The authors present a lecture devoted to the current problems of respiratory acoustics and their solution at the up-to-date stage of advancement in medicine. The paper touches upon integral methods of estimating state of respiratory system, topical acoustic diagnostics, and electronic devices intended for recording acoustic signals. As indicated, the device-based diagnostics holds strong positions to distinguish clinical picture of internal diseases. As part of public health service modernisation program in Russia, it will get one more impulse for advancement due to introduction of tele-health methods, thus resulting in resource saving and improvement in quality of medical services rendered to the population.

The authors deem the chronic obstructive lung disease to be nicotine-associated disease that mostly results from the imbalance in the ‘proteolysis-antiproteolysis’ system. The matrix metalloproteinases are independent factors that play an important role in forming respiratory ways inflammation. From the present-day standpoint of the pathogenesis of chronic obstructive lung disease, the authors consider the role of various representatives of the matrix metalloproteinases’ class and summarise the current data about the independent action of these enzymes on the pulmonary tissue, and their important function in the progradient course of the inflammatory response in the respiratory ways.

The authors provide detailed analysis of the present-day data about the mucoactive therapy methods. The multi-focus clinical examinations allowed finding out that the lysine salt of carbocisteine is highly efficient to be prescribed as mucoactive drug to children suffering from acute respiratory infections of lower respiratory ways and those with exacerbated chronic bronchopulmonary diseases, including bronchial asthma. The authors consider tobacco smoking to be a negative factor in treating children suffering from this pathology, including the active one known to be associated with the hyperproduction of sputum, against the background of expectorant therapy and low recovery reserves of the local immunity. The mucoactive therapy should be chosen based upon a number of individual features of a patient, its age, peculiarities of the tussive syndrome, knowledge of pharmacological properties of a drug, and negative factors that appear to affect the efficiency of therapy.

Sarcoidosis is a disease of unknown nature characterised by formation of non-caseifying epithelioid-cell granuloma in the target affected organs. The International Classification of Diseases, 10th Edition, attributes the sarcoidosis to the class of diseases of blood, blood-making organs and immunological disorders. The authors provide an overview and their own data about clinical manifestations of extrapulmonary sarcoidosis: lymphatic nodes, spleen and bone marrow.

The model of experimental chronic renal insufficiency allowed to study the state of lipid peroxidation processes in rats’ respiratory system, identify activation of free radical reactions in pulmonary tissue proved to be several times more than the serous indices, and detect considerable anti-oxidative effect of bioflavonoid dihydroquercetin that manifested itself in inhibiting induction of the first stage lipid peroxidation products and increasing activity of serous ceruleoplasmin.

The author estimates ties between the state of myocardium, level of hypoxemia and intensity of systemic inflammation in 41 patients aged 47 to 75 years suffering from chronic obstructive lung disease. As indicated, as the disease progresses and hypoxemia intensity increases, the systemic inflammation processes intensity that results in growing pulmonary hypertension, extent of compensatory hypertrophy of right ventricle, and myocardial dystrophy of both ventricles.

The paper provides results of examination of clinical and functional state of the respiratory system in 176 patients at all stages of chronic renal disease development. As reported, the bronchopulmonary complications begin to form at early stages of the disease. The progressive loss of renal functions triggers a chain of pathological mechanisms that cause irreversible changes in the pulmonary tissue. The long-lasting uraemia results in morphofunctional rearrangement oflung tissue characterised by fibrous changes that determine disorders of the ventilation-perfusion mechanisms.

The laser Doppler flowmetry allowed to study the particular issues associated with endobronchial microhemocirculation in patients with chronic lymphatic leukaemia, and find out that as the blood disease progressed, the indices of endobronchial microhemocirculation considerably decreased. This occurred due to hyperleukocytosis of the peripheral blood and anaemic syndrome. After cytostatic treatment, the endobronchial microcirculation indices improved but did not normalise completely due to lots of factors that influenced their pathogenetic mechanisms. The microhemocirculation pathology resulted in disorders in tissue trophism and local metabolism, onset of tissue hypoxia that in turn caused disorders of drain function of bronchi and progress of inflammatory process.

The author provides data about introduction of vaccine ‘Pneumo-23’ in 98 patients with chronic obstructive lung disease of varying severity. The efficiency of vaccination has been estimated based upon the dynamics of medico-social indices. During 12 months, the mean quantity and duration of hospitalisation in case of chronic obstructive lung disease of mild and moderate severity considerably decreased. As stated, there was a reliable decrease in a number of cases and days of temporary disability among the patients with the mild course of the chronic obstructive lung disease. The persistent loss of occupational capacity remained relatively stable while it increased by 25% in the non-vaccinated group (the control group comprised of 20 patients). The findings allowed to recommend applying pneumococcal vaccine as a part of integrated treatment of mild and moderate chronic obstructive lung disease.

Based upon 102 clinical observations, the authors have studied the capability of sulodexide to conduct secondary prevention of recurrences of pulmonary embolism, compared to the standard methods of prescribing indirect anticoagulants (warfarin). Introduction of sulodexide proved to have considerable efficiency to prevent recurrences of the disease, and was associated with a lesser quantity of haemorrhagic complications. The author draws a conclusion that sulodexide can be recommended to be used in medical practice to conduct secondary prevention of pulmonary embolism as an alternative of warfarin.

The paper describes results of researches into the stability of lysosomal membranes and secretory and synthetic activity of blood monocytes and peritoneal macrophages in 56 healthy women of child-bearing age with ovulatory and anovulatory menstruation. In women with ovulatory menstruation, the indices of lysosomal membrane stability, secretion of lysosomal enzymes of monocytes/ macrophages during probable ovulation day and preovulatory period remained unchanged, given minor decrease in the synthesis of lysosime during ovulation. In women with anovulatory menstruation during probable ovulation (13-15* days) there was obvious labilisation of lysosomal membranes with considerable increase in the secretion and decrease of synthesis of lysosime.

As part of medical preventive examination, the FEB RAS Medical Society staff conducted screening of bronchial obstruction in 502 research workers (300 men and 202 women) using computer spirometry and acoustic tracheal phonography of forced expiration (author’s method). As indicated, both these methods applied together have been more sensitive than the traditional spirography. This method is promising to screen the respiratory function of organised population.

The authors have examined dynamic lung volumes (vital lung capacity, forced vital capacity and forced vital lung capacity for the 1st second) and calculated parameters in 1900 healthy peopled aged 10 to 17 years, living from their birth in Primorsky Krai. There was a need to conduct Stange>s tests to identify the organism resistance to hypoxia and detect early and/or latent forms of respiratory distress. The trans-throacic computed bronchophonography allowed to examine acoustic regularities of sound conduction on the breast of 114 healthy children aged 12 to 17 years. The regional standards for the respiration function and acoustic sound conduction on the breast of healthy adolescents are required to be taken into account when carrying out preventing examinations and interpreting results of examinations in case of any respiratory diseases in this age group.

The authors provide results of examination of 120 children with clinical manifestations of acute respiratory viral infection. Type А (H1N1)/04/2009 influenza was diagnosed in 35.8 % of cases. All cases were the influenza of moderate severity, the clinical picture of which has been similar to the seasonal influenza. In 95.3 % of cases, the course of the disease was complicated due to associated bacterial infection. The anti-viral treatment resulted in a decrease of duration of the disease and number of complicated cases.

To this day, all pathogenetic mechanisms of forming alimentary intolerance in children, the influence of the child’s organism responsiveness, issues of treatment and prevention remain unstudied. The authors have conducted an integrated clinico-immunological, biochemical and functional examination in dynamics of 39 children with lactase insufficiency aged 1.5 to 12 months, and found out the formation of alimentary intolerance of lactose in children has been associated with digestive disorders at all stages: abdominal, wall and intracellular digestion with the modified state of mucosal immunity, the bowels microbiota and imbalance in the production of pro-inflammatory and anti-inflammatory cytokines. Studying non-specific factors for the protection of mucous tunic of the digestive tract, features of mucosal immunity is very promising to decode the pathogenesis of the alimentary intolerance in children and to develop algorithms for treating and preventing this pathology.

The authors have conducted three-stage examination of rural adolescents aged 12 to 18 years by ISAAC protocol in the Zabaikalye Territory in random samples in 2005 and 2008. The follow-up cases showed that the rate of asthma-like symptoms and bronchospasm manifestations in response to physical load has increased. The more profound examinations in dynamics allowed to mark a reliable increase in the number of children with verified diagnosis of bronchial asthma: from 3.1 to 5.8% in boys and from 2.9 to 5.6% in girls. The gender differences were unreliable. The prevalence rate of the bronchial asthma in adolescents living in rural areas proved to be considerably higher than that officially reported, and was 3?% in 2005 and 5.7?% in 2008. The mild forms of the disease prevailed.

The authors have examined 120 children aged 3 to7 years suffering from bronchial asthma of varying severity and detected a group of patients having maximal manifestations of perinatal lesions of the central nervous system. As shown, the children from this group have had an imbalance of functional activity of Tand B-cell immune system components, phagocytosis system, level of primary stress-limiting hormones that caused earlier manifestation of bronchial asthma and its persisting course. The information gathered from the neuropsychological examination allowed to conclude that in children with perinatal lesions of the central nervous system, among the main predictors of persisting course of the bronchial asthma were functional deficit of activity of the right and increasing cognitive functions of the left hemispheres, emotional and motivation-related behavioural disorders, increasing personal and situation anxiety.

On examining 118 patients with the community-acquired pneumonia caused by various pathogens, the authors estimated the receptor activity of immune competent cells of peripheral blood, induced sputum and mucous tunic of large bronchi. To identify cells, the authors used monoclonal antibodies. There were unidirectional changes like lowering receptor activity in 6 and 7 of 9 cell populations under study, respectively. Also, there were differences in the state of excitatory cells of the peripheral blood and in the induced sputum, depending on pneumonia aetiology. The immune competent cells of the mucous tunic of bronchi were characterised by stability in the state of receptor activity. These indices almost coincided with the control ones.

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.

The author presents a lecture devoted to antibiotic resistance of Staphylococcus aureus, Pseudomonas aeruginosa, Staphylococcus pneumoniae and Mycobacterium tuberculosis strains. The examinations conducted by the VGMU Epidemiology Department staff in various regional medical and preventive treatment facilities via genetic methods of identification allowed authors to point out the growing number of infections caused by microorganisms being resistant to antibiotics. The leading factor proved to be responsible for the increase of antibiotic-resistant strains is increasing frequency of prescription of antimicrobial agents, first of all, broad-spectrum antibiotics. The authors highlight the need to territorially monitor the resistance and disclose the results among the doctors of various specialties.

The authors have studied medical and demographic processes that are indicative of the regularities of ageing in Sakhalin Oblast in the framework of sustainable development. The Oblast demographic situation is characterised by increasing life duration, shorter life duration of men living in rural areas, increasing gender differences among the rural dwellers up to 10years and among the urban dwellers up to 13 years. The mortality rate for both men and women of elderly age tends to increase but the men’s mortality rate is 2.1 times higher than that of women. The principal death causes are blood circulation diseases, neoplasms, accidents, intoxication, and injuries. The elderly-age disability is two times higher in people living in the rural areas. The main causes of disability are blood circulation diseases, neoplasms, and musculoskeletal system diseases. In view of growing rates of mortality, disability, gender differences in the life duration, it is possible to draw a conclusion that there is a phenomenon of premature ageing of the Sakhalin Oblast population.

The authors have examined 65 patients aged 48 to 74 years with chronic obstructive lung disease. Combined with the traditional treatment, some patients took dietary supplement ‘Tinrostim’ and trimetazidine. The computer electrocardiotopography and traditional elecrocardiography allowed to reveal that the first method has proved to be 1.6 times more sensitive in diagnosing dystrophic myocardial lesions. The findings are indicative of the positive effect of tinrostim and trimetazidine on the myocardium in patients with chronic obstructive lung disease.

This paper provides description of clinical trials of the device designed for tracheobronchial sampling, in other words - pharyngeal trap. The authors have compared cyto-morphological characteristics of basal tracheobronchial secretion sampled from the healthy volunteers and patients suffering from acute respiratory system diseases. As shown, the cellular composition of the substrate sampled and tracheobronchial secretion were practically identical. Women’s cytograms were different at various phases of menstrual period, but no gender differences were found. As regards asymptomatic tobacco smoking, community-acquired pneumonia, acute respiratory diseases, chronic bronchitis, chronic obstructive lung diseases and bronchial asthma, the doctors have revealed specific nosological features of cyto-morphological characteristics of the basal tracheobronchial secretion. The authors’ methods are recommended for wide application in clinical practice.

The authors present the theoretical and methodological substantiation of module and block educational technology and the developed point and ranking score system for evaluating educational achievements during teaching clinical discipline ‘pediatrics’ at treatment faculty of medical university. Relative ranking was made using basic and additional criteria, which were estimated by 100 per cent point scale during the whole teaching of that discipline. The offered ranking system has some positive effects on the quality of students’ theoretical and practical training.

The paper has been prepared based upon materials in scientific publications dated to Prof. P.I. Fedotov’s 100-year jubilee (1911-2011). Prof. P.I. Fedotov is widely regarded the founder of pulmonologists’ school of Primorsky Krai. The paper describes short history of Russian discussion on the development of teaching of acute pneumonia.

During the World War II, malaria took toll on the American, Britain and German troops. Thanks to the Soviet military doctors, its influence upon the battle missions of the Soviet Army soldiers was reduced to a minimum. This paper tells about experience gained during elimination of malaria outbreak at the South Front. Professor PI. Fedotov, aviation doctor, the future head of department of internal diseases propedeutics in Vladivostok State Medical University, participated in that serious fight against malaria infection. The paper shows the documents and eyewitness testimonies, which have never been published before