Aim. The analysis of the main problems of organization and management of medical care for patients with respiratory disrasrs in the Far Eastern Federal District is carried out. It is suggested to optimize and improve pulmo-nological care to the population and increase its effectiveness.

Materials and methods. For the organization of the study there were used the methods of structural and comparative analysis, content analysis of scientific literature on the problems of organization and management of pulmonary care, expert evaluation, statistical, sociological and information-analytical methods, databases of the Ministry of Health of the Russian Federation, the Federal State Statistics Service.

Results. It has been established that one of the significant regional problems at present time is significant territorial disparities in the provision of specialized pulmonary care for the population with health care resources: medical personnel and bed-care funds. In particular, the differences in the availability of pulmonologists in the region amount to 3.7 times, and by specialized hospital beds by 8.8 times. At the same time, in 3 subjects of the Far Eastern Federal District there are no specialists in the pulmonary profile, and the available bed capacity is mainly concentrated in the health care institutions of urban settlements, mainly in regional centers. Among the defects in the quality of medical care for patients with a pulmonary profile in outpatient conditions, the analysis shows that the main share is not represented by diagnostic errors or treatment defects, but by incomplete examination of patients, whose share is 62.1%, increasing to 76.1% in rural health institutions. The main causes of them are “the lack of necessary conditions” (from 20.2 to 36.8% depending on the nosological forms of pathology and the conditions of medical care) and “incomplete and inadequate examination” (from 16.7 to 56.7%).

Conclusion. The analysis of the resource provision of pulmonary care to the population indicates significant regional differences, the extent of which must be taken into account when planning and organizing specialized medical care in order to manage it better. At the same time, current trends cannot ensure equal accessibility and quality of medical care and create certain risks in the provision of the health care system of the constituent entities of the Russian Federation with specialized resources. Consequently, the conditions in which they carry out their work activities, the availability of opportunities for the realization of existing potential and its development play a significant role in ensuring the quality and efficiency of the work of specialists. At the same time, the analysis of expert and sociological assessment of resource provision, the conditions of medical care and the organizational and methodological mechanisms of its management indicates significant reserves that can be used in the organization of medical care for patients with a pulmonary profile at the primary health care level and increase its effectiveness. In this regard, optimization of the medical network and the structure of medical care in modern conditions should be one of the priorities of the regional policy.

Aim. To study the relationship between the structure of the inflammatory-cell pattern and the profile of respiratory cytokines with the nature of their changes in response to acute cold exposure in asthma.

Materials and methods. 42 patients with a diagnosis of persistent mild-to-moderate asthma were observed. All patients were treated with inhaled glucocorticosteroids. The comprehensive study included the assessment of asthma control, lung function before and after a 3-minute test of isocapnic hyperventilation with cold (-20°C) air (IHCA), the analysis of induced and spontaneously produced sputum with determination of cytosis, cell composition and concentration of IL-1b, IL-8, TNFα, IL-13, IL-18, IL-5, IL-10 initially and after the IHCA test.

Results. According to the results of the response to the IHCA, the patients were divided into two groups: the 1^st group (n=20) was with no reaction to IHCA, the 2^nd group (n=22) with cold airway hyperresponsiveness (CAHR) (AFEVj =-4.2±1.2 and -15.3±1.7%, respectively, p=0.001). The patients were comparable in terms of asthma control (ACT 19.6±1.4 and 19.1±1.3 points, respectively, p>0.05) and lung function (FEVt 94.1±3.1 and 101.2±3.9% pred., respectively, p>0.05). When analyzing sputum cytograms, the patients of both groups were characterized by a mixed pattern of bronchial inflammation with a large pool of eosinophils (4.65±1.49 and 7.0±2.0%, respectively, p>0.05) and neutrophils (57.0±2.18 and 52.2±2.96%, respectively, p>0.05). In response to the IHCA, an increase in cytosis was observed in the 2^nd group (by 0.04±0.21 and 0.94±0.23 cells/mcL, respectively, р<0.01), and the number of bronchial epithelial cells decreased in both groups (by 2.94±1.27 and 2.76±1.44%, respectively, p>0.05). In patients of the 2^nd group, a close relationship was found between the baseline content of sputum epithelial cells and FEVj/FVC (r=-0.57; p=0.009); MEF25-75 (r=-0.47; p=0.048), as well as between the number of macrophages and neutrophils (r=-0.86; p=0.000001), which indicated the dominant role of neutrophils in the implementation of CAHR. Under the influence of the cold trigger, a significant increase in TNFα levels, IL-1b and IL-8 concentrations were registered in group 2 in comparison to the 1^st group. In the general group of patients, a close correlation was found between the level of asthma control (ACT) and changes in the IL-1b concentration after the IHCA (r=-0.34; p=0.043), as well as between the initial concentration of TNFa in the sputum of patients and the severity of the bronchoconstrictor reaction to inhaled cold air (r=0.35; p=0.036).

Conclusion. It is suggested that the neutrophil pool of the bronchi of patients with CAHR is a critical factor in the development of an imbalance in the system of Th2 and Th1 types of cytokines regulating broncho-spasm. Bronchial epithelial cells were considered as an additional factor for stimulating the Th1 profile of cytokines. The decrease in the number of these cells is caused by destruction mediating the release of proinflammatory mediators from the cells.

Introduction. The respiratory complications prevail among the causes of postoperative mortality in the thoracic surgery. The respiratory muscle (RM) dysfunction may be considered as one of the most important pathogenetic factors of such complications.

Aim. To evaluate the RM strength in the early postoperative period after thoracic surgery.

Materials and methods. 52 patients were examined after elective thoracoscopy and thoracotomy surgery. The first group consisted of 24 patients with duration of the operation for 90 minutes and the less. The second group included 28 persons with duration of the surgery for more than 90 minutes. RM strength was measured using “MicroRPM” (CareFusion, UK). Maximal inspiratory (MIP), expiratory (MEP) and nasal (SNIP) pressure indicators were estimated at the following time points: before surgery, in 60 minutes, 180 minutes and 24 hours after extubation.

Results. The significant differences between the strength indicators of RM were revealed inside the both groups at the different phases of the investigation. The drastic drop of all the strength indicators in comparison with the initial values was detected in 60 minutes after the extubation in the patients of both groups. The values increased in 180 minutes. 24 hours after the surgery the readings of RM strength retained the growth trend, but they did not reach the initial values. Evaluation of the remainder between RM strength indicators before the surgery and at the specific time point revealed the significant differences between the compared groups in the terms of the reduction extent for MIP at all the time points, and for SNIP in 180 minutes after extubation only.

Conclusion. These data show the more evident dynamics of RM strength restoration with thoracoscopic techniques being used, which allowed to decrease the surgery duration and to reduce cumulative dose of the muscle relaxant.

Aim. To identify features of changes in electrical activity of inspiratory muscles and their relationship with anthropometric indicators in different age groups.

Materials and methods. There were examined 57 men with the same strength of respiratory muscles, aged 20 to 65 years old, who were divided into 3 groups. The 1st group included 26 young people, the 2nd group consisted of 20 middle-aged people, the 3rd group had 11 elderly patients. The examination included determination of anthropometric indicators, assessment of motor activity, inspiratory muscle strength, analysis of the electrical activity of inspiratory muscles when performing functional tests.

Results. In young people compared with patients of groups 2 and 3, a significant difference in anthropometric indicators was revealed. In patients of group 1, the dynamics of electromyography (EMG) indices of inspiratory muscles was the greatest when performing functional tests. There was revealed correlation between age and dynamics of the EMG amplitude indicators of external intercostal muscles (r=0.48, p<0.05), sternocleidomastoid muscles (r=-0.41, p<0.05) and diaphragm (r=-0.63, p<0.05); dynamics of EMG amplitude indicators of diaphragm and circumference of the chest on the inspiration (r=-0.77, p<0.05) and expiration (r=-0.73, p<0.05), dynamics of EMG amplitude indicators of sternocleidomastoid muscles and circumference of chest on inspiration (r=-0.61, p<0.05) and expiration (r=-0.59, p<0.05).

Conclusion. There is a negative relationship between dynamics of EMG amplitude indicators of inspiratory muscles when performing functional tests with age and chest circumference on inspiration and expiration. The main feature of electrical activity of inspiratory muscles in young people when performing functional tests is revealed in active participation of auxiliary muscles, in particular, the sternocleidomastoid muscle. In middle-aged and elderly people, dynamics of indicators of electrical activity of inspiratory muscles during performance of functional tests was the same.

Aim. To study the quality of life (QoL) in patients with COPD depending on the exacerbation risk category and the phase of the disease in correlation with respiratory symptoms.

Materials and methods. The study involved 53 patients with COPD who were divided into two groups. The group 1 included the patients of the low risk category of exacerbations (n=22), the group 2 had the patients in the high risk category (n=31). The frequency of exacerbations per year, the severity of respiratory symptoms, QoL using the CAT test and the mMRC scale were included in this analysis.

Results. The level of QoL (according to the CAT test) in group 1 during exacerbation is significantly worse by 16.5% (p<0.05) than with stable COPD. In group 2, QoL was significantly lower than in group 1 at both points of the study (p <0.001). In most patients of group 1, the severity of dyspnea by mMRC was <2 points, in group 2 it was ≥ 2 points. Moreover, in group 1, the indicator was significantly lower than in group 2 (p<0.001). In patients of both groups during exacerbation, positive associations were found between the CAT test, severity of cough (r=0.31; p<0.05) and sputum (r=0.31; p<0.05). It was revealed that the risk of frequent symptoms with stable COPD in group 2 was significantly higher than in group I (RR=0.33; 95% CI [0.18-0.61]) and it increased in the period of exacerbation by 19% (RR=0.52; 95% CI [0.34-0.79]).

Conclusion. Based on the data obtained, it was found out that QoL in patients with COPD is associated with a risk category of exacerbations and a phase of the disease. Regardless of the risk category, QoL, according to the CAT test, is associated with the severity of respiratory symptoms. The risk of frequent symptoms is increased in patients with COPD of the high risk category both during exacerbation and during the stable course of the disease, and is significantly higher than in patients of the low risk category.

Introduction. Chronic kidney disease (CKD) is a common pathology of non-infectious etiology. However, there are not enough studies on renal dysfunction in chronic obstructive pulmonary disease (COPD).

Aim. To study the functional state of the kidneys in patients with COPD by assessing the glomerular filtration rate (GFR) and identifying factors associated with its change.

Materials and methods. The study included 65 patients (from 45 to 60 years old) with moderate and severe COPD. Research methods included assessing the severity of clinical symptoms, the number of exacerbations which the patients suffered over the previous year, GFR calculation by the level of creatinine (GFRcr) and cystatin C (GFRcys).

Results. The study revealed that 16.9% of patients with COPD had a decrease in GFRcr<60 mL/min / 1.73 m² for 3 months. It allows to diagnose CKD. Hyperfiltration was statistically more often detected when calculating GFR by cystatin C level than when using serum creatinine. The level of GFRcr was statistically lower in individuals with severe clinical symptoms and amounted to 85.1 [65.9; 103.9] mL/min / 1.73 m², which was 1.1 times lower than in individuals with low severity symptoms (93.4 [85.6; 119.7] mL/min / 1.73 m²). GFR in patients with COPD is associated with age, body mass index, smoking person index, severity of inflammation, ventilation disorders, clinical symptoms, hypoxia.

Conclusion. Changes in GFR of varying severity were detected in a large number of patients with COPD. Evaluation of GFR by cystatin C level is more preferable for early detection of hyperfiltration. In individuals with severe clinical symptoms, changes in GFR are more significant than in the group with a low severity of symptoms. Based on the obtained data, it seems appropriate to determine GFR for patients with COPD in dynamics for the early detection of signs of renal dysfunction and the development of therapeutic and preventive measures.

Aim. To study the effect of hypothermia and hypogravity on the morphofunctional state of the mucous membrane of the trachea.

Materials and methods. The conditions of hypogravity were modeled in a clinostat for modeling hypogravity (Patent RU183861U1). The study was conducted on 30 male rats, 8-10 weeks old with a body weight of 150300 g. All animals were divided into 3 groups (the control one including intact rats; the experimental one with rats of orthostatic hanging for 30 days and the experimental one with orthostatic hanging for 30 days against the background of cold (-15°C) exposure in a climate chamber. Oscillatory activity of cilia was recorded using a computer system. To evaluate the cilia activity, the frequency of cilia beating by cilia per second of time (Hz) was recorded as well as histological analysis of tracheal tissues.

Results. It was found out that a combination of two stress factors, which include orthostatic hanging and prolonged exposure to low temperatures, significantly changes the morphological and functional structure of the tracheal mucosa compared with the intact group of animals and the group of orthostatic hanging. Long-term action of cold and orthostatic hanging was accompanied by a decrease in the height of the cilia of the ciliated epithelium and tracheal epithelium, accompanied by a significant decrease in cilia vibrations.

Conclusion. The combined effect of the orthostatic hanging and prolonged exposure to low temperatures leads to morphological and functional disturbance of the mucosal epithelium, which in the future will require appropriate correction.

Aim. To study the effect of exacerbation of cytomegalovirus infection (CMVI) in women in the third trimester of pregnancy on utero-placental, fetal-placental and fetal blood flow.

Materials and methods. 120 women were examined at 31-34 weeks of pregnancy, uncomplicated and complicated by CMV exacerbation. The first group consisted of 30 seronegative women with physiological pregnancy, the second one had 30 women of the same gestation period with latent CMVI, the third one included 30 women with CMVI exacerbation and the fourth one had 30 patients who had CMVI exacerbation combined with symptoms of threatened miscarriage.

Results. It was found out that in the second group the systolic-diastolic ratio (SDR) in the right uterine artery was 1.96 [1.74 -2.43] relative units, and in the left one it was 1.98 [1.81-2.16] relative units (in the first group it was 1.72 [1.61-2.22] relative units, p=0.0060 and 1.65 [1.55-2.23] relative units, p=0.0026, respectively). At the same time, the value of SDR in the umbilical artery and the middle cerebral artery did not differ significantly in these groups. In women of the third group, compared to the second group, there was an increase in SDR in the right uterine artery to 2.43 [1.14-3.11] relative units (p=0.00006), in the left uterine artery to 2.49 [1.91-3.51] relative units (p=0.0069). At the same time, vascular resistance in the umbilical artery increased to 3.26 [2.913.91] relative units and vascular resistance (SDR) decreased in the middle cerebral artery to 4.43 [3.79-4.59] relative units (in the second group it was 2.66 [2.48-3.03] relative units, p=0.000005 and 5.1 [4.59-5.90] relative units, p=0.000008, respectively). In the fourth group, in comparison with the third one, the highest values of SDR, pulsator index (PI) and resistance index (RI) were registered in the right uterine artery: SDR was 3.18 [2.55-3.60] relative units, p=0.0073; PI was 1.37 [1.07-1.58] relative units, p=0.010; RI was 0.68 [0.61-0.72] relative units, p=0.010; in the left uterine artery: SDR was 3.08 [2.53-3.60] relative units, p=0.0096; PI was 1.38 [1.06-1.58] relative units, p=0.012; RI was 0.68 [0.61-0.72]) relative units, p=0.010; and in the umbilical artery: SDR was 3.86 [3.38-4.35] relative units, p=0.0027; PI was 1.30 [1.211.51] relative units, p=0.0017; RI was 0.74 [0.72-0.80] relative units, p=0.0043 against the background of lower SDR values in the middle cerebral artery (3.95 [3.08-4.23] relative units, p=0.0083; RI was 0.75 [0.67-0.76] relative units, p=0.0063).

Conclusion. An increase in vascular resistance in the right and left uterine arteries may indicate a change in the structural and functional state of the endothelial lining of the uterine arteries and a violation of the morphological structure of the spiral arteries, and in the umbilical artery - an increase in resistance to blood flow in the terminal branches of the chorion villi. In the pathogenesis of decreased vascular resistance in the middle cerebral artery, the expansion of fetal cerebral blood vessels against the background of an exacerbation of CMVI associated with the threat of miscarriage in pregnant women is played an important role.

Aim. To study the role of eicosapentaenoic acid and superoxide dismutase in the development of hemic hypoxia in first-trimester pregnant women with an exacerbation of cytomegalovirus infection (CMVI).

Materialsandmethods. A comparative analysis of data obtained during the examination of 75 pregnant women of the first trimester aged 18 to 36 years old, among whom there were 40 with exacerbation of chronic CMVI (the main group) and 35 practically healthy women with uncomplicated pregnancy (the control group). IgM and IgG antibodies to CMV, low-avidity IgG (avidity index) were determined by solid-phase enzyme immunoassay. CMV DNA was detected by real-time PCR analysis. The content of eicosapentaenoic acid (in %) in the membrane of peripheral blood erythrocytes was studied by gas-liquid chromatography. The study of superoxide dismutase activity (in U/g Hb) in red blood cells was performed by spectrophotometry.

Results. The study found that the antioxidant potential of peripheral blood red blood cells was suppressed in women with exacerbation of chronic CMVI, as indicated by a decrease in the concentration of eicosapentaenoic acid by 25% (p<0.001) and the enzymatic activity of superoxide dismutase by 33% (p<0.001), compared with similar indicators of the control group.

Conclusion. Exacerbation of chronic CMVI in the first trimester of gestation is associated with a disturbance of the antioxidant potential of peripheral blood red blood cells, due to low levels of о низким уровнем ɷ-3 eicosapentaenoic acid and enzymatic activity of superoxide dismutase. The revealed changes in eicosapentaenoic acid and superoxide dismutase levels in women with exacerbation of chronic CMVI indicate their pathogenetic role in the development of hemic hypoxia. As a result of inhibition of antioxidant protection, the interaction and content of proteins associated with the lipid bilayer is disrupted, which leads to changes in the microviscosity and deformability of red blood cell membranes, a decrease in the functional activity of red blood cells, and the development of hemic hypoxia.

Introduction. Cytomegalovirus infection (CMVI) causes placental abnormalities, almost always accompanied by an imbalance of steroid hormones. It was decided to analyze which stages of hormonal metabolism are most affected by it. One of the markers of placental insufficiency and the development of the threat of termination of pregnancy is 5β-pregnandiol.

Aim. To study the content of 5β-pregnan- 3α, 20α-diol in the placenta of early stages in the exacerbation of CMVI during pregnancy.

Materials and methods. There were studied 98 samples of chorion villi taken during medical abortions at 5-6, 7-8 and 9-10 weeks of pregnancy from practically healthy women (control group) and pregnant women with laboratory-diagnosed CMVI exacerbation (main group). CMVI was diagnosed by determining class M- and G-antibodies using the ELISA, cytomegalovirus DNA was detected by PCR. The content of 5β-pregnan-3α, 20α-diol in the placenta was determined by cytophotometry.

Results. There was a statistically significant (p<0.001) decrease in the content of 5β-pregnan-3α, 20α-diol in samples of villous chorion in pregnancy complicated by CMVI exacerbation at 5-6 weeks (10.08±1,034 and 15.63±1,067 standard units, respectively), 7-8 weeks (12.63±1.098 and 18.56±0.993 standard units, respectively) and 9-10 weeks (17.17±1.107 and 25.90±1.591 standard units, respectively).

Conclusion. The findings suggest that exacerbation of CMVI in the first trimester of pregnancy is associated with impaired production of 5β-pregnane-3α, 20α-diol in the placenta, which may indicate the formation of a threatened abortion.

Aim. To study the structural organization of the connective tissue of the vein wall of the umbilical cord vessels from seropositive to cytomegalovirus (CMV) women with an exacerbation of infection in the third trimester of pregnancy.

Materials and methods. There was done the study of the activity of glycosaminoglycans in the connective tissue of the vascular wall of the vein and the content of elastase in the umbilical cord homogenate obtained during childbirth at 38-39 weeks of pregnancy from 35 CMV-seropositive women with an exacerbation of infection in the third trimester of pregnancy (the main group), and from 32 CMV-seronegative women (the control group). The material for the histo-chemical study was the sections of the venous wall of the umbilical cord vessels adjacent to the placenta. The activity of glycosaminoglycans was studied by Steedman, the content of elastase was studied by enzyme immunoassay.

Results. The study of umbilical cord tissue extracts revealed a 1.3-fold increase in immune enzyme elastase indices (p<0.001) in the group of CMV-seropositive women with an exacerbation of infection in the third trimester of pregnancy. Histochemical examination of the same umbilical cords revealed an increase in the intensity of the reaction to acidic glycosaminoglycans located in the subendothelial layer, in the intermuscular layers of connective tissue, in the cytoplasm of fibroblasts and in the smooth muscle cells of the inner layer of the umbilical vein muscles. The most pronounced reaction to glycosaminoglycans was detected in the collagen fibers of the subendothelial layer of the umbilical vein. In addition, areas of pronounced destruction and desquamation of endothelial cells were detected. The connective tissue of the subendothelial layer was characterized by the disappearance of the tortuosity of collagen fibers with signs of atrophy and a decrease in the number of cell elements in the vascular wall.

Conclusion. Based on the results of the study, it was shown that the exacerbation of CMV infection in the third trimester of pregnancy is characterized by an increase in the enzymatic activity of elastase and the production of acid glycosaminoglycans in the connective tissue of Wharton’s jelly, which leads to the destruction of collagen fibers and disturbance of the framework and elasticity of the vascular wall of the umbilical vein.

Aim. To assess the functional state of the liver in congenital cytomegalovirus infection in dead full-term newborns.

Materials and methods. 59 newborns who died on the 2-5 day of life were examined. 25 of them (the first, control group) did not have intrauterine viral aggression and sexually transmitted infections against the background of the absence of a negative impact of moderate and severe somatic and obstetric pathology in their mothers during gestation; in 18 (second group, comparison), markers of congenital infection were not determined against the background of an exacerbation of cytomegalovirus infection in their mothers in the second trimester of pregnancy; 16 (the third group, the main group) were diagnosed with intrauterine cytomegalovirus infection. The cause of death of children in the first group was complications of childbirth, intrapartum hypoxia, atelectasis and hyaline membrane lung; in the second one there were utero, intrapartum and postnatal hypoxia, and atelectasis of the lungs; in the third group there was cerebral ischemia, ven-triculomegaly, choroid plexus pseudocyst and subarachnoid hemorrhage, local and generalized forms of congenital infection. The content of total protein, albumins, total, indirect, and direct bilirubin, medium-molecular peptides, and lactate dehydrogenase activity were determined in blood serum from the umbilical vein using a biochemical method.

Results. It was found out that the second group of newborns in comparison with the first group did not show significant differences in the concentration of total protein and albumins. At the same time, in the third group, there was a drop in the total protein content to 52.8±1.28 g/L (in control it was 61.8±1.42 g/L; p<0.05) and albumins to 31.2±1.34 g/L (in control it was 38.2±1.21 g/L; p<0.05) against the background of the maximum increase in total bilirubin to 40.0±2.05 mmol/L (in control it was 26.5± 2.18 mmol/L; p<0.001), indirect bilirubin to 37.9±2.04 mmol/L (in control it was 24.6±2.17 mmol/L; p<0.001), direct bilirubin to 2.61±0.18 mmol/L (in control it was 1.89±0.07 mmol/L; p<0.001), lactate dehydrogenase to 267.6±12.41 IU/L (in control it was 210.6±10.12 IU/L, p<0.001) and medium-molecular peptides to 0.312±0.012 units of optical density (in control it was 0.278±0.005 units of optical density; p<0.001).

Conclusion. The above-mentioned biochemical changes indicate that the predominance of anaerobic processes and more pronounced endotoxemia play an important role in the pathogenesis of disturbances of the liver's protein synthesis and pigment functions in newborns with intrauterine cytomegalovirus infection.

Introduction. The study of the possibility of reducing toxic damage to the liver by carbon tetrachloride by the introduction of natural antioxidants is of interest, since the search for antioxidant agents with hepatoprotective activity is an important area of research in experimental pharmacology.

Aim. To study the possibility to correct free radical lipid oxidation of rats’ organism membranes with the introduction of the phytoadaptogens.

Materials and methods. The animals were divided into 5 groups and each of them had 10 rats: intact animals (1) which were held in standard conditions of vivarium; the control group (2) in which rats were given carbon tetrachloride during 3 days daily; the experimental groups (3, 4, 5) in which before the introduction of carbon tetrachloride animals had a daily oral intake of the tincture ginseng, of the tincture schizandra, of the tincture aralia in a dose of 1 ml/kg.

Results. It was found out that in the blood and in the liver of experimental animals the introduction of carbon tetrachloride during 3 days contributes to the increase of lipid hydroperoxides level (by 23 and 43%, respectively), of diene conjugate (by 22 and 39%), and of malonic dialdehyde (by 55 and 79%) against the decrease of antioxidant system activity in the blood of intact animals. The introduction of the phytoadaptogens to rats in the conditions of oxidative stress contributes to the decrease in the blood of lipid hydroperoxides by 13-18%, of diene conjugates by 13-18%, malonic dialdehyde by 19-29% in comparison with the rats of the control group, in the liver by 17-25, 17-24 and 32-39%, respectively. While analyzing the effect of the phytoadaptogens on the activity of the components of antioxidant system it was shown that the level of ceruloplasmin in the blood of animals was higher by 26-41%, of vitamin E by 4-23% in comparison with the same parameters of the rats of the control group, in the liver by 32-74 and 47-57%, respectively.

Conclusion. So, the application of the mentioned phytoadaptogens in the conditions of introduction of carbon tetrachloride in the organism of animals under experiment leads to the stabilization of the processes of peroxidation against the increase of antioxidant system activity.

This review summarizes and analyzes the results of modern experimental studies indicating the involvement of mechanical stress as an independent key factor in the formation of airway remodeling in patients with chronic obstructive lung diseases, in particular asthma and chronic obstructive pulmonary disease (COPD). The mechanisms modulating the structural changes of the respiratory tract are described at the level of the respiratory epithelium, fibroblasts, and smooth muscle cells. Attention is paid to possible molecular mechanisms mediating the effect of mechanical stress on the respiratory tract under conditions of increased bronchial resistance. Possible participation of transient receptor potential (TRP) channels with mechanoreceptor properties in the process of remodeling is reviewed. These channels are widely expressed in the respiratory tract and can affect the formation of structural changes in the bronchial wall in asthma and COPD under the influence of mechanical forces leading to tissue deformation. To date, there are no effective pharmacotherapy agents that may prevent airway remodeling in patients with asthma and COPD, what makes the study of the role of the mechanoreceptors in this pathological process extremely relevant.

Introduction. In modern pulmonology, chronic non-specific lung diseases are considered as multifactorial diseases. They are based on increased sensitivity to environmental factors. A significant role in the manifestation of lung diseases is played by genetic component, in particular, xenobiotic biotransformation enzyme genes of the glutathione-s-transferase family (GSTS). Glutathione-s-transferases (GST) are a family of enzymes involved in detoxification. Genes encoding the proteins GSTA1, GSTM1, GSTP1 and GSTT1 are polymorphic, this can lead to complete or partial loss of enzyme activity and be a predisposing factor for the development of various pathological changes in sensitive people.

Aim. A review containing data on the association of the risk of developing lung diseases in carriers of polymorphic genes encoding the second phase enzymes of the xenobiotic detoxification system of the glutathione transferase family to present the current state of the issue, to understand the direction of research and unresolved problems.

Materials and methods. There was made an analysis of publications containing the results of a study of the association of the risk of lung diseases in carriers of polymorphisms of xenobiotic biotransformation genes of the GTSS family.

Results. The analysis data indicate the association and adverse effect of functionally defective alleles of the genes of the glutathione-s-transferase family (GSTM1 (0), GSTP1 (s) and GSTT1 (0)) on the course of bronchial asthma. The results of studies on the associations of various variants of genetic polymorphism and the development of bronchial asthma are associated with the differential sensitivity of people to various environmental factors, the presence of ethnic differences, combinations of functionally defective variants of several genes.

Conclusion. Evaluation of the role of polymorphisms of xenobiotics biotransformation genes in the study of phenotypes of lung disease in children helps to improve and optimize diagnostic and therapeutic measures.

This article presents a brief review on blood oxygen-transport-function of pregnant women with community-acquired pneumonia. At this moment, the reasons of the increased number of severe complications and fatal outcomes among pregnant women with pneumonia have not been identified. Influenza viruses take a special place among the causative agents of community-acquired pneumonia of pregnant women. Pregnant women are considered as an independent risk group due to the development of adverse outcomes of the disease. During physiological pregnancy, susceptibility to respiratory infections and the probability of complications increase as a result of significant increase in gas and energy exchange. During pregnancy, a number of compensatory mechanisms are activated to facilitate optimal, more intensive functioning of the respiratory system. This provides a normal course of pregnancy and childbirth. In case of community-acquired pneumonia, the activating of compensatory mechanisms becomes difficult or impossible. Respiratory disorders with hypoxia, changes in energy metabolism, immune status disorders and the presence of an infectious and inflammatory focus associated with respiratory diseases may have a negative effect on pregnancy. In turn, a number of obstetric complications and gynecological diseases can cause serious disorders of the respiratory and cardiovascular systems. Minimal changes in the mother's PaO₂ and PaCO₂ levels may indicate severe respiratory dysfunction and fetal oxygenation disorders even in the absence of a vivid clinical picture. The amount of information in literature on the state of oxygen transport function and hemodynamics in the fetoplacental complex while suffering from pneumonia depending on the period of gestation period is insufficient. There is not enough data on the course of pregnancy and fetal compilations caused by different types of pathogen, stage of pregnancy and severity of infectious process. The condition of the fetoplacental system of women with pneumonia is of great interest.