Estimation of Renal Clearance in Hypertensive Rats According to fMRI Data.

Renal clearance in Wistar rats with multifactorial cardiovasorenal model of arterial hypertension was assessed by fMRI using (EPI_Diffusion_map) protocol after injection of extracellular contrast agent gadolinium Gd-DTPA. Linear regression analysis was used to assess local concentrations of the contrast agent in the abdominal aorta, kidney compartments, pelvis, and bladder areas. Detection of marker clearance in order to verify the glomerular filtration rate was performed by the RPP (Rutland-Patlak plot) method. In 3 months after hypertension modeling, glomerular filtration rate decreased by 2 times in comparison with the control (31.2±0.44 and 62.3±1.31 µl/min/100 g, respectively; p<0.001). Our findings can indicate the formation of hypertensive nephroangiosclerosis in rats with experimental arterial hypertension. It was found that kidney damage in hypertensive rats is associated with hypofiltration.

Structural and Functional Changes of the Thoracic Aorta in Experimental Arterial Hypertension.

The functional characteristics of the thoracic aorta in Wistar rat with experimental arterial hypertension were studied using MRI. The intravital images of the aorta were obtained using a synchronizer of cardiac and respiratory cycles. The pulse-gradient Turbo-spin-echo sequence and the BODY CARDIAC movie 10 mode were used. The unfavorable factor of increased BP initiated structural and functional changes in the thoracic aorta. At the initial stages, they manifested by an increase of the lumen and a decrease in endothelium-dependent vasodilation. Progression of arterial hypertension (3-6 months) was associated with narrowing of the lumen of both ascending and descending parts of the aorta. Deformation of the aortic arch due to increased density of the vascular wall was observed by the sixth month of the development of arterial hypertension.

[Chronic obstructive pulmonary disease as a model of premature aging: the pathogenetic role of mitochondria.]

Chronic obstructive pulmonary disease (COPD) is a disease with typical features of premature aging. Modern theories of the pathogenesis of COPD include a number of interrelated concepts that dominate in different time periods. In this work, based on the analysis of the results of our own and published scientific studies, it is demonstrated that the mitochondria-mediated component seems to be the link of most of the recognized theories of the pathogenesis of COPD as a model of early premature aging. The issues of mitochondrial involvement in the pathogenesis of COPD are actively studied, but are not fully understood and do not always have an unambiguous interpretation. The paper systematizes information on the contribution of mitochondrial dysfunction to various aspects of the pathogenesis of COPD, including the relationship between inflammation, hypoxia, oxidative stress, protease imbalance, damage to tissue and cellular phenotype with reprogramming of metabolism and accumulation of a pool of cells with an «aged¼ phenotype. Observations suggest that mitochondrial dysfunction may be a key factor contributing to the initiation and progression of COPD, the accumulation of systemic effects, the formation of comorbidity, and premature aging. The argumentation of this concept provides an evidence-based basis for the development of promising, pathogenetically substantiated targeted strategies for the prevention and control of COPD at the topical and systemic levels.

Magnetic Resonance Imaging of Rat Brain in Assessment of the Neuroprotective Properties of Histochrome in Experimental Arterial Hypertension.

The neuroprotective effects of the course therapy with Histochrome in Wistar rats with modeled arterial hypertension were studied by using magnetic resonance imaging (MRI) in diffusion-weighted mode. The behavioral status of the animals was assessed using the open-field test. MRI analysis revealed more pronounced increase in the signaling characteristics of the brain tissue in hypertensive rats in comparison with the control (intact) animals. It was caused by excessive accumulation of fluid in the intra- and extracellular spaces of the brain tissue, which is associated with hypervolemia induced by the multifactorial cardiovasorenal model of hypertension. After a course of Histochrome injections to hypertensive rats, the cerebral microcirculation disorders were leveled, while the behavioral status was characterized by shortened latency of the visit to the center of the open field by 20% and improvement of cognitive activity (by 1.6 times) and the exploratory component (by 30%).

[Machine Learning Methods for Prediction of Hospital Mortality in Patients with Coronary Heart Disease after Coronary Artery Bypass Grafting].

Aim      To compare the accuracy of predicting an in-hospital fatal outcome for models based on current machine-learning technologies in patients with ischemic heart disease (IHD) after coronary bypass (CB) surgery.Material and methods  A retrospective analysis of 866 electronic medical records was performed for patients (685 men and 181 women) who have had a CB surgery for IHD in 2008-2018. Results of clinical, laboratory, and instrumental evaluations obtained prior to the CB surgery were analyzed. Patients were divided into two groups: group 1 included 35 (4 %) patients who died within the first 20 days of CB, and group 2 consisted of 831 (96 %) patients with a beneficial outcome of the surgery. Predictors of the in-hospital fatal outcome were identified by a multistep selection procedure with analysis of statistical hypotheses and calculation of weight coefficients. For construction of models and verification of predictors, machine-learning methods were used, including the multifactorial logistic regression (LR), random forest (RF), and artificial neural networks (ANN). Model accuracy was evaluated by three metrics: area under the ROC curve (AUC), sensitivity, and specificity. Cross validation of the models was performed on test samples, and the control validation was performed on a cohort of patients with IHD after CB, whose data were not used in development of the models.Results The following 7 risk factors for in-hospital fatal outcome with the greatest predictive potential were isolated from the EuroSCORE II scale: ejection fraction (EF) <30 %, EF 30-50 %, age of patients with recent MI, damage of peripheral arterial circulation, urgency of CB, functional class III-IV chronic heart failure, and 5 additional predictors, including heart rate, systolic blood pressure, presence of aortic stenosis, posterior left ventricular (LV) wall relative thickness index (RTI), and LV relative mass index (LVRMI). The models developed by the authors using LR, RF and ANN methods had higher AUC values and sensitivity compared to the classical EuroSCORE II scale. The ANN models including the RTI and LVRMI predictors demonstrated a maximum level of prognostic accuracy, which was illustrated by values of the quality metrics, AUC 93 %, sensitivity 90 %, and specificity 96 %. The predictive robustness of the models was confirmed by results of the control validation.Conclusion      The use of current machine-learning technologies allowed developing a novel algorithm for selection of predictors and highly accurate models for predicting an in-hospital fatal outcome after CB.

[Machine Learning Methods in Assessing the Risks of Target Organ Damage in Masked Hypertension].

Aim To develop models for predicting the risk of target organs damage (TOD) in different phenotypes of "masked" arterial hypertension (MAH) based on methods of machine learning (ML).Material and methods A retrospective cohort analysis was performed for 284 clinical records of patients (261 males, 23 females; median age, 38 years). Group 1 included 125 patients with grade 1-2 arterial hypertension (AH) and low or moderate risk; group 2 included 159 subjects with normal "office" blood pressure (BP) exposed to chronic professional stress. The 24-h BP monitoring (24-h BPM) and ultrasound examination of the heart and carotid arteries were performed; glomerular filtration rate (GFR) was estimated using the СКD-EPI formula. MAH was phenotyped by clustering 24-h BPM data, and the risk of TOD was predicted by analysis of odd ratios (OR) and with the ML methods, random forest (RF) and artificial neural networks (ANN). Data were analyzed using the R language in the RStudio environment.Results According to results of the 24-h BPM and cluster analysis, 121 (76.1 %) subjects of group 2 had MAH. The MAH phenotypes were identified as follows: systolic-diastolic (SDMAH) (43.8 %); isolated systolic (ISMAH) (35.5 %), and isolated diastolic (IDMAH) (20.7%). As compared to stable AH, subjects with different MAH phenotypes showed both increases and decreases in individual 24-h BPM indexes. Thus, in subjects with IDMAH, mean 24-h values of systolic and diastolic BP were significantly lower than with AH while in SDMAH, they were considerably higher. The OR analysis demonstrated that odds of differently located TOD were associated with definite MAH phenotypes. With that, ISMAH was associated with the highest risk of glomerular hyperfiltration; IDMAH was associated with reduced GFR and vascular remodeling; and SDMAH was associated with left ventricular myocardial hypertrophy. The developed models for predicting the risk of TOD based on the RF and ANN methods showed a high accuracy, which was provided by multistep procedures of selecting the predictors and cross-validation.Conclusion Modern ML technologies enhance the risk stratification of patients with different clinical variants of AH.

[Assessment of the respiratory muscles strength at patients with chronic obstructive pulmonary disease with various forms of comorbidity].

The respiratory muscles (RM) strength is the main indicator of their functional state. However, RM strength is not used as criteria for chronic obstructive pulmonary disease (COPD) stratification. AIM: To evaluate the RM power of COPD patients with various variants of comorbidity and to determine the role of comorbidity in the development of respiratory muscle dysfunction. MATERIALS AND METHODS: RM strength of 64 men with exacerbation of COPD was studied. The severity of comorbidity was assessed by the Charlson index. Depending on the prevalence of comorbidity, patients were divided into 3 groups: cardiovascular, cerebrovascular and metabolic. Maximum inspiratory (MIP) and expiratory (MEP) pressures in the oral cavity, maximum rate of pressure development (MRPD), sniff nasal inspiratory pressure (SNIP), MEP/MIP and SNIP/MIP indexes were determined with MicroRPM device (UK). Measured values of MIP, MEP and SNIP were compared with the proper ones. The most noticeable decrease of RM strength was defined in the group of patients with severe comorbidity. RESULTS: In case of a mild comorbidity MEP and SNIP values were 68 and 78% of the predicted values and MIP value corresponded to the personified standard. RM strength of patients with COPD depended on the clinical variant of comorbidity. Thus, in the group of patients with cardiovascular variant of comorbidity auxiliary inspiratory muscles strength decreased. In the group of patients with cerebrovascular variant of comorbidity the expiratory muscles dysfunction predominated. In the group of patients with metabolic variant of comorbidity diaphragm dysfunction predominated. CONCLUSION: The pathogenetic significance of various factors of COPD comorbidity in the development of RM dysfunction was confirmed by the results of the correlation analysis.

[Comparative analysis of the strength of the respiratory muscles in community-acquired pneumonia with different severity of endogenous intoxication].

AIM: To assess the strength of the respiratory muscles in patients with community-acquired pneumonia (CAP) with varying severity of endogenous intoxication. MATERIALS AND METHODS: In the hospital, 78 men aged 1826 years with CAP were examined. СAP was diagnosed in 56 (72%) patients, severe CAP in 22 (28%). The severity of endogenous intoxication was verified using intoxication indices: hematological index of intoxication (HII), leukocyte index of intoxication (LII), nuclear index of intoxication (NII) and Krebs index. Middleweight molecules (MWM) was determined by spectrophotometry in the serum and the concentration of interleukin (IL)-10 and tumor necrosis factor  (TNF-) by ELISA. The strength of the respiratory muscles was measured on the device Micro RPM (Care Fusion, Great Britain). The maximum expiratory pressure (МЕР), inspiratory pressure (MIP) in the oral cavity, the Maximal Rate of Pressure Development (MRPD) during inhalation (MRPDin) and exhalation (MRPDex), and intranasal test (SNIP) were determined. Statistical processing was performed using descriptive statistics, MannWhitney test, correlation and cluster analysis. RESULTS: Three clusters of endogenous intoxication corresponding to mild, moderate and severe degree were identified. The first cluster was represented only by patients with mild CAP, the second-mild CAP and severe CAP, and the third severe CAP. Dysfunction of the expiratory respiratory muscles prevailed during the height of the disease in patients with the first cluster, and in the second and third inspiratory, including the diaphragm. The level of actually measured values of MIP and SNIP was 68% and 58% of those due to severe endogenous intoxication. Significant negative correlations were established LII, HII, MWM, TNF-, IL-10 с MEP, MRPDex, MIP и SNIP. Respiratory muscle dysfunction remained only expiratory respiratory muscles in convalescents of the first cluster, and expiratory and inspiratory muscles of the second and third cluster. CONCLUSION: The development of respiratory muscle dysfunction in CAP is associated with the influence of endogenous intoxication factors. The results can be used in personalized programs of rehabilitation.

[The behavioral status of rats with experimental comorbidity of chronic obstructive pulmonarydisease and acute cerebral ischemia]. / Povedencheskii status krys pri éksperimental'noi komorbidnosti khronicheskoi obstruktivnoi bolezni legkikh i ostroi ishemii golovnogo mozga.

AIM: To compare behavioral patterns of rats with experimental chronic obstructive pulmonary disease (ECOPD), acute cerebral ischemia (ACI) and a combination of these pathologies. MATERIAL AND METHODS: The study included 70 male Wistar rats (weight 250-300 g) divided into 5 groups. ECOPD was modeled by a combination of inducers (purified papain and bacterial lipopolysaccharide), and ACI by a single-stage bilateral occlusion of common carotid arteries. The neurological status was assessed with NSS, and the behavioral status was assessed using the battery of tests including 'open field', 'radial eight-arm labyrinth', 'O-shaped elevated labyrinth'. RESULTS AND CONCLUSION: With the combination of ECOPD and ACI, a minimal (20%) survival rate of animals and the maximum severity of neurological and behavioral disorders, were recorded. The latter were characterized by a sharp restriction of locomotor and research activity, spatial memory, high anxiety and increasing autonomic imbalance. Survival rate of rats with isolated ACI was 35%, and disturbances of their neurological and behavioral status were moderately expressed. In rats with isolated ECOPD, the neurological deficit was mild. Behavioral disorders were manifested by a moderate limitation of locomotor function, a slight increase in anxiety with preserved research activity and spatial memory. The results of the study indicate the relevance of the respiratory and cerebrovascular comorbidity model for assessing changes in physiological functions and their subsequent correction.

[Morphofunctional features of the cerebral cortex in chronic obstructive pulmonary disease concurrent with ischemic stroke]. / Morfofunktsional'nye osobennosti kory bol'shikh polusharii mozga pri sochetanii khronicheskoi obstruktivnoi bolezni legkikh i ishemicheskogo insul'ta.

OBJECTIVE: To determine the structural changes in the cerebral cortex tissues, which are characteristic of the severe course of chronic obstructive pulmonary disease (COPD) and ischemic cerebral stroke (ICS). MATERIAL AND METHODS: The autopsy material of the microcirculatory bed of the cerebral cortex from 18 people aged 48-64 years who had died from COPD, ICS, and a concurrence of these conditions underwent histological examination and morphometric analysis. RESULTS: The state of the brain from the persons who died from ICS was characterized by a decline in the total number of neurons and glial elements, by structural and regional blood flow changes with obvious venous hyperemia, stasis, and red blood cell aggregation in the vessels. There was pericellular and perivascular edema in the perifocal area of the brain from people who died from COPD, as well as morphological signs of cerebral hemodynamic disorders. The brain structural features in ICS concurrent with COPD included a double decrease in the numerical density of capillaries, their hyperemia, perivascular edema, and venous plethora, a substantial change in the diameter of non-muscular venules, parenchymal atrophy, and stromal sclerosis, indicating the presence of a chronic process. CONCLUSION: Patients with ICS in the presence of COPD versus those who died from the isolated variants of these conditions were recorded to have an obvious decrease in the numerical density of capillaries, their hyperemia, and a pronounced change in the structure of the cerebral vein wall, which is a consequence of multisystem processes associated with COPD.

Magnetic Resonance Imaging in Assessment of Cardiac Remodeling in Rats with Experimental Arterial Hypertension.

Magnetic resonance imaging was employed to examine the morphofunctional status of myocardium in Wistar rats with multifactor cardiovasorenal model of arterial hypertension. In 3 months after the onset of experiment, the rats demonstrated a pronounced hypertrophy in left ventricular myocardium mostly due to thickening of the posterior and lateral walls against the background of relatively stable thickness of ventricular septum. The left ventricular endsystolic volume markedly increased in parallel with moderate increase of the end-diastolic volume. The standard calculated indices were used for precise assessment of the type of remodeling of individual myocardial structures. The study showed that multifactor arterial hypertension model was characterized by domination of hypertrophic mode of the left ventricular remodeling, whereas the concentric variant was observed more rarely by 2.5 times. The greatest alterations were observed in the posterior and lateral walls of the left ventricle, which could result from the hemodynamic effects of hypervolemic arterial hypertension.

[Assessment of the respiratory muscles strength at various stages of ischemic stroke]. / Otsenka sily dykhatel'nykh myshts na razlichnykh stadiiakh ishemicheskogo insul'ta.

Power characteristics of the respiratory muscles (RM) in the dynamics of ischemic stroke (IS) is an important tool for the early diagnosis of RM dysfunction and development of individual programs for treatment at different stages of rehabilitation. AIM: To assess the power of RM in patients with IS at different stages of the disease. MATERIAL AND METHODS: Power characteristics of RM of 56 patients with IS with different severity of the disease were examined after 2-4, 5-6 and 13-14 months of IS onset. Maximum inspiratory (MIP) and expiratory (MEP) pressures in the oral cavity, maximum rate of pressure development (MRPD) and sniff nasal inspiratory pressure (SNIP) were determined. RESULTS AND CONCLUSION: A decrease in expiratory and inspiratory RM strength was shown in the early and late periods of IS, severity of which was depended on the severity of neurologic disorders. The bronchial obstruction resulted in RM dysfunction. Expiratory muscles weakness only was observed in the remote period while one third of patients had obstructive disorders of breathing. The functional activity of different RM at different IS stages was correlated with the smoking index, forced expiratory volume in the first second, forced vital capacity, skeletal muscles mass and severity of dyspnea, asthenia and disturbances of vital functions. These differences were the most obvious in elderly group of people. RM power examination of IS patients is an important mechanism of early diagnosis and rehabilitation.

Respiratory muscles dysfunction and respiratory diseases.

This review presents an analysis of the literature on the topic of respiratory muscle (RM) dysfunction in various forms of respiratory pathology: chronic obstructive pulmonary disease (COPD), asthma, community-acquired pneumonia, idiopathic pulmonary fibrosis (IPF), sarcoidosis and interstitial lung diseases (ILD), associated with systemic connective tissue diseases (polymyositis, dermatomyositis and systemic lupus erythematosus - SLE). Various clinical and pathophysiological aspects of RM dysfunction and general patterns of its pathogenesis were examined. It was proved that the role of RM in the development of respiratory failure depends on the form and stage of the pulmonary pathology and the severity of systemic manifestations of these diseases: excessive proteolysis, oxidative stress, hypoxia, chronic systemic inflammation. These factors modify the morphofunctional status of RM, worsens their contractile function, which is contributed to the development of respiratory failure. In some cases, the primary weakness of RM precedes the clinical manifestation of pulmonary pathology, which is distinctive for some variants of myositis-associated ILD and SLE. Endogenous intoxication syndrome plays a significant role in the development of RM dysfunction during community-acquired pneumonia. It is noted that sarcoid pulmonary ventilation disorders associate with the RM weakness, but not with the degree of lung damage. In most cases, secondary RM dysfunction predominates that contributes to respiratory failure progression, which is especially noticeable in case of COPD, asthma and IPF.

[The Analysis of Social Economic Factors Impact on Epidemic Situation with Tuberculosis in Regions of the Russian Federation].

The article presents original multi-factorial linear regression models developed on the basis of panel structure of data. The distribution of the regions of the Russian Federation according tuberculosis burden was implemented using cluster analysis technique. The evaluation of degree of impact of analyzed factors to epidemic process was implemented using Pratt metric. In overall, approximately 100,000 records from 78 regions of the Russian Federation were processed. four regional clusters were marked out differentiating by level of morbidity, prevalence and mortality of tuberculosis. The diversity of social economic factors impacting the main indices of epidemic process is reducing as its intensity increases. If in the first cluster 7 factors impacted on morbidity and 4 factors -- on mortality, then in the fourth cluster only 1 factor impacted morbidity and 2 -- on mortality. At that, intensity of their impact on epidemic process increased significantly. So, for example, the role of such factor as "Area of housing per capita" in decreasing of tuberculosis morbidity among regions of the 4th cluster assessed in 79%, and among regions of 1st cluster only in 17%. The study results demonstrated that modern techniques of machine learning permit to develop models for quantification assessing of impact of social economic conditions of a particular region on activity of epidemic process of tuberculosis.

Chronic obstructive pulmonary disease and cerebrovascular diseases: functional and clinical aspect of comorbidity.

Literature data of chronic obstructive pulmonary disease (COPD) and cerebrovascular diseases (CVD) comorbidity are represented in this review. Key aspects of this interaction and its importance for clinical medicine have been considered. CVD and COPD are the main mortality factors in adults, which contribute to great economic wastes. The incidence of chronic cerebral ischemia for COPD patients is almost three times as high as for general population. The incidence of ischemic stroke for COPD patients is 1,2 times higher than in general population. For hemorrhagic stroke and subarachnoid haemorrhages, this figures are 1,3 and 1,46 respectively. Chronic systemic inflammation, tissue hypoxia and oxidative stress play the crucial role in respiratory and cerebrovascular comorbidity. Metabolites of these processes (especially proinflammatory cytokines, reactive oxygen species, C-reactive protein and some neurotrophins) increase the permeability of blood-brain barrier, destroy brain cells and activate atherogenesis in pre- and intracerebral arteries. Endothelial dysfunction affects autoregulation of cerebral circulation. Systemic symptoms of COPD are closely associated with different structural-functional disorders of the brain such as reduction in white matter integrity, grey matter volume reduction and cerebral microbleeds. Also, venous encephalopathy is developed as a result of intrathoracic pressure elevation and stasis in superior vena cava system. These processes result in neurological symptomatology. The intensity of symptoms depends on COPD severity. The occurrence of cognitive impairment, psychic tension, depression, panic disorders also increases. However COPD and CVD comorbidity is an important problem of modern medicine, pathophysiologic mechanisms and clinic aspects of this problem remain unresolved. Understanding of their role opens perspectives for rational pharmacotherapy.

[Matrix metalloproteinase-1, -8, -9 and the risk of cardiovascular complications in patients with CHD before and after myocardial revascularization].

There is still a great need for detection of biomarkers for early prediction and diagnosis of cardiovascular complications (CVC) in patients with CHD. Objective: To determine the role of MMP-1, 8, 9 in the risk of CCO in patients with CHD before and after coronary artery bypass grafting (CABG). Methods. The study included 75 patients with coronary heart disease before and after myocardial revascularization by CABG, including 40 men and 35 women aged from 45 to 74 years. Patients were divided into two groups: I group - 25 patients with CVC registered after CABG (acute myocardial infarction, ischemic stroke, pulmonary thromboembolism Branch); II group - 50 patients with coronary heart disease without complications after myocardial revascularization. Blood sampling was performed the day before surgery, on the 1st, 3rd and 10th days after CABG. Determining the level of MMP-1, 8, 9 in the serum was performed by ELISA using reagents specific «RD Diagnostics Inc.¼, USA. Results are expressed in ng/ml. Data are presented as medians and quartiles of two (Me, Q25, Q75). Within and between-group differences were evaluated using the Mann - Whitney, Spearman correlation coefficient and c2 test within the application program SPSS №16. Statistically significant differences between the indicators considered when you reject the hypothesis and significance level of p<0,05. Results. A statistically increased concentration of MMP-1 and MMP-8 in patients in group I. Undetermined significant dynamics of MMP-9 in patients after myocardial revascularization. Conclusion. The results indicate that the level of MMP-1, 2.5 ng/ml or more in patients with CAD is a diagnostic criterion for the risk of TE complications. No association between high content of MMP-8 and the presence of complications in patients after surgery. There were no significant dynamics of MMP-9 in patients after myocardial revascularization.

[Ecological-hygienic aspects of the prevalence of respiratory diseases in adolescents and children of the Primorsky Krai].

There was executed the ecologic-hygienic assessment of the distribution of respiratory diseases prevalence in bioclimatic zones of the Primorsky Krai. The aim of the study was a systematic assessment of the impact of ecological-hygienic factors of environment on the distribution of respiratory diseases in adolescents and children of the Primorsky region. As an information database there were used indices of the prevalence of diseases of the respiratory system of the ICD-10 class of the official statistical report forms for the period of2000-2013 and the parameters of the environment offactor modules (6 - socio-sanitary, 5 - environmental). The numerical values of modules offactors were determined according to a specially developed scoring scale. The study of the prevalence was carried out with the use of a classical method of data analysis - descriptive statistics, Chi-square criteria. By means of the method of regression analysis from the SPSS package software there was established the relationship of environmental factors and the level of the prevalence of diseases, and were calculated values of the factor loadings influencing on the morbidity rate of children and adolescents. The study revealed that in the structure of morbidity diseases of the respiratory system account of 39% in adolescents, 61% - in children. Constructed predictive models describe the trend of the increasing in the prevalence in adolescents and children. Over the past 15 years, the level of respiratory diseases morbidity rate increased by 46.1%. It is established that the prevalence of respiratory diseases in children and adolescents from various districts of the Primorsky territory depends on the features of the bioclimatic zones and the degree of sanitary-hygienic situation, as well as combinations of parameters that form these zones; the highest cumulative level of the prevalence is observed in the bioclimatic zone of the coast, that is caused by the various degree of the impact of biotropic factors of environment; The prevalence of diseases of respiratory system is mainly affected by bioclimatic factors: residence in an area of high humidity, temperature swings, movements of air masses in combination with air pollution.

Endothelial dysfunction of cerebral and major arteries during chronic obstructive disease.

Vasomotor activity of the major and cerebral arteries was studied in mice with chronic obstructive pulmonary disease. Regional differences were revealed in the endothelium-dependent response of arteries. The development of chronic obstructive pulmonary disease was associated with a paradoxical response of the dilatational component of vasoregulation against the background of increased constrictive influences of the vascular endothelium in the major and cerebral vessels.

[Local cellular and humoral immunity in pneumonia patients]. / Mestnyi kletochnyi i gumoral'nyi immunitet u bol'nykh pnevmoniei.

The paper reports a study of some local immunity factors in pneumonia aimed at specification of mechanisms inducing respiratory immunodeficiency and their effects on the disease course. Local cellular immunity of the lungs was studied by estimation of the total number of cells in the bronchoalveolar lavage, their viability, alveolar macrophages (AM), neutrophils, T- and B-lymphocytes, AM and neutrophil phagocytic index and number, receptor apparatus. The lavage IgA, IgM, IgG, lysozyme were estimated. It was found that local cellular and humoral immunity depend on clinicoetiological form of pneumonia. Cellular and humoral immunodeficiency was the greatest in staphylococcal infection. The role of cellular and humoral immunity dysfunction in the lungs in genesis of bronchoobstructive syndrome is specified. Recovery of cellular and humoral immunity in pneumonia reconvalescents is behind clinical recovery. Grave immunodeficiency in severe or lingering pneumonia may be a pathogenetic factor of chronic inflammation in the lungs. To evaluate functional condition of local immunity of the lungs it is valid to study cellular and humoral factors of local pulmonary immunity in bronchoalveolar lavage.