The study objective is to develop a new algorithm for diagnosing lung function disorder types. A retrospective analysis of lung function tests results (spirometry, body plethysmography and lung elasticity measurement with the esophageal balloon) was performed in 575 patients with diffuse parenchymal lung diseases. The algorithm, recommended by the expert commission of American Thoracic Society and European Respiratory Society in 2005, showed low sensitivity: disturbances of respiratory mechanics were determined only in 43% of cases. The proposed algorithm, based on the analysis of vital capacity, total lung capacity, residual volume, the ratio of RV/TLC and FEV₁/VC, was more sensitive, basically due to better diagnosis of restrictive syndrome of ventilation disorders. The accuracy of the proposed algorithm depends on the method of normal limits definition. When normal limits were defined as percentage of predicted values, ventilation disorders were detected in 72% of cases. Utilizing equations for upper and lower limits of norm, the algorithm recognized ventilation disorders in 62% of cases.

The aim of the study was to evaluate the effect of TRPM8 cold thermoreceptor gene polymorphisms on the development of asthma phenotype with cold airway hyperresponsiveness (CAH). 167 cases of mild-to-moderate persistent asthma were retrospectively analyzed. In each case, the examination included two repeated bronchoprovocation tests with 3-min isocapic cold air hyperventilation with 6-month interval, standard spirometry and genotyping of seven TRPM8 polymorphisms (rs11562975, rs17868387, rs28901637, rs138810119, rs2052030, rs17865682 and rs1003540). A double positive response to the bronchoprovocation test served as a criterion for the phenotype of asthma with CAH. Based on the results of the study, previously revealed relationship between rs11562975 polymorphism and CAH was confirmed, and also three new polymorphisms (rs17868387, rs17865682 and rs1003540) differentially associated with CAH asthma phenotype were identified. The obtained data indicate the contribution of the molecular genetic peculiarities of TRPM8 to the pathogenesis of CAH and substantiate the further search for additional molecular mechanisms of cold-induced respiratory reactions.

The aim of the study was to determine the role of rs11562975 polymorphism of TRPM8 gene and tobacco smoking in the formation of severe bronchial obstruction in asthma patients. According to this aim, 416 patients with varying severity of asthma were examined. The study design included standard spirometry, genotyping of rs11562975 TRPM8 gene polymorphism and evaluation of the status and duration of smoking. The study revealed the detrimental effect of smoking on the respiratory function in patients with a pack/year index ≥10. rs11562975 polymorphism had a modulating effect on the smoking in patients with asthma. The influence of smoking ≥10 packs-years on the formation of severe bronchial obstruction was more pronounced among carriers of GC genotype, compared to patients with GG genotype. In case of pack-year history ≥20, the GC genotype significantly increased the risk of severe bronchial obstruction in the examined patients.

The aim of the work was to study the activity of alpha-2-macroglobulin in connection with clinical-functional manifestations of asthma in patients with cold airway hyperresponsiveness. According to the airway response to 3-minute isocapnic hyperventilation with cold (-20ºС) air, 28 patients with mild persistent asthma were divided into groups: the 1^st group (18 people) included the patients with cold airway hyperresponsiveness; the 2^nd group (10 people) included the patients without cold airway hyperresponsiveness. The patients were assessed upon the symptoms of asthma, the level of asthma control by the questionnaire Asthma Control Test; the lung function was studied; the regulatory activity of alpha-2-macroglobulin was assessed in the induced sputum in connection with the contents of myeloperoxidase which is a pro-inflammatory enzyme of oxidative stress. The patients of the 1^st group were found to have a lower level of alpha-2-macroglobulin activity than of the 2^nd group, which was associated with the signs of asthma worsening: a low level of Asthma Control Test, more expressed lung function disorders and a greater increase of FEV₁, МEF₅₀ to the inhalation with β₂-agonist. A positive influence of alpha-2-macroglobulin activity increase on the small airway response to cold stimulus exposure was shown. The level of alpha-2-macroglobulin can be used as a criterion for activation of exudative inflammation induced by cold and escalation of chronic inflammation persistence in airways associated with asthma worsening.

The aim of the study is to describe pathogenetic features of phenotypes of asthma at a resort stage of medical rehabilitation. 300 patients with asthma who arrived on the Southern coast of the Crimea (Yalta) for medical rehabilitation were examined. As a result of the study 7 phenotypes of asthma at a resort stage of medical rehabilitation were distinguished. Asthma phenotypes created by the cluster analysis are pathological conditions of patients which were caused by different pathogenetic mechanisms. Each phenotype of asthma is characterized only by its peculiar pathogenetic features in the form of the manifestation of a different degree and relation of clinical changes and functional indices of airway obstruction, an allergic (eosinophilic) inflammation, a condition of physical working capacity and the quality of life taking into account the gender of patients, their body weight, an age of a disease debut and features of application of medications. The established pathogenetic mechanisms of each asthma phenotypes can be considered when individual programs of medical rehabilitation at the resort are formed

To study the immune status of patients in an acute period of ischemic stroke, a clinical and immunological observation of 45 patients was performed. At the 2^nd day after the onset of the disease, an increase in the leukocyte count (p˂0.01) and a decrease in lymphocytes (p˂0.05), T-lymphocytes (CD3+) (p<0.01), T-helpers (CD4+) (p˂0.01) and cytotoxic T-lymphocytes (CD8+) (p˂0.05) were observed. There was also a tendency to decrease the content of natural killers (NK cells, CD16+) and cells that express the receptors for IL-2 (CD25+) (p˃0.05). In the humoral immunity an increase in the number of B-lymphocytes (CD20+) (p˂0.05) and dysgammaglobulinaemia due to the tendency to hyperfunction IgA and IgM (p˃0.05) and an increase in IgG (p˂0.05) was observed. Deviation of the immune status of normal values was more pronounced with increasing severity of neurological symptoms and infarct size. With a moderate and severe stroke on the NIHSS scale and the infarct size of more than 15 mm, more pronounced lymphopenia (p˂0.05) was noted with a significant decrease in the T-lymphocyte (CD3+) (p˂0.05), T-lymphocyte subpopulations (CD4+; p˂0.05) and CD8+; p<0.005), as well as NK cells (CD16+) and cells expressing receptors for IL-2 (CD25+) (p˃0.05). Thus, these studies demonstrate the involvement of the immune system in a complex set of reactions involved in the development of cerebral accidents and suggest an increased susceptibility of these patients to the development of infectious complications. The lack of immune status changes against standard therapy requires an immune-corrective therapy (in case of violations of basic parameters of the immune system).

The aim of the work is to assess the effects of cytomegalovirus infection on the 20α-hydroxysteroid dehydrogenase activity in the villous chorion syncytiotrophoblast in the first trimester of pregnancy. The materials for the study included 48 villous chorions samples taken during spontaneous abortions at 8^th-10^th weeks of gestation from women with reactivation of cytomegalovirus infection (the main group). The control group included 35 villous chorions samples from pregnant women with chronic cytomegalovirus infection in the latent stage taken at medical abortions at the same stage of gestation. The results of women’s examination were studied taken into account the activity of cytomegalovirus infection by immunoassay by detection of IgM antibodies or by 4 times and more increase of IgG antibody titers in the paired serums in dynamics in 10 days. The activity of 20α-hydroxysteroid dehydrogenase was assessed by the histochemical method. Quantitative evaluation of the reaction products was carried out on sections under the microscope MT (Japan) connected to software-hardware complex «SCION Corporation» (USA). At histochemical specimen of villous chorion of pregnant women who had a reactivation of cytomegalovirus infection during pregnancy (main group), there was a decrease of cytophotometric parameter of 20α-hydroxysteroid dehydrogenase activity till 30.1±2.12 pixels/μm² (p<0.001) compared with the control group. The decrease in the reaction activity in syncytiotrophoblast indicated a decrease in the contents of 20α-dihydroprogesterone in placenta, which contributed, in our opinion, to spontaneous abortion.

To assess the role of cholesterol and estradiol in the development of placental insufficiency under cytomegalovirus infection (CMVI) in the period of gestation, cholesterol and estradiol were studied in the peripheral blood of 35 pregnant women who had a reactivation of chronic CMVI (IgG antibody titer to CMV is 1:1600) in the third trimester of pregnancy (the main group). As a control the blood plasma of 35 healthy women of the same period of gestation and age as in the main group were studied. It was found out that the reactivation of chronic CMVI in the third trimester of gestation was followed by the decrease of concentration of cholesterol by 23% ( p<0.001), of estradiol by 65% (p<0.001) in comparison with the values of healthy women. To analyze the chosen values for assessment, the discriminant function was found. It had the probability of differences not less than 95%; which that the discriminant equation was derived which for this study had the following formula: D=(-379×total cholesterol)+(-0.072×estradiol) , where D is a discriminant function whose limit value is (-2673.59). If D is equal or less than the limit value, then the development of placental insufficiency in women in the third trimester of pregnancy is predicted, and if D is more than the limit value, then the normal course of the third trimester of pregnancy is predicted. Thus, the obtained results allow to establish the main role of disturbances of total cholesterol contents and key steroid hormone of pregnancy (estradiol) in the pathogenesis of placental insufficiency development under CMVI during gestation, which can be the basis for improvement of diagnostic and medical basis under this pathology of pregnant women.

The contents of total cholesterol (TC) and triglycerides (TG) in nasopharyngeal aspirate were studied in 233 mature newborns from mothers with normal pregnancy and complicated with cytomegalovirus infection (CMVI). The first (control) group included 30 babies of 38-40 weeks from mothers with physiological course of pregnancy. Among the newborns with moderate cerebral ischemia and antenatal history complicated with chronic CMVI in their mothers in the second trimester of pregnancy, four groups were distinguished and each of them was divided into two subgroups. Subgroup A had patients whose mothers did not have the threat of miscarriage during pregnancy and subgroup B had children from mothers who had the threat of miscarriage in the second trimester of gestation. The second group included 50 newborns whose mothers had a latent course of chronic CMVI; the third group included 50 children from mothers with reactivation of chronic CMVI (antibody titers of IgM to CMV were 1:200-1:400, antibody titers of IgG to CMV were 1:200-1:400, the avidity index of IgG antibodies to CMV was more than 65%); the fourth group consisted of 51 newborns whose mothers suffered an acute form of chronic CMVI (antibody titers of IgM to CMV were 1:200-1:400, antibody titers of IgG to CMV were 1:200-1:800, avidity index of IgG antibodies to CMV was more than 65%); and the fifth group had 52 children from mothers who suffered a reactivation of chronic CMVI (antibody titers of IgM to CMV were 1:200-1:400, antibody titers of IgG to CMV were 1:400-1:600, avidity index of IgG antibodies to CMV was more than 65%). The children of 2А, 3А and 4А subgroups, in comparison with the first group, in nasopharyngeal aspirate did not have any significant changes in the contents of TC and TG. In 5A subgroup against the absence of reliable differences of TG concentration there was registered a fall of TC level till 0.189±0.015 mmole/L (in control and 2A subgroup it was 0.250±0.016 mmole/L, р<0.01 and 0.246±0.015 mmole/L, р<0.01, respectively). When comparing the lipid composition of nasopharyngeal aspirate in newborns of 2B and 3B subgroups with the one taken from healthy children there were not found any significant differences in TC and TG. But in 4B and 5B subgroups there was a fall of TC till 0.191±0.014 mmol/L (р<0.01) and till 0.146±0.010 mmole/L (р<0.001), while the values of TG grew till 0.169±0.009 mmole/L (p<0.05) and till 0.198±0.009 mmole/L (p<0.001); at the same time the contents of TG in the first group was only 0.142±0.008 mmole/L. Thus in newborns with moderate cerebral ischemia and antenatal history complicated with 4 times growth of antibody titers of IgG to CMV and the threat of miscarriage in the second trimester of gestation, the decrease of TC can lead to less expressed compensatory-adaptive reactions, and the increase of TG, including fatty acids peroxides, results in the starting of mechanisms of intrauterine degradation of pulmonary surfactant and membrane-destructive processes in central nervous system.

The contents of total cholesterol, high-density lipoproteins, low-density lipoproteins, and triglycerides in cord blood were studied at moderate cerebral ischemia in 230 mature newborns from mothers with chronic cytomegalovirus infection (CMVI) in the second trimester of gestation (main group). The first group (control group) consisted of 30 newborns from mothers with physiological pregnancy. Depending on the activity of chronic CMVI, 4 groups were distinguished, in each of which there were 2 subgroups. Subgroup A included newborns from mothers with pregnancy and an uncomplicated threat of miscarriage, and in subgroup B there were the patients whose mothers suffered the threat of miscarriage at 16-21^st week of gestation. The second group was represented by 50 newborns whose mothers had a latent course of chronic CMVI. The third group included 50 children from mothers with reactivation of chronic CMVI (titers of IgM antibodies to CMV were 1:200-1:400, IgG antibody titers to CMVI were 1:200-1:400, avidity index of IgG antibodies to CMVI was more than 65%). The fourth group included 50 newborns whose mothers suffered an acute phase of chronic CMVI (titers of IgM antibodies to CMV were 1:200-1:400, IgG antibody titers to CMV were 1:200-1: 800, avidity index of IgG antibodies to CMV was more than 65%), and in the fifth group there were 50 patients with antenatal history with reactivation of chronic CMVI (IgM antibody titers to CMV were 1:200-1:400, IgG antibody titers to CMV were 1:400-1:1600, avidity index of IgG antibodies to CMV was more than 65%). When comparing 2A and 2B subgroups with the first group, there were no significant changes in total cholesterol of high and low density lipoproteins and triglycerides. In children in 3A subgroup, the concentration of low density lipoproteins decreased to 0.34±0.02 mmol/L, and in 3B subgroup to 0.32±0.02 mmol/L with simultaneous increase in the triglyceride level to 0.51±0.03 mmol/L (in the first group, it was 0.53±0.03 mmol/L, p<0.001 and 0.43±0.03 mmol/L, p<0.05, respectively). In comparison with the first group in 5B subgroup, the lowest total cholesterol values (1.82±0.05 mmol/L, p<0,05), low-density lipoproteins (0.21±0.05 mmol/L, p<0.001), as well as high triglycerides (0.59±0.03, p<0.001) were registered. These can weaken the compensatory-adaptive reactions of the hormonal system that regulates the immune response, vascular permeability and the blood-brain barrier, as well as disrupt the blood supply to the brain in newborns with moderate cerebral ischemia.

The objective of the research was to study genital mycoplasma contribution to the development of reproductive disorders. Mycoplasma detection rate in genital smears of pregnant women of Khabarovsk was studied by a polymerase chain reaction (PCR) method. Ureaplasma (urealyticum+parvum ) was detected in 56.3% of cases; Mycoplasma hominis in 7.5% of cases , Mycoplasma genitalium in 0% of cases. Genital mycoplasmas were detected in chorionic and fetal tissue samples in early-term spontaneous miscarriage cases, suction biopsies in women with recurrent miscarriage, tissue samples in elective abortions, placental samples of women whose pregnancy ended in preterm delivery, and placental samples of women who gave birth to children at term. Ureaplasma (urealyticum+parvum) DNA was detected in 11.9%, 18.8%, 1.4%, 32.6%, and 25.0% of cases, respectively; Mycoplasma hominis DNA in 7.4%, 12.5%, 2.6%, 2.3%, and 0% of cases, respectively; Mycoplasma genitalium DNA in 5.2%, 6.3%, 1.4%, 2.3%, 0%, respectively. Genital mycoplasmas were detected in autopsy material of children who had died in neonatal and postnatal periods. Relationship between mycoplasma concentration in vaginal flora of pregnant women and preterm delivery was identified using real-time PCR. Mycoplasma detection rate in reproductive pathologies was found to be significantly higher than in control groups. The results of the study favor the view of etiopathogenetic role of mycoplasmas in development of complications and outcomes of pregnancy.

The purpose of the research was to study the role of the angiogenic system in the pathogenesis of the luteal phase insufficiency in women in reproductive age with primary oligomenorrhea in the pubertal period. In a comparative aspect with healthy women (the control group), the hemodynamics in the ovarian arteries and in the arteries of the ovarian stroma in 30 women in reproductive age with primary oligomenorrhea in the pubertal period (the study group) was studied. The angiogenic system was studied by the indices of the vascular endothelial growth factor (VEGF) and its receptor (VEGFR1) in the blood serum. It was found out that in 10 women of the studied group the ovulatory menstrual cycle was accompanied by luteal phase insufficiency; the serum progesterone concentration was 1.7 times lower (27.41±3.10 nmol/L) than in the control group (47.64±4.19 nmol/L, p<0.001). In women with luteal phase insufficiency, the VEGF concentration (11.17±6.18 pg/ml) and the angiogenic coefficient of VEGF/VEGFR1 (0.76) were 2 times lower than in the control group (209.06±20.41 pg/ml; 1.52) and in women with primary oligomenorrhea in the pubertal period with a full luteal phase (237.98±24.67 pg/mL; 1.44). The blood flow velocities in the ovarian artery and in the vessels of the ovarian stroma with the dominant follicle did not differ from the parameters of the opposite ovary and were lower in comparison with those of the control group. A model for predicting the formation of a functionally active yellow body has been developed. Thus, the reduction of the angiogenic potential and imbalance in the angiogenic ovary system with a dominant follicle is one of the links in the pathogenesis of luteal phase insufficiency in women in reproductive age with primary oligomenorrhea in the pubertal period. 2 times increase of the VEGF concentration and of angiogenic coefficient by more than 1.0 provides adequate angiogenesis in the dominant follicle and the formation of a full-valued yellow body.

In order to study the effect of environmental conditions on the characteristics of the nutritional status (the change in the nature of diet due to the transition to a westernized type), 299 women were examined in the pregnant and nonpregnant state belonging to the following ethno-ecological groups living in the Khabarovsk Krai and in the Middle Amur region: urban and rural not indigenous (mainly Russian) and rural indigenous (Nanais) ones. Anthropometric parameters (height, weight, thickness of the skin-fat folds) as parameters of the nutritional status were evaluated at the initial examination and in trimester dynamics by means of caliperometry, somatometry, and generally accepted statistical methods of analysis of the obtained material. As a result of the expedition study, significant ethnic differences in the growth rate of indigenous and newcomers were determined. When examining pregnant and nonpregnant women, there was an increase in body weight corresponding to the norm only in pregnant women of the urban not indigenous population, which indicates the influence of actual nutrition, conditioned both by ecological and social living conditions. The study found that in the group of pregnant indigenous rural population, a positive increase in the thickness of all skin-fat folds in dynamics from I to III trimester was determined, however, the greatest confidence in the increase was noted in the group of urban pregnant women (р≤0.05-0.001), which proves a more pronounced ecological and social component. Analysis of the body mass index to body surface area index in pregnant women of the Amur region and the indigenous population of the Amur Region made it possible to evaluate the feeding type as an "intermediate Far Eastern" adaptive one, requiring dynamic control and justified correction.

In this paper the results of comparison and assessment of the importance of several methods of atmosphere microdimensional pollution research are given. Two methods of sampling are compared: the selection of snow and ultrasonic flushes from needles. The tests received by two of these ways selected in the settlement in the Terny in winter of 2016/2017 are analyzed by means of laser granulometry. It is shown that both methods can be used in environmental monitoring and the results are comparable with each other. It should be noted that the ultrasonic flushes is more convenient as it doesn't depend on seasonality and rainfall.

The search and development of methods for correction of oxidative stress in conditions of exposure to adverse environmental factors is an actual problem of modern medicine. In experimental conditions the possibility to correct free radical lipid oxidation of rats’ cell membranes was studied with the external application of the ointment of herb convolvulus and of the ointment of herb chickweed. The animals were divided into 4 groups and each of them had 20 rats: intact animals which were held in standard conditions of vivarium; the control group in which rats were exposed to ultraviolet radiation during three minutes daily; the experimental group in which before ultraviolet radiation animals had a daily external application of the ointment of herb convolvulus; the experimental group in which before ultraviolet radiation animals had a daily external application of the ointment of herb chickweed. It was found out that in the blood of experimental animals a daily ultraviolet radiation during three minutes contributes to the increase of lipid hydroperoxides level (by 15-19%), of diene conjugate (by 14-16%), and of malonic dialdehyde (by 40-66%) against the decrease of antioxidant system activity in the blood of intact animals. The introduction of the ointment of herb convolvulus and of the ointment of herb chickweed to rats in the conditions of oxidative stress contributes to the reliable decrease in the blood of lipid hydroperoxides by 9-13%, of diene conjugates by 8-13%, malonic dialdehyde by 15-28% in comparison with the rats of the control group. While analyzing the effect of the ointment on the activity of the components of antioxidant system it was shown that the level of ceruloplasmin in the blood of animals was significantly higher by 13-20%, of vitamin E by 8-14%, of catalase by 13-28% in comparison with the same parameter of the rats of the control group. So, the application of the ointment of herb convolvulus and of the ointment of herb chickweed in the conditions of oxidative stress induced by the influence of ultraviolet rays leads to the stabilization of the processes of peroxidation against the increase of antioxidant system activity.

The mineral status of healthy and ill citizens of Blagoveshchensk was studied with the help of atomic absorption spectroscopy. It was found out that in the whole blood of healthy people from Blagoveshchensk in comparison with some average standard rates given in literature, there was a bigger (р<0.001) concentration of Сo (3.5 and more times), of Сs (15 times more), of Li (4.5 times more), of Mn (34.3 times more), of Ni (4 times more), and there was significantly less of Cu, Fe, Hg, K, Na, Mg, Rb, Zn. At focal tuberculosis the deficit of Сa and Mg and the excess of Cd, Cr, Cs, Hg, K, Li and Pb were registered. And the other way round, under fibrous-cavernous type in the blood there was a low level of Са, Mg, Mn and Ni (р<0.001), approximately normal contents of Cu, Fe and Zn, and a high (р<0.001) concentration of Сd, Cr, Cs, Hg, K, Li, Mn, Na, Ni, Pb, Rb. Moreover, in the blood of people with lung tuberculosis the contents of Hg were 3-5 times more than in healthy people. Under the peptic ulcer disease the mineral imbalance was revealed through the decrease in the blood of Са and Mg level (р<0.001) and the increase of (р<0.001) Сd, Cr, Cs, K, Li, Mn, Na, Ni and Pb concentration.

The article presents the literary overview dedicated to the diaphragmatic hernias. As an example, a case of the traumatic diaphragmatic hernia with the clinical picture of the pleurisy was described. The thoracoabdominal knife injury of the diaphragm was the feasible reason of this hernia. In this case, a long asymptomatic course of the disease with some gastroenterological symptoms was the reason for the early diagnostics not to be performed. Firstly, the patient was hospitalized to the pulmonology department because of the pleurisy-like clinical picture of his case. A diaphragmatic hernia was found only after examination of the patient. A laparoscopic operation failed and the patient was successfully treated by the surgery.

Own clinical observations of rare pulmonary diseases related to the uterus pathology are presented. These observations reflect clinical-roentgenologic features of benign uterus leiomyoma with lung metastases, lymphangioleiomyomatosis and thoracic endometriosis. The description of three different diseases in one report is conditioned by the fact that they all have one and the same lesion of metastases, i.e. hormonally active uterus in women of reproductive age. Though these diseases are different, but they demand differential diagnostics both between each other and other disseminated pulmonary diseases. This work demonstrates the possibilities of application of multispiral computed tomography with postprocessing imaging. A lot of attention is paid to roentgen semiotics of pulmonary changes typical for each of these diseases.