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.

Left posterior block of bundle of His occurs under posterodiaphragmatic myocardial infarction. Based on the anal-ysis of 14 observations the authors make up conclusion that ap-plication of computer electrocardiotopography with registration of 260 unipolar leads allows to specify necrosis size under myo-cardial infarction complicated by left posterior block of bundle of His, and in some cases to detect the block itself.

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.

During the recent years, a high emphasis is placed on the computed electrocardiotopography. Notwithstanding the advantages of the method over the standard ECG, the mapping of the surface of body has not become a widespread method because of the complexity to interpret the findings. A group of 74 practically healthy persons (59 men and 15 women) has been examined. The complex analysis of the heart electric field, according to computed electrocardiotopograph data, has enabled to study and describe adequately the features of the electrocar-diotopograms of the healthy patients with normal, horizontal and vertical position of electrical axis of heart.

Osteoarthritis (OA) is a degenerative inflammatory disease of the synovial joints associated with age, cardiovascular comorbidity, and other factors. It is based on articular cartilage (AC) and subchondral bone (SCB) damage. Recent studies have shown that age-related changes, cardiovascular diseases, and OA may have a few common molecular mechanisms. At the same time, the conditions and the degree of influence of arterial hypertension (AH) and hyperlipidemia (HL) on joint tissues remain unclear. The goal of the study is to analyze the effect of AH and HL on the processes of cellular stress, AC remodeling, and OA development. An experimental study was carried out on 18 adult males of purebred guinea pigs (28–30 weeks old, weight 750–900 g). The first (AH model), second (HL model), and third (control) groups included six individuals each. The results of the study demonstrated that AH and HL directly affect the joint tissues and cause cellular stress, which is manifested in changes in the morphofunctional characteristics of chondrocytes. Changes in the cellular phenotype lead to the degradation of AC and SCB, as well as to the ectopic angioproliferation. However, cardiometabolic factors influence AC remodeling processes in different ways. Thus, during isolated AH, hypertrophic differentiation of chondrocytes, AC destruction, and a loss of cambial cells are observed. Cell death processes, pathological AC mineralization, and enhanced pathological angiogenesis are observed in HL. The greatest changes in AC are caused by the combination of AH and HL. A combination of cardiometabolic factors results in necrotic destruction of AC and SCB replacement with osteopod-like matrix.

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.

Aim. To determine the expression level of endothelial factors (VEGF-A, CD34+) in the tissues of the joints in experimental arterial hypertension (AH), hyperlipidemia (HL) and their combination.Material and methods. An experimental study was conducted on 24 sexually mature males of outbred guinea pigs. All animals were divided into 4 groups of 6 animals each. In the first group, AH was reproduced by intramuscular injection of a hydrocartisone solution. HL in the second group was simulated by intraperitoneal injection 1 time in 3 weeks of Tween 80 and diet modification. In the third group, the combination of AH and GL was reproduced by injection of a hydrocartisone solution, Tween-80 and diet modification. On the 60-day animals were pull out of the experiment by euthanasia. Hock joint tissue sampling was performed, in which the expression of endothelial vascular growth factor A (VEGF-A), CD34 was determined using a peroxidase immunohistochemical reaction.Results. It was found that during experimental AH, expression of VEGF-A increased in the subchondral bone. In experimental HL, preferential induction of VEGF-A and CD34 in the articular cartilage and subchondral bone is observed. When combined with cardiovascular factors, the highest expression of the molecular mechanisms of cardiometabolic stress, including VEGF-A and CD34 is observed.Conclusion. The results indicate that cardiovascular factors affect the joint tissue. This allows us to make an assumption that the joint tissues belong to the target organs of cardiovascular diseases and make it possible to judge the important role of cardiovascular comorbidity in the pathogenesis of degenerative inflammatory joint diseases.

Minimizing the risk of exacerbations of chronic obstructive pulmonary disease (COPD) along with symptoms control are the most important therapeutic tasks in COPD. The effective solution of this problem is still being discussed. The prevention of COPD exacerbations is of social and economic importance and should be the primary concern in the treatment of this disease. Unresolved problems in the treatment of COPD are low patient compliance to therapy and side effects of medication. According to recent guidelines, in case of persistent COPD exacerbations with patients receiving long-acting bronchodilators (LABA), the use of inhaled corticosteroids (ICS) must be considered; this reduces the incidence of moderate and severe COPD exacerbations, especially if a patient has a history of bronchial asthma or blood and/or sputum eosinophilia. Availability of LABA/LAMA and ICS/LABA fixed combinations in Russia provides two possible options to administer a free triple combination consisting of a single LAMA plus ICS/LABA or ICS plus LAMA/LAMA. According to multiple trials, the use of fixed combinations could provide twice improvement in the patient adherence to the therapy, which therefore leads to higher efficiency. The main complaint about ICS with COPD patients is an increased risk of pneumonia as well as the development of systemic adverse reactions typical for corticosteroids. However, the use of extra-fine ICS could significantly reduce the risk of pneumonia compared with fine-particle inhalators and also increases the effectiveness of therapy as the pathological process in COPD mainly involves the small airways.

The paper reviews polysomnography of 83 patients with chronic obstructive lung disease associated with obstructive sleep apnoea syndrome/hypopnoea. The obstructive sleep apnoea syndrome was diagnosed in 62 patients (75 %): there were mild (26 patients), moderate (17 patients), and severe (19 patients) forms of the disease. As reported, there was a reliable correlation between the body mass index, the number of apnoea episodes and the haemoglobin oxygen saturation in arterial blood. There was no correlation related to the forced expiratory volume in one second. Therefore, it could be supposed that the pathogenesis of obstructive sleep apnoea syndrome in case of chronic obstructive lung disease depends on the degree of adiposity rather than the intensity of lower respiratory airway obstruction.

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.

Summary. Clinical and functional status including quality of life, CAT test and BODE index in relation to level of hypoxemia was assessed in 44 patients with COPD only and in 35 patients with COPD and cardiovascular co-morbidity (ischemic disease heart and systemic hypertension). CAT score, BODE index and MRS score were higher and 6-min walking distance was shorter in hypoxemic COPD patients n comparison to COPD patients without hypoxemia. The most significant disorders were seen in COPD patients with cardiovascular co-morbidity. CAT is a simple and effective test to assess the impact of disease on health status in COPD patients with cardiovascular co-morbidity and hypoxemia.

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.

Sixty-three patients with COPD and 82 patients with COPD and concomitant IHD have been examined. A leading role of hypoxemia in development of myocardiodystrophy and advantages of computed electrocardiotopography over other methods in detection myocardial dystrophic lesions have been demonstrated. Those lesions were more severe in the patients with co-existing COPD and IHD.

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.