Since the beginning of the 50s of the last century, numerous classifications of sarcoidosis have been proposed, which to one degree or another satisfied specialists at certain stages of the development of medical technologies. Currently, sarcoidosis of the respiratory system is divided into five stages (from 0 to IV) based on the results of chest Xray examination. Active introduction into clinical practice of computed tomography and its more advanced version – lowdose multislice computed tomography (MSCT) – allows to carry out an effective diagnosis of sarcoidosis, including in outpatient practice, as well as when performing active screening and dynamic monitoring of the course of the disease. On the basis of the studies which were carried out, the dissonance between the progress in technology (from X-ray pattern to MSCT) and the stagnation of the conceptual issues of the classification of sarcoidosis is discussed, which urgently requires its reforming. Firstly, the category of patients with concomitant lesions of the intrathoracic lymph nodes (ITLN) and parenchyma (stage II) has sharply increased, which reflects the increased technological level of radiological diagnostics. As a result, the percentage of stages with isolated lymph node involvement (stage I) and isolated dissemination of the parenchyma (stage III) decreased. The classification based on MSCT data allows to more accurately determine the severity of the disease. This is of therapeutic and prognostic importance, since most patients of stage I generally do not need treatment, while symptomatic stage II requires hormone therapy. One should also take into account the possibility of spontaneous remission, which is observed more often in stage I. The main conclusion is that at present day the principle of staging in the classification of sarcoidosis can no longer satisfy the realities of modern clinics. It is more correct to single out the clinical and radiological forms of sarcoidosis: sarcoidosis of the ITLN, sarcoidosis of the ITLN and lungs, sarcoidosis of the lungs, as well as sarcoidosis of the respiratory system, combined with a single lesion of other organs.

Aim. A scientific assessment of the main indicators of morbidity and mortality of the population from laryngeal cancer in the Far Eastern Federal District over the past ten years (2009-2019).

Materials and methods. In the process of work, indicators of morbidity and mortality, reporting forms of statistical registration of oncological patients and regulatory documents of higher organizations, information on ten-year observations on the dynamics of changes in digital values of the investigated pathology were used.

Results. The main data on morbidity and mortality of patients with laryngeal cancer are given in the Far Eastern Federal District, where 2019 new cases of malignant neoplasms were registered in 34152, which is 8.5% more than ten years ago. There were 2171 patients with laryngeal cancer under outpatient observation, i.e. 26.5% per 100.000 population in the region. In the structure of primary morbidity and total mortality among all departments of the respiratory system, laryngeal cancer ranked second after malignant neoplasms of the trachea, bronchi and lung. During the study period, the number of patients with advanced forms of the disease increased with a simultaneous decrease in the number of patients with stages I and II of the oncological process. Over the past ten years, the incidence of disease has increased more significantly in the female population. The percentage of actively identified patients during this time increased by several orders of magnitude, with a simultaneous increase in the index of the accumulation of populations of patients with laryngeal cancer. Morphological confirmation of the diagnosis was lower than the Russian average. The proportion of patients registered for five years or more did not reach the average republican values. Lethality in the first year since the diagnosis was established was characterized by dynamically decreasing digital values, despite the increase in the number of neglected cases, which can be explained by the high level of modern methods of treatment.

Conclusion. Against the background of the increasing absolute number of patients with malignancies in the Far Eastern Federal District in 2019, there was a decrease in standardized indicators (world standard) of morbidity and mortality from laryngeal cancer in the male population, with an increase in the number of women who fell ill and died from this pathology.

Aim. To assess the functional parameters of the respiratory system and their impact on the survival of patients with lymphangioleiomyomatosis (LAM).

Materials and methods. A study of lung function (spirometry, bodyplethysmography, diffusion test) was carried out in 131 patients with LAM (mean age 41±10 years), who were under observation and treatment in medical institutions in Moscow (Pulmonology Scientific Research Institute, Sechenov University, Moscow City Clinical Hospital named after D.D.Pletnev). The diagnosis of the disease was made based on the diagnostic criteria for LAM, formulated by a group of experts at the initiative of the European Respiratory Society in the guidelines for the diagnosis and treatment of LAM.

Results. The mean VC value was 95±25% pred., FEV₁ /VC − 56±20%, FEV1 − 64±31% pred., DL_CO − 49±24% pred. DL_CO, FEV₁ /VC, FEV₁ and VC were reduced in 87, 76, 70 and 27% of patients, respectively. The obstructive ventilatory defect was detected in the overwhelming majority of cases − in 75%, restrictive ventilatory defect − in 4 patients, mixed defect − in 1 patient. In 28 (21%) patients, there were no pulmonary ventilation disorders. The Cox regression model showed that baseline DL_CO and FEV₁ are the main factors determining the risk of death.

Conclusion. In patients with LAM, the obstructive ventilatory defect predominates, the restrictive ventilatory defect is quite rare. The lung diffusion capacity is reduced in 87% of patients with LAM. Parameters of lung function are closely related to survival.

Introduction. Obstruction of small airways in asthma is accompanied by greater hypersensitivity to nonspecific irritants and inflammation activity, which is associated with a worsening of the clinical course of the disease. The combination of beclomethasone dipropionate/formoterol fumarate (BDP/FF), used in the form of an extrafine metered dose aerosol, is capable of having an anti-inflammatory effect on the small airways. Dynamic changes in the structure and function of granulocytes of inflammatory bronchial infiltrate after exposure to cold air in patients with asthma treated with BDP/FF have been little studied.

Aim. To study the nature of changes in eosinophil and neutrophil pools of bronchial granulocytes in asthma patients with cold airway hyperresponsiveness (CAHR) during long-term therapy with extrafine BDP/FF.

Materials and methods. The clinical study involved 25 asthma patients with CAHR. The design of the work included a questionnaire survey of patients using the Asthma Control Test (ACT) questionnaire, spirometry (Easy on PC, ndd Medizintechnik AG, Switzerland), an isocapnic hyperventilation by cold air (IHCA), collection and cytological examination of induced and spontaneously produced sputum. The examination was carried out at the beginning and after 12 weeks of BDP/FF therapy (100/6 μg, twice a day).

Results. 12-week treatment with extrafine BDP/FF led to an improvement in asthma control (ACT increased from 17.1±1.1 to 22.5±0.5 points, p˂0.001) and patency of small bronchi (increase in МEF₅₀ was 0.47±0.21 L/s, МEF_25-75 – 0.42±0.17 L/s). BDP/FF therapy had a positive effect on cellular inflammation, leading to a decrease in the number of eosinophils in sputum from 9.5 (3.0; 19.5) to 2.2 (1.3; 4.7)% (p˂0,05). A decrease in the number of eosinophils was also observed after cold bronchoprovocation: from 9.0 (2.8; 15.4) to 4.7 (2.8; 7.8)% (p˂0.05). There was no dynamics in neutrophils after BDP/FF treatment before and after IHCA (59.9±1.3 and 57.1±2.0%, respectively, p>0.05).

Conclusion. Improvement of disease control in asthma patients with CAHR after 12 weeks of therapy with extrafine BDP/FF is associated with the regulation of eosinophilic inflammation, a decrease in the number of eosinophils in the airways and suppression of the activity of the neutrophilic pool of bronchial granulocytes in response to cold bronchoprovocation. 

Introduction. Hypoalimentation with the formation of protein-energy malnutrition can reduce the body’s resistance to acute respiratory infections (ARI). Soy and pumpkin can be a promising source of normalization of the diet.

Aim. To study the effectiveness of the use of soybean-pumpkin products in the diet of healthy people to increase the resistance of the human body to ARI.

Materials and methods. An open, randomized, parallel group study was conducted. Group 1 included 18 people who took a soy-pumpkin drink and dessert for 10 weeks in addition to their usual diet. Group 2 included 17 people on a regular diet. The concentration of vitamin E, cholesterol, α- and β-lipoproteins was determined in blood serum. Diene conjugates and unoxidized lipids were determined in the expired air condensate (EAC) by means of spectrophotometry. Lung function was assessed using spirometry.

Results. According to the questionnaire survey, 50% of the participants in group 1 registered a positive dynamics from the regular use of soybean-pumpkin products. Only one participant underwent ARI. In the 2nd group, 7 people (41%) applied for medical help (χ²=4.43; p˂0.05), of which 6 (35%) had ARIs. At the end of the observation, an increase in vitamin E (from 34.1±0.68 to 36.4±0.55 μg/mL, p=0.0036), a decrease in total cholesterol (from 4.85±0.23 to 4.32±0.14 mmol/L, p=0.0013) and β-lipoproteins (from 2.92±0.24 to 2.31±0.18 mmol/L, p=0.0003). At the beginning of the study, in individuals of group 1, there was a relationship between age and the concentration of total cholesterol (r=0.50; p=0.036) and β-lipoproteins (r=0.47; p=0.048), as well as the weight and level of α-lipoproteins (r=-0.49; p=0.041), the concentration of unoxidized lipids (r=0.55; p=0.02), diene conjugates (r=0.48; p=0.043) in EAC. After regular use of soybean-pumpkin products, this correlation dependence was lost.

Conclusion. Regular use of soy-pumpkin products for 10 weeks has a beneficial effect on the lipid profile of the blood, increases antioxidant defence, and reduces the susceptibility of a healthy person to ARI.

Introduction. Cytomegalovirus infection (CMVI) makes a significant contribution to the development of pregnancy pathologies, including dysfunction of the placenta. However, the mechanism of such an effect of CMV has not been precisely established. For the coordination of biochemical reactions in the placenta, an optimal concentration of substances, including nucleotides, is required. Nucleoside diphosphatase is an enzyme that catalyzes the hydrolysis of nucleotide diphosphates to nucleotide and phosphate.

Aim. Determination of the activity of nucleoside diphosphatase in the placenta in physiological and complicated CMVI reactivation in the third trimester of pregnancy.

Materials and methods. A study of 62 placentas obtained during childbirth at 38-40 weeks was carried out. The first group consisted of the placentas from women with CMVI reactivation in the third trimester of pregnancy and the second – the placenta of women without a history of infectious pathology. Diagnosis of CMVI was carried out by determining antibodies of class M and G by ELISA, as well as CMV DNA was detected by PCR. Histochemical analysis of nucleoside diphosphatase was performed according to the method of A.B.Novikoff and D.S.Goldfischer modified by Z.Lojda et al.

Results. In the second group, the placenta nucleoside-diphosphatase had a pronounced activity in the syncytiotrophoblast and the connective tissue stroma of the villi. When CMVI was reactivated in the third trimester of pregnancy, a decrease in the intensity of the histochemical reaction to nucleoside-diphosphatase was found: the cytophotometric index in the first group significantly (p<0.001) decreased to 13.06±0.089 rel. units (in the second group it was 14.11±0.119 relative units).

Conclusion. The decrease in the activity of nucleoside diphosphatase found during the reactivation of CMVI in the third trimester of pregnancy might indicate a decrease in nucleotide metabolism in the placenta. In our opinion, the study of enzymes involved in the exchange of nucleotides will help to reveal the mechanisms by which CMV causes disturbances in the functioning of the placenta, leading to the development of complications of pregnancy.

Aim. To carry out a comparative analysis of the phospholipid profiles and annexin V content in the villous chorion obtained from women with spontaneous abortion associated with exacerbation of cytomegalovirus infection (CMVI) and the physiological course of pregnancy.

Materials and methods. 66 patients were randomly selected at a gestational age of 6-8 weeks. A control group was identified in the amount of 32 healthy pregnant women with medical abortion. The main study group consisted of 34 women with spontaneous abortion associated with exacerbation of cytomegalovirus CMVI. The material for the study was the villous chorion, peripheral blood and urine. Type-specific antibodies to CMV immunoglobulins M and G class and the avidity index were determined in blood serum by the method of enzyme-linked immunosorbent assay. Lipids in the villous chorion homogenate were extracted with a chloroform-methanol mixture, phospholipids were fractionated by thin layer chromatography. The quantitative determination of annexin V was carried out by the method of enzyme immunoassay.

Results. The phospholipid profile of the villous chorion in the main group was characterized by a decrease in the fraction of phosphatidylcholine to 22,39±0,04% (control group – 28,50±0,052%; p<0,001), phosphatidylethanolamine to 27,63±0,011% (control group – 30,11±0,073%; p<0,001), phosphatidylinositol up to 14,24±0,021% (control group – 16,17±0,018%; p<0,001), an increase in lysophosphatidylcholine up to 2,25±0,032% (control group – 1,07±0,022%; p<0,001), phosphatidylserine up to 14,57±0,075% (control group – 10,02±0,012%; p<0,001), sphingomyelin up to 18,92±0,012% (control group – 14,13±0,012%; p<0,001). At the same time, an increase in the content of annexin V was revealed up to 43,12±0,50 U/mL (control group – 20,21±0,50 U/mL; p<0,001).

Conclusion. The results of the study showed that in the villous chorion from women with spontaneous abortion associated with exacerbation of CMVI, there was a change in the profile and ratio of phospholipids, as well as in the concentration of annexin V. The established increase in the content of phosphatidylserine and the associated annexin V in the villous chorion indicates a violation of the hemostatic system and microcirculation due to increased thrombus formation, which supports local inflammation and apoptosis of the trophoblast, which leads to embryonic demise and spontaneous abortion.

Aim. To assess the change of immunomorphological parameters in the placenta in women with exacerbation of cytomegalovirus infection (CMVI) in the second trimester of pregnancy, complicated by chronic placental insufficiency.

Materials and methods. The concentration of TNF-α in the homogenate of 120 placentas and the histometric parameters of chorionic villi were determined in patients who underwent latent CMVI and exacerbation of CMVI in the second trimester of gestation. Group 1 included 30 placentas from seronegative women with a physiological course of pregnancy, group 2 included 30 placentas from patients with latent CMVI and chronic compensated placental insufficiency, group 3 – 30 placentas from women with exacerbation of CMVI and chronic compensated placental insufficiency; and group 4 – 30 placentas from pregnant women with exacerbation of CMVI and chronic subcompensated placental insufficiency.

Results. In the 1st group in the placenta homogenate the concentration of TNF-α was 16.8±1.86 pg/mL; the number of villi with a diameter of 30-50 microns was 25.4±2.08%, with a diameter of 60-90 microns – 64.4±2.43% and with a diameter of more than 90 microns – 10.2±0.88%; the number of terminal villi with 1-3 capillaries was 27.0±2.29%, with 4- 6 capillaries – 42.1±2.02%, with 7-10 capillaries – 23.9±1.58% and villi with more than 10 capillaries – 7.0±0.79%. In group 2, the concentration of TNF-α in the placenta homogenate was amounted to 22.1±2.06 pg/mL (p>0.05); among the villi, anatomical forms with a diameter of 30-50 μm (p<0.01) were found 1.41 times more often, and villi with a diameter of 60-90 μm (p<0.01) were 1.19 times less common; the number of villi with 4-6 capillaries decreased by 1.21 times (p<0.05) and the number of villi with 7-10 capillaries increased by 1.43 times (p<0.001). In the placentas of group 3, compared with group 2 in the homogenate, there was an increase in the concentration of TNF-α to 60.2±3.47 pg/mL (p<0.001) against the background of a decrease in the concentration of villi with a diameter of 30-50 μm to 26.4±2,61% (p<0.05), villi with 7-10 capillaries up to 20.7±1.53% (p<0.001) and an increase in the number of villi with 1-3 capillaries up to 34.8±3.05% (p<0.05). In the placental homogenate of group 4, compared with group 3, the concentration of TNF-α (p<0.05) increased 1.31 times, the number of villi with a diameter of 60-90 μm increased to 70.2±1.59%, (p<0,01) and villi with 1- 3 capillaries to 46.8±3.76% (p<0.05) with a decrease in the number of villi with a diameter of 30-50 μm to 18.9±1.69% (p<0,05), with 7-10 capillaries up to 13.3±1.36% (p<0.001) and with 10 or more capillaries – up to 3.9±0.43% (p<0.01).

Conclusion. In women with exacerbation of CMVI in the second trimester of pregnancy and the development of chronic subcompensated placental insufficiency, inhibition of the growth and angiogenesis of terminal villi is observed against the background of the maximum concentration of TNF-α in the medium.

Aim. To evaluate the prognostic value of micromorphometry of placental terminal villi for early diagnosis of intrauterine infections in newborns.

Materials and methods. A molecular genetic and micromorphometric study of 34 placentas obtained from women whose pregnancy ended in preterm labor at 30-36 weeks and 46 placentas of persons who gave birth to full-term babies was performed. In samples of placental tissue, the polymerase chain reaction was used to identify the genome of the following pathogens of intrauterine infections: Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma species (Ureaplasma urealyticum+Ureaplasma parvum), Chlamydia trachomatis, Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenza, Listeria monocytogenes, Cytomegalovirus, Herpes simplex virus, Human herpes virus 4 type, Human herpes virus 6 type, Parvovirus B19. Morphometry was performed using an image analysis system on a Carl Zeiss microscope and Axio Imager software. An average number of capillaries in the terminal villi and the distance from the capillaries to the syncytiotrophoblast were calculated.

Results. The genome of intrauterine infection pathogens was detected in 55.9% of placentas from preterm birth, including DNA of Ureaplasma species – 29.4%, Mycoplasma hominis – 23.5%, Mycoplasma genitalium – 5.9%, Streptococcus agalactiae – 11.7%, Cytomegalovirus – 5.9%, Human herpes virus 4 type – 14.8% as a part of mono- and co-infections. In full-term pregnancy, the infection of the placentas was found to be 3.4 times less – 16.3% (p<0.0002). In monoinfections, DNA of Ureaplasma species – 4.6%, Mycoplasma hominis – 6.9%, Streptococcus agalactiae – 2.3%, Human herpes virus 4 type – 2.3% were detected. An average number of capillaries (abs. value) in the terminal villi of infected placentas, both at full-term (5.35±1.07) and premature (3.97±0.19) pregnancies, proved to be significantly less than in uninfected placentas (5.74±0.05 and 4.63±0.28), respectively. An average distance from the capillaries (µm) of the terminal villi to the syncytiotrophoblast in infected placentas both at full-term (1.62±0.15) and premature pregnancies (2.20±0.2) proved to be significantly greater than in uninfected placentas (1.02±0.03 and 1.72±0.14, respectively).

Conclusion. Comparison of the morphometric parameters of terminal villi in the examined placenta with an average rate of infected and uninfected placentas of full-term and premature pregnancies makes it possible to predict the risk of intrauterine infection in a newborn.

Introduction. Magnesium is directly involved in the regulation of lung function. However, the effectiveness of various magnesium preparations for activating lung function is not unambiguous. One of the reasons for this may be age-related differences in the nature of structural and functional changes in the lungs in response to the administration of magnesium.

Aim. To study the reactivity of the lungs respiratory division of different ages rats to prolonged administration of magnesium chloride.

Materials and methods. The experiments were performed on 48 male Wistar rats of 3 and 15 months of age. The experimental animals, in addition to the standard diet, received magnesium chloride at a dose of 50 mg/kg body weight daily for 21 days. At the end of the experiment, lung tissue samples were taken for histomorphological and biochemical studies.

Results. At the end of the experiment, 3-month-old rats treated with magnesium chloride showed an increase in the size of the alveoli, a decrease in the relative area of the parenchyma and stroma, and an increase in the relative area of air spaces. A decrease in the thickness of the interalveolar septum and the concentration of oxyproline in the lung tissue of these rats may indicate a decrease in the number of connective tissue elements. In 15- month-old experimental animals, on the contrary, an increase in the relative area of the parenchyma and stroma of the lungs (by 14%), a decrease in the relative area of air spaces (by 12%), and an increase in the concentration of oxyproline in the lungs (by 21%) were observed.

Conclusion. Thus, the research results indicate age-related differences in changes in morphological and biochemical parameters characterizing the state of the respiratory division of the lungs with prolonged administration of magnesium chloride. The nature and severity of these changes suggests that in 3-month-old rats magnesium increased lung activity, and in 15-month-old animals, on the contrary, it decreased.

Multiple myeloma occupies a leading position among malignant blood diseases. There is clinical evidence that multiple myeloma can be complicated by secondary amyloidosis. The article presents a clinical case for the diagnosis of multiple myeloma complicated by secondary pulmonary amyloidosis. The participation of doctors of various specialties (pulmonologist, hematologist, pathologist), the use of high-tech diagnostic methods (histological examination of a biopsy of lung tissue, trepanobiopsy, immunohistochemical examination of histological preparations of lungs and bone marrow), made it possible to establish a clinical diagnosis. 

Aim. The article describes the experience of using direct oral anticoagulants – drugs Dabigatran, Rivaroxaban and Apixaban for the secondary prevention of thrombosis in patients with the most common variants of hereditary hematogenous thrombophilia.

Materials and methods. 86 patients were under observation: 53 men, 33 women. Only the registered fact of thrombosis, thromboembolism, ischemia or organ infarction was the basis for the diagnosis of hematogenous thrombophilia and further secondary prevention of thrombosis. In 80 cases, there was a combined form of thrombophilia. In addition to hereditary factors, there were acquired thrombogenic factors. Dabigatran etexilate (Pradaxa®) for the prevention of thrombus formation was prescribed to 41 patients aged 20 to 60 years; duration of admission from 12 months to 9 years, the dose of the drug was selected individually from 150 to 300 mg per day. Rivaroxaban (Xarelto®) for the prevention of thrombus formation was prescribed to 25 patients aged 18 to 54 years, duration of admission from 12 months to 7 years, the dose of the drug is 10-20 mg per day. Apixaban (Eliquis®) was prescribed to 10 patients, aged 30 to 50 years, the duration of admission was from 6 months up to 2 years, dosage 5-10 mg per day. For hyperhomocysteinemia, Angiovit® or Pentavit® was prescribed. Protein C and antithrombin III preparations with their congenital deficiency were used according to indications.

Results. After Dabigatran was prescribed, only one patient had a recurrent pulmonary embolism due to low adherence to treatment. In other patients who were prescribed direct oral anticoagulants, no recurrence of thrombotic complications was recorded. No hemorrhagic complications were diagnosed with the use of Dabigatran and Apixaban. In 5 patients receiving Rivaroxaban, there were minor epistaxis; in three cases they stopped when the dose was reduced from 20 to 15-10 mg, two patients were transferred to dabigatran. No life-threatening bleeding has been reported.

Conclusion. Dabigatran, Rivaroxaban and Apixaban are effective and safe drugs for antithrombotic therapy. The absence of the need for constant laboratory monitoring and extremely rare hemorrhagic complications makes it possible to use them in patients living in areas remote from large medical centers. Only 10 patients under our supervision with a diagnosis of “hematogenous thrombophilia” are currently taking warfarin. Timely diagnosis of the variant of hematogenous thrombophilia and the appointment of adequate anti-thrombotic therapy contributes to the relapse-free course of the disease.

A personalized approach, taking into account the genotype and individual characteristics of the patient, provides great opportunities for more effective prevention, treatment and rehabilitation. The review is focused on the main directions of personalized medicine. Prospects for the development of personalized rehabilitative medicine, including the use of non-drug methods, are described. Studies showing the influence of physical factors on the genome are discussed. It has been shown that the effects of physiotherapeutic factors are genetically determined. Advances in the field of physiogenetics indicate the need for developing and implementing personalized rehabilitative technologies.

Electrocardiography occupies a special place among a significant list of other methods for diagnosing the pathology of the cardiovascular system of athletes. Often its results differ significantly from those in the general population, being a consequence of the adaptation of the heart to economical functioning at rest and super-intensive work in training and competitions. This review focuses on the features of the “athlete’s electrocardiogram (ECG)”. in particular, those changes that are not a reason for removing athletes from physical activity, but in combination with known factors can lead to more serious changes up to sudden cardiac death. Fatal rhythm disorders in athletes are described, possible in Wolff-Parkinson-White syndrome, syndrome of ion channel pathology, arrhythmogenic dysplasia of the right ventricle, etc. Particular attention is paid to arrhythmia due to connective tissue dysplasia syndrome. Knowledge of these issues is necessary to choose the right tactics for an athlete with changes to the electrocardiogram and in the protocol of daily Holter monitoring of the electrocardiogram, and a doctor related to sports medicine should be aware of the features of “electrophysiological remodeling” of the athlete’s heart, normal and pathological “sports electrocardiogram”, about conditions accompanied with the development of serious rhythm disorders and algorithms for examining the cardiovascular system of the athlete.

Reproduction and maintenance of the integrity of the epithelial layer requires a precisely balanced rate of growth and cell death. In overcrowded areas of tissue, some of the cells undergo a consecutive loss of intercellular connections, which leads to a progressive decrease in their number. To keep the barrier intact, the epithelium eliminates dying cells by means of extrusion. Cell extrusion is a unique morphological phenomenon inherent in the epithelium, in which cells prone to apoptosis or non-apoptotic elements are removed from the tissue, thus breaking the symmetry of the layer. During extrusion, the site intended for apoptosis, due to signals from neighboring elements, forms and compresses the ring of the actomyosin complex, which leads to the removal of dying cells from the epithelium. Apoptosis of epithelial cells of the respiratory tract is the main mechanism for a decrease in the cell number after hyperplastic changes in it, arising from exposure to negative factors, viral or bacterial infection. In the review, the authors demonstrate the original photographs of the extrusion of airway epithelial cells.

The analysis of the history of creation and development of the Federal State Budgetary Scientific Institution “Far Eastern Scientific Center of Physiology and Pathology of Respiration”, its contribution to the results of research work of the Russian Academy of Sciences and the effectiveness of medical activities of healthcare institutions in the Far East region.