There was done analysis of epidemiological monitoring of respiratory diseases (RD) on the territory of the Far Eastern Federal District (FEFD), which allows to assess the levels, structure and regional features of the spread of pathology among different populations and territorial formations, the dynamics of the disease and its relationship with the environmental factors of the region. To organize the study, the methods of cluster, structural and comparative analysis, predictive modeling, dynamic series analysis, statistical and information-analytical methods, databases of the Ministry of Health of the Russian Federation, the Federal State Statistics Service of the Russian Federation were used. The epidemiological analysis of the main indicators of RD level and dynamics in the FEFD territory indicates the presence of regional differences in the registered morbidity, the degree of which is due to the natural-climatic and socio-demographic characteristics of the habitat. 77.8% of the region's subjects are in the zone of low morbidity. At the same time, the values of maximum and minimum levels of general and primary RD morbidity in the region differ by 2.2 and 2.4 times, respectively, becoming the most pronounced among the adult population (by 3.6 times). In chronic bronchitis and COPD, the regional gradients of the registered morbidity are 10.9 and 9.8 times, respectively. It was found that the values of the primary RD morbidity in children's population in the FEFD are 14.4% higher than at the federal level, and among the adult population the gradient of values has the opposite indicators: 24.9% lower. At the same time, if the incidence of pneumonia in the region is 15.2% higher than the incidence of pneumonia in the Russian Federation as a whole, the incidence of chronic forms of RD in the region is 17.3-28.9% lower than at the federal level. The level of primary RD morbidity in 2005-2016 in the Far Eastern Federal District increased by 23.3%, including bronchial asthma (by 20.3%) and COPD (by 47.7%), and the incidence of pneumonia significantly decreased. At the same time, the average annual rate of increase in primary RD morbidity is higher than in the Russian Federation as a whole. This is shown by the predictive model of morbidity dynamics, the linear trends of which are more progressive in the FEFD compared to the dynamics at the federal level. The rate of positive dynamics of morbidity, significantly exceeding the same rate of morbidity growth at the federal level, indicates an increase in the level of availability and quality of medical care for patients with pulmonological profile, timely and early detection of chronic forms of respiratory diseases, positive motivation of the population for treatment in medical organizations. These trends in the dynamics of the registered morbidity are due to the active introduction of effective methods of diagnosis and treatment of chronic respiratory diseases, preventive and educational programs implemented both at the federal and regional level.

The aim of the study was to analyze the peculiarities of TRPM8 receptor expression at protein level in induced sputum and nasal epithelium of asthma patients, and to evaluate their relationship to maintenance therapy and cold airway hyperresponsiveness. The study enrolled 43 patients, including those with persistent mild-to-moderate asthma and those with chronic non-obstructive bronchitis (control group). Analysis of TRPM8 expression was performed by indirect flow cytometry. In addition, patients underwent spirometry and a bronchoprovocation test with 3-minute cold air hyperventilation. As a result, we found that TRPM8 was expressed on macrophages of induced spleen and nasal epithelium. Its expression in patients with asthma who did not receive maintenance therapy was more pronounced as compared to the treated patients or the control group. Moreover, the relationship between increased expression of TRPM8 on macrophages and cold airway hyperresponsiveness was established. Further studies should reveal the possibility of TRPM8 usage as a prognostic biomarker of asthma at various stages of the disease development.

In 185 patients with chronic hemoblastosis (chronic lymphocytic leukemia, chronic myeloid leukemia, idiopathic myelofibrosis, multiple myeloma) after autopsy, the pathology of the bronchopulmonary system was studied. It was found out that in addition to immunodeficiency, an important role in the occurrence of respiratory diseases in chronic lymphocytic leukemia, as well as in chronic myeloid leukemia and idiopathic myelofibrosis in the stage of blast crisis is played by specific leukemic infiltration of the lungs, bronchi, pleura and diaphragm; the presence of leukostasis in the vessels of medium and small caliber with violation of microcirculation; compression of the diaphragm by significantly increased spleen and liver; in some cases (especially in chronic lymphocytic leukemia) hyperplasia of the lymphoid follicles of the bronchial tree. In chronic myeloid leukemia and idiopathic myelofibrosis, hyperthrombocytosis with the development of the sludge syndrome in small vessels of the lungs is essential. Pulmonary localization of inflammatory processes in patients with multiple myeloma is facilitated by lymphoid and plasma cell infiltration of the lungs, paraproteinosis of the lungs, localization of myeloma nodes in the ribs, lung tissue and bronchi.

To assess the anti-inflammatory effect of millimeter therapy in the treatment of partially controlled asthma, the fatty acid composition of erythrocyte membranes and their oxygenase derivatives were studied. Eighty-five subjects aged 18 to 45 years old were examined, 60 of them were diagnosed with partially controlled asthma and 25 were a control group, which consisted of conditionally healthy subjects without bronchopulmonary pathology. Two study groups were formed. Patients of the 1^st group (n=30) received only basic medical treatment: inhalation glucocorticosteroid and β₂-agonists of short action on demand. Patients of the 2^nd group (n=30) underwent complex treatment: basic medical treatment in combination with millimeter therapy according to the developed technique. Clinical symptoms (frequency of nocturnal and daily asthma attacks per week, severity of cough, need for short-acting bronchodilators during the day), results of the asthma symptom control questionnaire (ACQ-5 test), lung function, composition of fatty acid (FA) in erythrocyte membranes, level of eicosanoids were assessed. The dynamics of clinical-functional and laboratory indicators in patients was evaluated one month after the start of treatment. The study established a modification of FA erythrocyte membranes composition, characterized by an increase in the proportion of some representatives of saturated and monounsaturated FA, increased production of arachidonic acid and its cyclooxygenase and lipoxygenase metabolites (thromboxane B₂, leukotriene B₄) against the background of deficiency of eicosapentaenoic and docosapentaenoic acids. A significant decrease in the level of oxygenated derivatives of fatty acids in the blood plasma of patients was revealed against the background of positive dynamics of clinical course of the disease in the 2^nd group receiving complex treatment, which indicates the normalization of metabolic transformations of oxygenated derivatives of fatty acids, and as a consequence the extinction of allergic inflammation under the influence of electromagnetic waves of the millimeter range of extremely high frequency.

Literature data on the ethiopathogenetic role of Ureaplasma species, Mycoplasma hominis in the development of premature delivery is contradictory due to the fact that Mycoplasma may be part of the normal microflora of women of reproductive age. The article is aimed to reveal the peculiarities of morphofunctional state of the placentas infected with Mycoplasma . The placentas were obtained from women whose pregnancy ended prematurely. Morphological, histological and molecular genetic study of 34 placentas from maternity patients with premature delivery was performed. Molecular genetic study was carried out by real-time PCR. Ureaplasma spp. was detected as a part of mono- and mixed infections in a concentration of 10*2 to 10*6 GE/mL in 32.3% of cases. Mycoplasma hominis was detected in 23.5% of cases, in a concentration of 10*3 to 10*6 GE/mL. Inflammatory changes in the membranes and placenta were revealed in all cases of Ureaplasma spp. detection as a monoinfection regardless of the degree of bacterial load, which confirms the belief about the pathogenetic role of Ureaplasma spp . in the process of reproductive disorders formation.

The general characteristics of the Mollicutes class of the family Mycoplasmataceae , the distribution and sources of mycoplasma infection, its clinical features and diagnostic methods are given. In scanning electron microscopy of blood plasma in patients with severe fibrous cavernous pulmonary tuberculosis in the phase of infiltration and seeding, elementary bodies of unidentified L-forms of bacteria and filamentous branching forms with various structures on the surface, presumably cells of mycoplasmas, were identified. All these formations together with mycobacterium tuberculosis form superinfection, which is the cause of the progression and outcome of the tuberculosis process.

Clinical and serological features of the gestational process in 85 women with pregnancy, uncomplicated and complicated with parainfluenza-influenza infection in the second trimester of gestation, were studied. All examined women were divided into three groups. The first group (control) included 32 women with physiological course of pregnancy and their healthy full-term newborns. The second group included 32 patients with respiratory mixed-virus infection in the second trimester of gestation, and in their newborns there was diagnosed moderate cerebral ischemia and no signs of intrauterine infection. The third group included 21 women with respiratory mixed virus infection in the second trimester of pregnancy, which was the cause of antenatal infection in their full-term infants with cerebral ischemia of moderate severity. It was shown that the women of the third group compared with the second and first groups often complained of headache, photophobia, sweating and weakness, increase in body temperature to 37.6-38ºC, hoarseness of the voice, sore throat, as well as a prolonged course of acute nasopharyngitis and acute laryngitis. The above clinical features of acute respiratory viral infection in women in the second trimester of gestation may contribute to antenatal infection and may disrupt optimal conditions for intrauterine brain development in their babies.

The purpose of the work is to study the processes of peroxidation of lipids and their influence on the structure of the endothelium of the umbilical artery of newborns from mothers who had experienced exacerbation of cytomegalovirus (CMV) infection in the third trimester of pregnancy. For the object of the study there were taken 45 umbilical cord samples during childbirth from women who had acute CMV infection in the third trimester of pregnancy (main group), and 25 umbilical cord samples from healthy women (control group). Clinical diagnosis of primary CMV infection was established by the presence of IgM antibodies to CMV and low-avid IgG in the peripheral blood (avidity index <50%), as well as CMV DNA detected by polymerase chain reaction in blood or urine; exacerbation of chronic CMV infection by the presence of IgM to CMV, high-avid IgG (avidity index >65%), and CMV DNA in scrapes taken from buccal epithelium. Lipid peroxides in the endothelium of the umbilical artery were detected by the Winkler-Schulze method. Morphological examination of the umbilical cord was performed by histochemical methods. The results of histochemical studies indicate that the exacerbation of CMV infection in the third trimester of pregnancy is associated with oxidative stress that causes the depletion of the protective systems and oxidant potential, which leads to the development of significant oxidative destruction of the endothelium of the umbilical cord artery of newborns. The revealed morphohistochemical changes in umbilical cord tissues in CMV infection can affect the functional state of this organ and be a morphological substrate for the appearance of its dysfunction, mainly the basis for the violation of fetoplacental blood circulation causing the development of hypoxia.

The aim of the work was to study the morphological structure of the thymus gland in 36 full-term newborns who died at the 2-5 day of life. The main group included 16 newborns who were diagnosed with intrauterine cytomegalovirus infection by the serological method and polymerase chain reaction. Cerebral ischemia of moderate and severe degree, subarachnoid and periventricular hemorrhages, as well as markers of local and generalized forms of congenital infection were revealed in children of this group. The comparison group was represented by 20 newborns with antenatal ontogenesis, uncomplicated by acute respiratory and herpes-virus infections, moderate and severe somatic and obstetric pathology in their mothers during pregnancy. The cause of their death was birth trauma, intranatal and postnatal hypoxia. In the description of the neonatal thymus, attention was paid to the following features: the general plan of the structure; structural changes in the capsule of the gland; the structure of the cortical and brain matter; violation of loose fibrous connective tissue and blood vessels of the organ. It was found out that the structure of the thymus gland in the main group was different from that in the comparison group, especially a predominance of neonates with increase and decrease in the organ mass. With the growth of the mass of the thymus there was frequently revealed subcapsular hemorrhage; the sharpness of borders decreased or completely disappeared between cortical and medullary substance; the areas of crust delymphatisation, Hassall’s corpuscles filled with detritus were often identified. The edema of the interlobular loose fibrous connective tissue increased, the endothelial edema and its desquamation in the lumen of blood vessels were noted. Lymphocyte clusters in the interlobular connective tissue were clearly visualized. In the case of a decrease in the body mass, small lobules, excessive formation of collagen fibers in the interlobular connective tissue, the loss of lymphocytes in the cortical substance and small Hassal’s bodies were more often recorded. Stimulation of thymus growth may be associated with the direct cytodestructive effect of the virus and intrauterine stress, leading to a drop in cortisol content. In the inhibition of immunopoesis growth, prolonged antenatal antigenic stimulation, higher level of cortisol against progressing alterative processes in glandulocyte of the cortex of suprarenal glands of the fetus play an important role.

The aim was to study the structure of the adrenal cortex in 36 dead full-term newborns. The main group consisted of 16 newborns with congenital cytomegalovirus infection, clinically manifested by moderate and severe cerebral ischemia, predominance of hypertensive-hydrocephalic syndrome, pseudocysts of the vascular plexus, sub-perpendicular and subarachnoid hemorrhages, monocytosis, vesiculosis, pneumonia, hepatitis and meningoencephalitis. The comparison group consisted of 20 dead newborns from mothers who did not have infectious diseases during pregnancy, as well as moderate and severe somatic and obstetric pathology. Birth trauma, intranatal and postnatal hypoxia were the main cause of their death. The evaluation of the pathomorphological picture of the adrenal cortex included a description of the general plan of the structure, the severity of alterative changes in glandulocytes, the number of adenomatous-like structures and their morphological forms, the reaction of loose fibrous connective tissue. It was found out that in suprarenal glands in children of the main group unlike the comparison group there was often detected a breach of the strands of granulocytes, there were found pronounced alterative changes in the cells; there were revealed large adenomatous-like structures in the lumen of which eosinophilic mass was often found and there was observed strongly-pronounced plethora of vessels. Only in the main group there were determined areas of thinning of the cortical substance of the glands, several adenomatous-like formations and anatomical forms containing in their lumen red blood cells and erythroblasts, as well as large hemorrhages. These structural changes indicated inhibition of adrenal cortex formation and prolonged antenatal stimulation of steroidogenesis under the influence of congenital cytomegalovirus infection leading to a decrease in glucocorticoid function of the suprarenal glands in children after birth.

The paper presents the results of the first study of the particle size distribution of atmospheric suspension contained in the snow of some settlements of the Magadan region (the town of Magadan, the town of Susuman and the urban settlement of Omsukchan). The study found a significant content of PM₁₀ particles in the air of Magadan town (28 to 65.7%), and a general dominance of particles under 50 µm in diameter (PM₅₀ fraction) from 44.4 up to 100%. The content of environmentally significant PM₁₀ particles in the air of smaller settlements of the Magadan region (town Susuman and settlement Omsukchan) does not exceed 21.1%. It can be concluded that the air in the Magadan town, due to the predominance of PM₁₀ and PM₅₀ particles, is characterized by a pronounced micro-particles contamination. This level of pollution, in conjunction with the harsh climate of this region, is a constant source of respiratory diseases and a factor in reduction of the quality of life.

A computer method for recording the temperature of inhaled and exhaled air is developed. Using this method, the airway conditioning function was studied in 10 healthy individuals and 16 patients with polypous rhinosinusitis, in order to predict the development of bronchial asthma in the latter. The proposed computer method for recording the temperature of the air inhaled and exhaled through the nose allows to obtain visual and accurate indicators. This method can be used in the conditions of pulmonological and otorhinolaryngological departments, for example, to predict the development of bronchial asthma in patients with polypous rhinosinusitis.

The purpose of the research is to develop a method for assessing the severity of symptoms of the endogenous intoxication syndrome and associated respiratory disorders in patients with colorectal cancer. The study involved 86 patients (the main group included 51 patients with colorectal cancer, the control group 35 relatively healthy people). All patients were studied upon indicators of clinical blood test, and hematological indices of intoxication were calculated. In the patients of the main group, an assessment of the oxygen status parameters was done. The study revealed that 52.9% of patients with colorectal cancer have symptoms of endogenous intoxication syndrome and respiratory disorders of varying severity, which are accompanied by decrease in oxygen delivery to tissues, its increased consumption and utilization. As a result of the study, there was proposed a method for calculation of the integral index of intoxication as a parameter of expression of endogenous intoxication and associated respiratory disorders. Statistically significant values of the correlation coefficients of the proposed indicator of intoxication and oxygen status parameters suggest a high diagnostic significance of this index in patients with colorectal cancer. Moreover, the application of this method in everyday practice is simple for the doctor and safe for the patient.

The purpose of the study is to propose a method of preoperative correction of the symptoms of endogenous intoxication syndrome and associated respiratory disorders in patients with colorectal cancer. The study involved 68 patients having a surgery for colorectal cancer of different localization, with an increased leukocyte index of intoxication by V.K.Ostrovsky in preoperative period. The first group patients (37 subjects) in the preoperative preparation program took Cytoflavin^® according to the developed scheme. The second group patients (31 subjects) had a standard preoperative preparation. As result of the research, there was revealed a positive effect of the proposed method of preoperative preparation on hematological parameters of endogenous intoxication (decrease in values of the parameters of Calf-Caliph, Ostrovsky and integral index of intoxication) and parameters of oxygen status, which changes indicated a decrease in tissue hypoxia (decrease in tissue oxygen consumption). The positive effect of the proposed method of preoperative preparation was observed in the postoperative period (reduced severity of respiratory disorders and hematological symptoms of endogenous intoxication).

The article gives information about the way how the problem of pharmacoresistant neuropathic pain is solved. It presents the definitions of pharmacoresistant neuropathic pain, which makes it possible to accurately identify such patients and to plan tactics for their treatment. Intrathecal opioid analgesia has been used in clinic practice since 1979 and has gained a great popularity till now due to its high analgesic potency. The case of treatment of pharmacoresistant neuropathic pain syndrome of central origin in a patient who had spinal injury and stabilizing spinal surgery is presented. Conservative therapy for 3 years was considered to be ineffective and the patient was implanted with an intrathecal port for long-term opioid therapy. The follow-up period was 6 months. The effect of the procedure allowed the patient to abandon the massive drug therapy, as well as significantly improve the quality of life.

The review focuses on the role of interleukin-6 (IL-6) signaling in the development of a systemic inflammatory process in chronic obstructive pulmonary disease (COPD). In most researches the attention is paid to local inflammation in COPD. However, it is known that the pathology is characterized by a systemic inflammatory process, which is manifested in the increased levels of proinflammatory mediators in blood flow, and the study of the molecular mechanisms of its development is very important for the therapy of the disease. One of the key mediators of systemic inflammation is cytokine IL-6 which has pro- and antiinflammatory properties. Its effect on the cells is determined by the type of signaling. Nowadays three types of IL-6 signaling are identified: transsignaling, classical and cluster signaling. The review presents the known pathophysiological mechanisms of the development of systemic inflammation in COPD involving IL-6. As a proinflammatory cytokine, IL-6 performs the following functions: transmission of a signal on lung tissue damage, initiation of leukocyte migration into the inflammation site, inhibition of T-cell apoptosis into the inflammation site, influence on T helper differentiation, participation in pathophysiological reactions of development of emphysema and fibrosis. The significance of IL-6 transsignaling for the development of inflammation in COPD has been confirmed by many studies, while there are practically no works devoted to the study of classical IL-6 signaling in COPD. The data presented in the review indicate the need for further study of the role of different types of IL-6 signaling, especially classical signaling, in the regulation of systemic inflammation in COPD.

The review provides information on the physiological role of medium-chain saturated and unsaturated (myristic, pentadecanoic) and long-chain (palmitic, stearic, oleic) fatty acids in embryonic development. The value of fatty acids in the formation of the lung surfactant of the developing fetus is shown. There is presented the information about the role of polyunsaturated acids of arachidonic and docosahexaenoic ω-6 family in the structural and functional development of the nervous system and the visual analyzer of the fetus and the newborn. The interdependent stimulating effect of unsaturated oleic and linoleic fatty acids on the differentiation of muscle cells is shown; the role of oleic and acids with 20 carbohydrate atoms in the mineralization of bone tissue is demonstrated; the value of oleic acid in the regulation of placental transport of amino acids through tol-like receptors 4 and cellular signaling is presented. The above mentioned factors allow drawing the conclusion about the need for further study of lipids as the main energy substrates, sources of plastic material, structural components of erythrocyte membranes, nerve tissue, visual analyzer, pulmonary surfactant and skeletal muscles. The accumulated data broadens the understanding of the role of lipids in metabolic processes, which will allow us to move from a fundamental research to practical aspects of the use of these substances in obstetrics and perinatology. In the long term, these results can be used to interpret and predict changes in metabolic disorders of lipids in various pathological conditions during pregnancy.

Chronic obstructive pulmonary disease (COPD) has many systemic effects, one of which is impaired renal function. Existing studies prove that patients with COPD often have risk factors for developing chronic kidney disease (CKD). Many risk factors for developing COPD are common for the onset of CKD. However, in routine clinical practice, there is an underestimation of the incidence of renal dysfunction in COPD patients, while in-depth and targeted studies reveal changes in renal function in patients with COPD. Topical methods for identifying initial changes in renal function in COPD patients are the study of the glomerular filtration rate, the evaluation of the level of microalbuminuria, the study of the index of resistance of renal vessels. The importance of identifying CKD in the early stages in COPD patients is determined by the increased risk of cardiovascular events and the onset of cardiorenal syndrome in patients.