Systemic scleroderma is a systemic autoimmune disease that affects multiple organs, including the bronchopulmonary system. The disease leads to progressive pulmonary fibrosis, which is the most common cause of death. Hence, standard therapy of systemic sclerosis should be supplemented with antifibrotic therapy. The article describes a clinical case of the efficacy of a combination of standard therapy with the tyrosine kinase inhibitor nintedanib in a patient with systemic scleroderma and a progressive phenotype ILD. The patient was taking nintedanib in combination with standard therapy (methylprednisolone, mycophenolate mofetil) for 7 months and showed improvement on CT in the form of a significant decrease in the ground glass lesions. In addition, bodyplethysmography showed a decrease in restrictive changes in the external respiration (an increase in the total lung capacity from 49 to 57%), an improvement in the lung diffusion capacity (an increase in total diffusion from 47 to 53%). This clinical case demonstrates the high efficacy of antifibrotic drug nintedanib in the complex therapy of patients with systemic scleroderma and progressive pulmonary fibrosis. Nintedanib increases the efficacy of basic therapy and improves the prognosis.

The purpose of this research was to assess a significance of a computed dermography (CD) method to detect bronchoobstructive syndrome (BOS), to evaluate bronchial reversibility during a bronchodilating test in chronic obstructive bronchitis (COB) patients and to reveal bronchoconstruction in healthy smokers. Eighty four persons were observed: 30 healthy non-smokers (the control group), 24 smokers not having clinical manifestations of pulmonary diseases (the risk group), and 30 patients with COB of different seventy at the exacerbation stage. The bronchial reversibility was diagnosed using instrumental methods: CD, spirography, peakflowmetry. The CD method rejects the theory organ-point and investigates more complex relationships in contradistinction to other well-known reflex-diagnostic methods. The CD is easy, non-invasive and informative. The control group was examined by the CD, spirography, peakflowmetry. Normal CD-criteria were found. The risk group was examined by the same methods before and in 5-10, 30-40, and 60-90 minutes after smoking. The CD method was found out to be an objective and more sensitive method which allowed to detect bronchoconstriction in smokers after smoking, while the results of the spirography and peakflowmetry were negative. The COB patients were examined before and in 30 minutes after the test with Berodual. As a result, the CD-criteria of the BOS were revealed. It was shown that the CD as more sensitive and objective method could be used equally to spirography and peakflowmetry to assess the bronchial reversibility in the COB patients and to choose bronchodilating therapy.

The main aspect in treatment of the patients with chronic obstructive pulmonary disease (COPD) is the detecting of the progressing bronchoobstruction (BO). The detecting of BO is carried out by such well-known methods as spirography and peakflowmetry. Some investigators emphasized insufficient evidence of these methods that is connected with subjectivism under realization of the research. The up-to-date methods must be objective, uninvasive, economical and easy. One of such methods is the computed dermography (CD-method) developed in Primorsky region and recommended by the Department of Health for application in medical practice. From the beginning of 2004 in Russia the new preparation of anticholinergic group of prolonged action — tiotropium bromide was registered. The purpose of this research was a clinicial-functional estimation of the efficiency of the tiotropium bromide (activity cholinergic receptors) in the patients with COPD of the CD-method of the function F5-3. 20 patients with COPD III-IV stages with clinical manifestations of the COPD has been had necessary therapy according to the stage of weight were observed in Regional pulmonary center. So, the CD-method was determined to be an objective and more sensitive method which allows detecting of the BO's progressing and prognosticate it in the patients with COPD after the long treatment tiotropium bromide.

98 patients with chronic obstructive pulmonary disease were inspected in during 2 years. Standard electrocardiogram, computer electrocardiotopogram, ultrasonic cardiography have been executed to all patients for the period of supervision. Diagnostic criteria of right heart hypertrophy have been revealed with using of computer electrocardiotopography method. Advantage of computer electrocardiotopography method in comparison with standard electrocardiogram and ultrasonic cardiography methods were shown for revealing of chronic pulmonary heart in patients with chronic obstructive pulmonary disease.

The article represents argumentative issues of Chronic Obstructive Pulmonary Disease (COPD) treatment which is a global problem of modern medicine. According to WHO data COPD is the third leading cause of death worldwide, annually about 2.8 million people die because of this disease, and over 20 years this statistics never changed. In developed countries the highest costs for health systems in the treatment of respiratory diseases are associated with COPD which affect the course of this disease causing an irreversible progressive decline in lung function, deteriorating quality of life, increasing the frequency of readmissions and mortality. Thus, the prevention of exacerbations of COPD is of social and economic importance and should be a priority in the treatment of this disease.

318 students from the Pacific State Medical University were questioned with special questionnaires in 2009-2011 to study the incidence of tobacco smoking among students. 32.1 % of respondents had been smoking, among which 37.9 % were young men and 28 % - young women. With regard to the 1 st and 6 th years of education, the number of smokers has risen, as the period of study has advanced: from 21.9 to 43.3 % among young men, and from 10.7 to 46.0 % among young women. Despite of the fact that by the 6th year of education the degree of nicotine addiction increased, there was an increasing motivation to give up smoking.

In the article the case of diffuse lymphangioleiomyomatosis of the lung at 21 year-old women is described The disease has manifested on the 38th week of the pregnancy. Leiomyomas of others localizations were absent. The clinical course was malignant: in 22 days after disease's manifestation women had died. The possible mechanisms of uncontrolled proliferation of nonstriated muscle's elements and features of lymphangioleiomyoma's morphological diagnostics are discussed.

The authors present an overview paper devoted to computer dermography (CD) known to be a conceptually new technology intended for health monitoring that carries out functional and topical diagnostics with high resolution. The CD method is easy to use for both medical workers and patients. While examining patients with chronic obstructive lung disease and bronchial asthma, the CD indices appear to be informative to diagnose bronchial obstruction, and be comparable with the data obtained as a result of spirometry and peakflowmetry. The CD method proves to be more sensitive than the spirometry to detect the bronchial obstruction at early stages of exacerbative bronchial asthma and latent bronchospasm in healthy smokers. The CD method can serve as additional method to diagnose broncho-obstructive syndrome, and is recommended for population screening and in medical institutions.

It was analyzed for pneumonia in 24 patients in the epidemic season of influenza A/H1N1 in October 2009 April 2010 in Primorsky Krai. They required urgent hospitalization in the intensive care unit and required in massive antiviral, wide spectrum antibacterial combined therapy, interferons, immunoglobulins, anticoagulants management. Women have been involved mostly. The pregnant women had the most severe pneumonia. The experience of treatment such pneumonia has been demonstrated.

The hemostasis system, the level of pulmonary hypertension and myocardial condition (the thickness of the anterior wall of the right ventricle of heart, dystrophic changes of right and left ventricles) depending on hypoxemia level have been examined in 47 patients with chronic obstructive pulmonary disease. It was suggested that as the severity of hypoxemia increases, hypercoagulation of the blood, the degree of pulmonary hypertension, myocardial hypertrophy of the right ventricle and dystrophic changes of both ventricles of heart rise.

Целью исследования стала оценка влияния тинростима (комплекса низкомолекулярных пептидов) на систему иммунитета и гемостаза и его клинической эффективности у пациентов с обострением хронической обструктивной болезни легких. В рандомизированном исследовании 108 больных показано, что включение тинростима в состав комплексной терапии оказывает корригирующий эффект на состояние иммунной системы: нормализуются показатели клеточного и гуморального иммунитета (повышается содержание CD3+-, CD4+-лимфоцитов и уровня компонентов комплемента, снижается концентрация циркулирующих иммунных комплексов и провоспалительных цитокинов в сыворотке крови), усиливается фагоцитарная активность нейтрофильных лейкоцитов. Под влиянием тинростима снижались показатели ортофенантролинового теста (с 21,4 ± 2,5 до 14,4 ± 2,2 мг/%; р = 0,026) и возрастала фибринолитическая активность крови (с 6,9 ± 0,59 до 10,7 ± 1,6 %; р = 0,037), что свидетельствует о купировании внутрисосудистого свертывания крови и способствует предотвращению процессов фиброзирования в бронхиальном дереве. Клинический эффект исследуемого препарата проявлялся в уменьшении выраженности основных симптомов заболевания: кашля ( р р р < 0,05).

The authors have examined two groups of patients with chronic obstructive pulmonary disease (24 patients without hypoxemia and 17 patients with hypoxemia) and revealed interdependence between hypoxemia level and system inflammation and haemosta-sis. The levels of systemic inflammation markers, hypercoagulation and fibrinolytic system suppression in patients with hypoxemia was considerably higher than those of the patients with normal parameters of the arterial blood oxygen saturation that was indicative of a considerable role of hypoxemia in pathogenesis of inflammatory reaction in case of chronic obstructive pulmonary disease.

Opportunities of the computer electro-cardiotopography in diagnostics of chronic pulmonary heart and myocardium dystrophy of a right ventricle are considered. 63 patients with chronic obstructive lung disease of various degrees are surveyed. It is shown, that electro-cardiotopography with potentials from 260 removals considerably surpasses standard ECG and an echocardiography in sensitivity in diagnostics of myocardium dystrophy of a right ventricle. The most specific to this pathology are the changes of the bottom horizontal lines on the right cartogram, where T-inversion or its deepening on more than 3 mm is registered. Also the suggested method was more effective than ECG and echocardiography in diagnostics of chronic pulmonary heart.

30 patients with chronic obstructive pulmonary disease (COPD), hypertonic disease and combined left and right heart hypertrophy were examined. The comparative (control) groups included 32 COPD patients with right heart hypertrophy as well as 35 ones with hypertonic disease. The results of combined heart hypertrophy diagnosis in COPD patients by means of the standard electrocardiogram and computer electrocardiotopography method showed the higher efficiency of the latter.

Studies aimed at determining computer dermography method parameters indicating Mcholin receptor activity of bronchi in COPD and used to diagnose and control treatment efficiency were carried out.