At present, there are a number of problems associated with the diagnosis of restrictive type of ventilation disorders: first, to identify restriction, it is necessary to perform body plethysmography, which is a laborious technique and requires the active cooperation of the patient with medical personnel; secondly, methodological issues that concern the criteria for the diagnosis of restriction are still under development. Impulse oscillometry (IOS) is a non-invasive and effortless technique for the patient to identify ventilation disorders, especially obstructive ones. In order to assess the informative value of IOS in the diagnosis of the restrictive ventilation disorders, respiratory impedance and its parameters were measured in 82 patients with various bronchopulmonary pathologies. The restriction was established on the basis of spirometric and bodyplethysmography studies. The results showed that IOS is a low-sensitivity method for detecting the restrictive type of ventilation disorders with mild reduced total lung capacity (TLC≥70%pred.), since in this case, the basic parameters of the IOS, such as the resistive component of the respiratory impedance (Rrs) at 5 and 20 Hz (Rrs5 and Rrs20, respectively), as well as the reactive component of the respiratory impedance at 5 Hz (Xrs5) remain within the normal values. When TLC was less than 70%pred., there was a decrease of Xrs5 with an increase in the resonance frequency and the preservation of the normal values of Rrs5 and Rrs20. The abnormal absolute frequency dependence of Rrs was determined at any degree of change in the TLC, increasing as it decreased.

In 46 patients with mild persistent asthma the collection and cytological study of the induced sputum (IS) was done to assess the inflammatory pattern of bronchi, structural organization of bronchial epithelium and secretory goblet cells; the level of the disease control by the data of the validated questionnaire Аsthma Control Test was found out; the base lung function (FEV₁) was determined; the response of airways to standard 3-minute isocapnic hyperventilation by cold (-20ºС) air (IHCA) was studied. By the results of IHCA test the patients were divided into 2 groups: with cold airway hyperresponsiveness (1^st group) and without any response to IHCA test (2^nd group). The patients of the 1^st group in comparison with the ones of the 2^nd group had a lower level of spirometric parameters and control over the disease. In the 1^st group there were found more significant changes in the structural organization and destructive-cytological activity of goblet cells against the decrease of a number of epithelial cells of IM and activation of a neutrophilic pool under eosinophilic pattern of inflammation. The patients with cold airway hyperresponsiveness were found to have a close correlation between identified disorders in the structural organization of the goblet epithelium, the number of neutrophils of IS and severity of the bronchial response to IHCA test. The association of disorganization of the goblet epithelium and bronchial response to cold stimulus against the features of inflammatory pattern can be considered a risk factor of escalation of mucociliary insufficiency and worsening of clinical course of a disease and the level of asthma control.

The aim of the study was to study the correlation between the indices of the functional state of the diaphragm and pulmonary hemodynamics in COPD patients at different stages of chronic pulmonary heart (CPH). 79 patients with COPD were examined. Patients were divided into 2 groups, taking into account the pulmonary artery pressure and the presence of clinical signs of right ventricular failure. The first group included 40 COPD patients complicated by compensated CPH; the second group included 39 patients with decompensated CPH. A complex examination of intracardiac hemodynamics and functional state of the diaphragm was carried out at the XD-11 XE device PHILIPS (USA). The following results were obtained: in patients with compensated CPH there was an increase in the thickness of the diaphragm, a decrease in the diaphragm mobility during tidal and forced breathing, and an increase in the rate of contraction of the diaphragm during tidal and forced breathing. Patients with decompensated CPH were found to have an increase in the thickness of the diaphragm, a sharp decrease in the diaphragm excursion during tidal and forced breathing, a decrease in the fraction of thickening of the muscular part of the diaphragm. The correlation analysis revealed the most informative ultrasound indices of the impairment of the functional state of the diaphragm in patients with COPD, significantly associated with pulmonary hemodynamic indices: diaphragm excursion during tidal and forced breathing, relaxation rate of the diaphragm muscle, thickness and fraction of thickening of the muscular part of the diaphragm. Determination of the functional state of the diaphragm in patients with COPD allows an early detection of signs of respiratory muscle dysfunction, a timely appointment of corrective therapy, and prevention of the development and progression of pulmonary-cardiac failure.

In order to analyze the relationship between the indices of arterial stiffness and the markers of vascular endothelial dysfunction and systemic inflammation, 69 patients with severe COPD and high-risk (GOLD 2013) during an exacerbation were examined. The stiffness of the vascular wall was determined with the help of an automatic sphygmograph and a sphygmomanometer "VaSera VS-1000". For the study, the carotid-femoral pulse wave velocity (PWV-aorta), right and left cardiovascular vascular index (R/L-CAVI) were chosen. Determination of the indices of systemic inflammation and vascular damage was carried out in the blood serum by the method of enzyme immunoassay. Analysis of the quantitative characteristics of arterial stiffness in patients with severe COPD and high risk revealed that in general in the group the studied indices were significantly higher than those of healthy individuals. The mean age of the vessels in the group of patients exceeded the biological age by 11.5% and amounted, on average, to 68.46-1.22 years. The in-group analysis revealed that concentrations of biomarkers of systemic inflammation and endothelial dysfunction were higher in COPD patients with R-CAVI values greater than 9, compared with less than 9 in the R-CAVI group. In a separate correlation analysis, it was found that the increase in the basic indices of arterial stiffness was associated both with the level of the indicators of systemic inflammation, and with the biomarkers of endothelial dysfunction. The obtained interrelations show that the formation of excessive vascular stiffness in patients with severe COPD of high risk is associated with the activation of inflammatory mediators and endothelial dysfunction, mostly with high levels of high - sensitivity C - reactive protein, fibrinogen, endothelin-1, homocysteine and TNF-α, and that’s why the determination of these parameters of AS is recommended, first of all, to these patients. The registration of events that manifest interdependent changes in the processes of vascular bed remodeling, systemic inflammation and endothelial dysfunction will allow early detection of patients with increased cardiovascular risk and timely intensification of therapy in this category of patients.

The aim of the study is to investigate a vasomotor function of patients with COPD against the development of acute myocardial infarction (AMI) with an elevation of the ST segment of the electrocardiogram. The brachial artery reactivity was studied in 42 patients with COPD during the course of treatment in the Amur Regional Clinical Hospital. All the patients were divided into two groups: 1^st group (22 patients) with COPD and AMI with an elevation of the ST segment; 2^nd group (20 patients) - with moderate COPD. The control group included 15 healthy people without cardiovascular diseases and respiratory pathology. The study was done at the ultrasonic device Toshiba Aplio XG with the linear probe of 10MHz using the method by D.S.Celermajer et al. (1992). The following results were obtained: the majority of COPD patients demonstrate vasomotor endothelial dysfunction that can cause atherosclerosis; in case of COPD and AMI comorbidity an endothelial dysfunction redoubles; development of AMI coincides with the “peak” of endothelial dysfunction determined with the help of endothelium-dependent vasodilatation. The method of endothelial dysfunction determination is non-invasive and accurate to predict cardiovascular diseases in COPD patients.

The work shows the results of the study of atmospheric suspensions of PM₁, PM₁₀, PM₅₀ contained in the snow of Blagoveshchensk during 2017. The distribution of suspended in the air particles of different origin in 19 areas with various anthropogenic impact was revealed. Big and midsize motor transport centers are the main suppliers of the biggest part of PM₁, PM₁₀ particles into the atmosphere. Suburban and park lands are the source of macroparticles (bigger than 50 μm). It was shown that microdimensional pollution of the atmosphere of Blagoveshchensk can be assessed as moderate.

The aim of the study was to investigate the content of spontaneous protein oxidative modification (POM) in the blood serum and pulmonary tissue of rats after local gamma irradiation of the projection area of the heart and lungs. The content of products of spontaneous POM (aliphatic neutral and basic aldehyde- and ketone-dinitrophenylhydrazones) in the blood serum and pulmonary tissue of 57 rats was studied. The animals were divided into 5 groups: “control group”, where there was gamma irradiation of the heart and lungs area, the collection of samples was done at the next day; “treatment group”, where a single session of low-intensity broadband red light was performed after local exposure to gamma radiation (the collection of samples was done at the next day); “chronic control group”, where there was an exposure to local gamma irradiation of the heart and lungs area, the collection of samples was done at the fourth day; “chronic treatment group” was daily exposed to low-intensity red light for 4 days after local exposure to gamma radiation, the collection of samples was done at the fourth day; “normal level group” was not exposed to either gamma radiation or broadband red light. In the pulmonary tissue and blood serum of control animals, a gradual increase in the content of spontaneous POM products was observed. The most significant difference from the normal level the “chronic control group” had. At the same time, the normalization of the content of POM products under the influence of low-intensity broadband red light in the tissues of the experimental groups was revealed. In the course of the experimental study, the normalization of processes of free radical oxidation of proteins in the lung tissue and in the serum of rats after gamma irradiation and the exposure of the projection region of the heart and lungs to low-intensity broadband red light was shown. Thus, low-intensity red light can be considered as a possible radioprotector.

The aim was to study the activity of progesterone and 5α-pregnan-3.20-dione conversion in the placenta at the exacerbation of cytomegalovirus infection (CMVI) during the first trimester of pregnancy. The study material included 50 villous chorions taken during medical abortions in the period of 8-10 weeks from women with exacerbation of chronic CMVI during pregnancy. The control group had 35 villous chorions of pregnant women of the same gestation period with chronic CMVI in the latent stage. Diagnosis of CMVI was performed taking into account the activity of CMVI with the immune-enzyme method by the level of antibodies of IgM and antibody titers of IgG in the paired serums in dynamics in 10 days. The progesterone content was determined at the “Stat Fax-2100ˮ spectrophotometer. The activity of 4-pregnene-3.20-dione dehydrogenase and 5α-pregnane-3.20-dione dehydrogenase was assessed by the histochemical method. Quantitative evaluation of the reaction products was carried out on sections under the microscope “Meiji Technoˮ connected to the software-hardware complex “SCION Corporationˮ. It was found out that progesterone content in villous chorions of women with reactivation of CMVI during pregnancy was reduced to 21.5±2.73 nmol/L in comparison with the control group (53.4±3.70 nmol/L, р<0.001). The disturbance of progesterone inversion intensiveness in placenta was proved by the decrease of enzyme activity: of 4-pregnene-3.20-dione dehydrogenase till 15.9±0.47 standard units (in control it was 28.6±0.58 standard units, р<0.001) and of 5α-pregnan-3.20-dione till 16.2±1.11 standard units (in control it was 25.0±1.91 standard units, р<0.001). Reduction in the intensity of progesterone conversion into 5α-dihydroprogesterone (5α-pregnan-3.20-dione) in the placenta with the exacerbation of CMVI can negatively affect the formation and functioning of the fetal nervous system.

The aim of the study was to assess the architectonics of the venous bed of the fetus part of placenta from women with the exacerbation of cytomegalovirus (CMV) infection in the first trimester of pregnancy. There were examined 75 patients after the term birth, among them there were 25 seropositive women with the exacerbation of CMV infection in the first trimester of pregnancy without clinical signs of threatened miscarriage; 23 seropositive women with the exacerbation of CMV infection in the first trimester of pregnancy and clinical signs of threatened miscarriage; 27 seronegative women without threatened miscarriage. The architectonics of the venous bed of the fetus part was studied with the pressing of contrast (red lead oxide in the linseed oil) through the umbilical vein into the vessels and placenta cotyledons. The roentgen shots were done at the device RUM-20 М “Sapphire”. During the research of the venous bed of the fetus part of placenta from women with the exacerbation of CMV infection and threatened miscarriage in the first trimester of pregnancy there was identified a velamentous attachment of the umbilical cord with the segmentary narrowing and venous varices as well as with the decrease of the outer diameter of veins of preconfluent zone of the fetus part of the organ. There is an increase in the number of asymmetrically located biconfluent venous vessels, the quantity of marginally located and blindly finishing curved vessels of veins and venous roots, which does not provide the effective blood flow and leads to the ischemia of the peripheral (edge) part of placenta. This reduces the delivery of oxygen and metabolites to the fetus, is accompanied with the development of plethora, stasis, thrombosis and inflammation in veins and arteries, as well as the increase of the risk of partial non-progressive separation of normally placed placenta and its partial intimate attachment to the uterus.

The aim of the study was to study the morphological structure of the liver in newborns with congenital cytomegalovirus infection. The material for the study was the liver of 36 full-term newborns who died on the 2^nd-5^th day of life from birth trauma, intranatal and postnatal hypoxia. The main study group included 16 full-term newborns with congenital cytomegalovirus infection. The comparison group included 20 newborns from mothers without any viral infections, as well as moderate, severe somatic diseases and obstetric pathology during pregnancy, and these babies died at the 2^nd-5^th day of life from birth trauma, intrapartum and postnatal hypoxia. The main cause of death of children of early neonatal age was intrauterine infection which was clinically manifested by moderate or severe cerebral ischemia with hypertension-hydrocephalic syndrome, pseudocysts of the vascular plexus, subependymal and subarachnoid hemorrhages, monocytosis, vesiculosis, pneumonia, hepatitis and meningoencephalitis and antenatal hypoxia caused by the development of subcompensated placental insufficiency. When describing the liver, the attention was drawn to the following macroscopic and pathohistological changes in the organ: 1) the condition of the capsule of the organ; 2) the change of the general plan of a structure; 3) the reaction of the bloodstream of the liver: 4) the condition of the portal tracts; 5) the state of the lumen of the bile ducts and its epithelium. The material was fixed in 10% neutral formalin, dehydrated in alcohols and poured into paraffin. For observational microscopy, histological sections 5-7 μm thick were stained with Böhmer hematoxylin and eosin. Morphological examination of the liver in the newborns of the main group showed an increase in the frequency of detection of subcapsular hematomas, pronounced congestion of sinusoids, foci of lymphohistiocytic infiltration of the connective tissue of the portal tracts, small-focal proliferation of Kupffer cells, alterative and proliferative changes in the epithelium of the bile ducts, as well as cells with viral metamorphosis. The revealed structural changes in the morphological structure of the liver in full-term newborns indicate the development of pronounced dyscirculatory, alterative and inflammatory changes in the liver of cytomegalovirus genesis.

Currently there is an active search for medicines increasing the stability of liver to pathological effects, reinforcing its neutralizing function, promoting its functional recovery after various injuries, including poisoning by industrial poisons. Therefore, the study of opportunities to reduce toxic liver damage by carbon tetrachloride introduction of synthetic and natural antioxidants is of interest. In experimental conditions the possibility to correct free radical lipid oxidation of rats’ organism membranes was studied with the introduction of the succinate containing drug called Reamberin (Polysan, St.Petersburg) and licorice syrup. The animals were divided into 4 groups and each of them had 10 rats: the group with intact animals which were held in standard conditions of vivarium; the control group in which rats were given carbon tetrachloride during 3 days daily; the experimental group in which before the introduction of carbon tetrachloride animals had a daily intra-abdominal intake of the Reamberin in a dose of 100 mg/kg (20 ml/kg); the experimental group in which before the introduction of carbon tetrachloride animals had a daily oral intake of the licorice syrup in a dose of 5 ml/kg. It was found out that in the blood and in the liver of experimental animals an introduction of carbon tetrachloride during 3 days contributes to the increase of lipid hydroperoxides level (by 24-43%), of diene conjugate (by 19-47%), and of malonic dialdehyde (by 61-81%) against the decrease of antioxidant system activity in the blood of intact animals. The introduction of the succinate containing drug to rats in the conditions of oxidative stress contributes to the decrease in the blood and in the liver of lipid hydroperoxides by 13-26%, of diene conjugates by 11-28%, and of malonic dialdehyde by 30-34% in comparison with the rats of the control group. Adding of the licorice syrup to rats contributes to the reliable decrease in the blood and in the liver of lipid hydroperoxides by 6-23%, of diene conjugates by 9-24%, and of malonic dialdehyde by 25-30% in comparison with the rats of the control group. While analyzing the effect of the antioxidants on the activity of the components of antioxidant system it was shown that the level of ceruloplasmin in the blood and in the liver of animals was reliably higher by 10-47%, of vitamin E by 13-42% in comparison with the same parameters of the rats of the control group. So, the application of the synthetic and natural antioxidants in the conditions of introduction of carbon tetrachloride of the organism of animals under experiment leads to the stabilization of the processes of peroxidation against the increase of antioxidant system activity.

The aim of the study was to analyze the effectiveness of different regimens of anti- Helicobacter pylori therapy and their influence on the small intestinal overgrowth syndrome (SIBOS) in type 2 diabetic patients with chronic gastroduodenal disorders. For this purpose an open comparative randomized study was performed in 138 type 2 diabetic patients with chronic gastroduodenal disorders, aged 54.4±5.2 on average. Gastroduodenal pathology was confirmed by gastroduodenoscopy, the H.pylori contamination by use of the unease method or finding bacterial antigen in excrements. The SIBOS was recognized by a respiratory hydrogen method with lactulose. Depending on the type of anti- H.pylori regimen all the patients were divided into 3 groups. Optimization 14-days triple therapy by use of Rabeprazol instead of Omeprazol was found to be effective with 80.6% of H.pylori eradication. Addition of both vismuth and probiotic resulted in increased eradication up to 94.1%, while the optimized triple regimen with Metronidazol and probiotic (intensified combined therapy) proved to be the most effective (97.2%) in H.pylori eradication. All 3 regimens of anti- H.pylori therapy resulted in the decreased number of SIBOS cases, but the best results in comparison with the initial data were obtained in the groups on the triple optimized and intensive combined therapy - up to 60 and 78.3%, respectively. The positive influence of anti- H.pylori therapy on SIBOS seen in the study allows the authors to propose one more indication for anti- H.pylori therapy.

Last years are marked by the increased number of cases of extra pulmonary localizations of tubercular process that are proved by the numerous publications. The diagnostics of these forms of tuberculosis is not easy because it requires a detailed examination of the patient. Cases of abdominal tuberculosis are among them. The article contains the data of modern medical literature on extra pulmonary forms of tuberculosis and information of clinical cases of posthumous diagnostics of tuberculosis of serous membranes of abdominal cavity and lungs.

At present time chronic obstructive pulmonary disease (COPD) is considered to be an airway disease with respiratory and systemic manifestations. Cardiovascular diseases have the largest influence on COPD severity among numerous coexisting diseases. These diseases are united together with such pathogenic factors as a sedentary lifestyle, disorder of lipid metabolism and hemostasis, endothelial dysfunction. Tissue hypoxia, oxidative stress, endothelial dysfunction, activation of neurohumoral systems, disorder of water-electrolyte metabolism, and also chronic systemic inflammation are the basic pathogenetic mechanisms of development of the coexisting cardiac pathology of patients with COPD. At the same time the regularities of changing of the clinical picture, peculiarities of a disease course, and also outcomes of COPD in case of comorbidity are still insufficiently studied. Today the main attention is focused on the introduction of noninvasive methods of diagnose of vessels’ elastic properties into clinical practice. Stiffness (rigidity) of the arterial wall studied through the use of the volume sphygmography method is considered to be one of the informative markers of cardiovascular morbidity and mortality. Pulse wave velocity depends on the stiffness of the vessel wall: the higher the vessel’s stiffness is, the thicker the vessel’s wall is and the smaller its diameter is, then the faster the pulse wave velocity is. An early disease detection of changings of arterial stiffness and metabolic disorders has an important clinic and prognostic value and makes it possible to coordinate therapy timely with the combined cardiopulmonary pathology and avert negative consequences of hemodynamic complications.

One of the main causes of the epidemic of tuberculosis in our country is the spread of strains of Mycobacterium tuberculosis , which are multiple and extensively drug-resistant. This serious drug resistance structure is explained by the wide circulation of strains of mycobacteria of the genetic family Beijing in the Russian Federation. Each of the stages of such an evolving infectious process is characterized by certain tissue and cellular reactions, shifts in metabolism and functional state of cells involved in the inflammatory process. The literature review covers the biological properties of this strain, the morphology of mycotuberculous inflammation from the position of cell-tissue reactions, the role of the vascular bed in this inflammation, and the study of the functional activity of cellular elements in the zone of tuberculous inflammation with the help of immunohistochemical study.

A review of the literature is devoted to the peculiarities of the lung structure of white rats. Morphological features of rat lungs are an experimental model in the case of the study of the development of left ventricular pulmonary hypertension. Rats have the features of the lungs structure, which differ from the lungs of man. The construction of blood vessels of the rat lungs should be studied in the case of a stressor lung. Peculiarities of innervation of the pulmonary veins of rats in the root of the lung make the left lung of rats an object of study necessary for solving the problems of modern pulmonology, cardiology and morphology. In the anatomical study, the root of the diaphragmatic lobe is located in the caudal sulcus of the left lung. In studying the features of the sintopia and holotopia of the root and gates of the left lung of sexually mature rats, the structural apparatus of the caudal sulcus is discovered, which is located for more than 11-17 mm on the medial surface of the diaphragmatic lobe of the left lung. The structural apparatus consists of the left caudal pulmonary vein, furrows on the surface of the diaphragmatic lobe of the left lung, the adventitial shell of the caudal bronchus, the visceral pleura, the bronchial nerves and blood vessels, the encapsulated receptors. The presence of cardiomyocytes in the intrapulmonary veins in rats confirms the hypothesis of a rhythmic, valve-like action of the transverse striated muscle of the pulmonary venous wall during systole and a possible role in pulmonary circulation. Data obtained through experimental intervention indicate the valve-like effect of the striated muscle of the pulmonary venous wall.

Examples of air pollution and its consequences are given. The main sources of dust formation are described, including sand and dust storms and man-caused wastes arising from the extraction of minerals, its types, form and properties. The dispersion of dust particles is characterized, as well as the danger of particles of 0.3 to 5 μm or less to humans. It is shown that the irritating, toxic, allergic, mutagenic, carcinogenic, fibrogenic and other effects of dust depend on the physicochemical properties, particle size and surface, their content in the room air or in the working area, the duration of the action. It is noted that the efficiency of dust also depends on the individual reactivity of the person. Briefly listed are the specific and nonspecific effects of dust and the mechanism of pneumoconiosis development.

The syndrome of lymphadenopathy (lymph-node hyperplasia) takes place in many diseases that are different by etiology, clinical course, methods of treatment and prediction. While identifying the cause of lymphadenopathy the diagnostic search should be based on the clinical situation (the character of lymphadenopathy, the presence of other symptoms, anamnestic data, the character of changes in the peripheral blood and others). The choice of the most informative method of diagnosis is defined by the diagnostic hypothesis with the consideration of the data of the primary examination of the patient, the parameters of the peripheral blood as well as the values of sensitivity and specificity of the corresponding method of study for verification of the disease supposed. The basis of this research was the material of computed-tomography examination of chest organs in 491 patients with different forms of mediastinum lymphomas in the consultative policlinic of the Far-Eastern Scientific Center of Physiology and Pathology of Respiration from 2011 till 2017. Among them there were sarcoidosis of intrathoracic lymph glands of the first, second and partially third stage (n=432); Hodgkin's lymphoma (n=17); metastases in lymph glands of mediastinum (n=25); lymphosarcoma (n=12), tuberculosis of lymph glands in adults (n=5). Beside prevailing digital radiologic studies, multispiral computed tomography was done to all of them and 78% went through fiberbronchoscopy. The verification was in 82% of patients: transbronchial biopsy under ultrasound visualization (72%) and transthoracic open biopsy (28%).