small cystic transformation of pulmonary tissue, clinically revealed progressive apnea, pneumo- and chylothorax and blood spitting. LAM can appear sporadically or develop in patients with tuberous sclerosal complex. The usual roentgenograms show main roentgen signs of LAMs: diffuse intensification of lung pattern of a net type, cellular transformation of lung structure due to the great number of thin-walled cysts of different size as well as the increase of the lungs volume. At the early stages of the disease the roentgen changes are not always revealed especially when there is no pneumothorax or pleural fluid (chylothorax). According to the opinion of the majority of researchers computer-aided tomography is the basic method of roentgen diagnostics of LAM. It is without doubt the leading method of image diagnostics especially at asymptomatic course of the disease. This work shows one of the three personal archive clinical observations of LAM. Modern methods of computer-aided tomography are used in diagnostics: multispiral computer-aided tomography with postprocessing of obtained images including 3D reconstruction. With the help of original methodologies (3D volumetry of cystic masses at inhale and exhale) comparative qualitative analysis of the volume of cavity was done at different phases of the breathing cycle. The analytical observation of the literature for the last few years has been presented; it reflects the clinical characteristic of LAM, modern methods of diagnostics and primarily of roentgen diagnostics. Besides, differential-diagnostic algorithms have been presented, they can be used both at ambulatory-policlinic stage of diagnostics and within specialized centers.

Community-acquired pneumonia (CAP) is one of the most widely spread respiratory diseases in all countries of the world. Timely diagnostics and adequate therapy of CAP are one of the most important problems of the internal pathology. The basis of CAP therapy is the administration of antibacterial drugs (ABD), but in spite of antibacterial therapy (ABT), mortality from CAP is high. The increase of efficiency of CAP therapy is possible only in case of timely made diagnosis and adequate estimation of the patient condition, which determines indications for hospitalization, as well as in case of timely started therapy and rational choice of ABD, taking into account any possible agent. The article contains modern data about etiology of CAP and the limited range of CAP agents and sensibility of microorganisms to ABD. Indications are given to administrations of ABD, the principles of the empiric choice of ABD in case of unknown CAP agent. The criteria necessary for determining the degree of CAP severity are indicated. They are used to determine the place of treatment and therapy volume according to CAP severity, presence or lack of accompanying pathology. Rational combinations of ABD based on the supposed etiological CAP factor are given. It is considered to be the basis of rational ABT. The causes of the increased resistance of CAP agents to ABD in Russia and other countries and connected with this factor differences in home and foreign recommendations are indicated.

The cellular mechanisms regulating the replacement of dying differentiated cells are one of the basic questions in research of respiratory system epithelium reparation after the damage. Numerous works in this field have shown that airways epithelium is presented by two pools of cell-predecessors: a basal cell and a specialized secretory cell which is similar to Clara cell. Morphological and functional analyses of processes of airways epithelium reparation after the influence of various damaging factors have allowed to identify the above-stated cell as proponents of highly differentiated elements.

The data is presented about bacteria living under extreme conditions in the upper atmosphere and about the alleged number of them in the world and the annual transfer from one continent to another. Based on the concept of chemical evolution, possible stages of bacteria emergence have been studied, positive aspects of the theory and its shortcomings have been estimated. The problem of the origin of bacteria is considered from the standpoint of the panspermia hypothesis. The interest in it has increased due to new information about the presence of bacteria-like structures in Martian meteorites ALH 84001, Alais, Ivuna and Orguei, Murchison and Efremovka and the content of various organics including purine and pyrimidine compounds. It is assumed that these compounds were brought to the Earth by meteorites and induced the creation of the genetic code followed by the transition to the DNA-RNA-protein life. The view that the Earth had a ready-made genetic code has been expressed. It was found out that the first communities of bacteria appeared 3.5 billion years ago in the aquatic environment and their subsequent evolution took place against the background of the geological evolution of the Earth. Prokaryotic communities formed oxygen atmosphere, due to which aerobic bacteria, small (biotic) circulation of substances at the ecosystem level, appeared. Finally, as a result of anaerobic prokaryote endosymbiosis aerobic bacterium originated eukaryotic cells, which led to the emergence of the modern biosphere.