An absence of a unique approach to an assessment of pneumonia severity makes difficult an objective evaluation of a patient’s status. A detection of the disease severity is intended to select patients with the systemic inflammatory response syndrome (SIRS), as long as it is based on dysregulation of the immune response and an excessive production of cytokines. The present work was aimed to show how far clinical and laboratory criteria of SIRS in pneumonia reflect the systemic inflammatory reaction of an organism. Markers of this reaction are cytokines: interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and C-reactive protein (CRP). The study group involved severe pneumonia patients. The pneumonia patients fitted to the SIRS criteria (ACCP/SCCM, 1992) were randomly divided into 2 groups according to a severity assessed by the SAPS II scale. The control group (/7=30) formed patients without SIRS. IL-6, IL-8, IL-10 and CRP blood concentrations were measured in both the groups simultaneously with detection of the SIRS signs on the 1^st, the 3^rd, the 5^th, the 7^th and the 10^th days of the study. The 1^st group included the patients (n=22) having the death probability of 7.64% (4.67-10.64) according to the SAPS II scale; the 2^nd group patients (/7=26) had the same index of 2.28% (0.81-2.93), p<0.006. The IL-6 concentration in the 1^st group was significantly higher than in the 2^nd group and the least IL-6 level was in the controls (p<0.006). The total IL-8 value in the 1^st group exceeded this parameter in the 2^nd and the control groups. But this summary difference between the 1^st and the 2^nd groups was not statistically reliable (p>0.05). The IL-10 level differed greatly (p<0.0001) between the 1^st and the 2^nd study groups as well as compared with the control group patients. The severe pneumonia patients (according to the SAPS II scale) demonstrated higher CRP concentration than the 2^nd group and the controls (p<0.001). Patients with pneumonia and SIRS signs were found to have high IL-6, IL-8, 11-10 and CRP blood concentrations, meanwhile the pneumonia patients without SIRS show a level of these markers not increased. So, the SIRS criteria characterize the severity of the inflammatory reaction of an organism based on  the IL-6, IL-8, IL-10 and CRP levels in pneumonia patients.

A quantitative composition of the immunocompetent cell subpopulations in mucous membrane of a lobar bronchus was studied in pneumonia patients according to the illness course. Features of the cell infiltrate composition in the proper lamina were revealed and a phenotypic characteristic of interepithelial lymphocytes in the lobar bronchus mucosa was found.

The results of cell fission research in the epithelium and the stroma of large bronchus mucosa was done in 10 healthy persons and 73 patients with acute pneumonia according to the course of the disease. Autoradiography with ³H-thymidine and immunohistochemistry with proliferating cell nuclear antigen (PCNA) were used. In all cases we obtained reliably high PCNA index of positive cell nuclei in comparison with a labeling level detected by the autoradiography. At the same time the labeling level dynamics in the epithelial and stroma cells of large bronchus mucosa maintained irrespective to the method used both in the healthy and in the course of the illness.

Investigation results of cytokine system in the patients with nosocomial pneumonia of different severity, etiology and clinical forms are presented. The prevalent activation of Th₂-lymphocytes determining the cellular immune deficiency in nosocomial pneumonia is displayed. A dynamic increase in IL-6, IL-8, IL-10 levels with simultaneous abrupt fall in IFNg level is a poor prognostic factor. The obtained results extend the knowledge of cytokine-mediated mechanisms of the lung injury.

We offer a method of artificial neurone net to solve diagnostic problems. The neurone net contains 128 entrances (amount of signs of a disease) for 10 neurones (number of diseases). Work of this programme diagnostic complex includes 2 phases: training and recognition. Stastitical material from 185 patients with protracted pneumonia, chronic obstructive bronchitis, different forms of lung tuberculosis and lung carcinoma, bronchiectasis, cystic fibrosis, subacute pulmonary artery thromboembolism was collected for creation the algorithm of the training with a teacher.
The programme was tried in a clinic after 67 patients had been trained with one-layer net variant. The results showed the opportunity to apply the artificial neurone net in medical diagnostic programmes.

Peculiarities of detection and treatment of caseous pneumonia depending on timely diagnostics were searched in 128 newly diagnosed patients. The primary detection of the disease in 86% of the patients was shown to be made mostly in therapeutic and pulmonological departments. The length of staying at general somatic hospitals exceeded 7 days in 56% of the patients. A correlation was studied between a delay of the detection of the caseous pneumonia in the general healthcare facilities and a high mortality rate which prevalently — in 63% of the cases — took place during first 2 months after the diagnosis was reached.
The study results demonstrated the necessity of the empirical (testing) anti-tuberculosis therapy in therapeutic departments under keeping the epidemiological requirements when continuing the signs suspected for acute progressive tuberculosis and caseous pneumonia in particular.

We studied influence of laser therapy on membrane permeability, serum microelement concentration and microcirculation in a complex treatment of pneumonia. One hundred and five pneumonia patients were observed. They were divided into two groups: a study group of 68 patients received medication and laser therapy and a comparative group of 37 patients received medication only. There were greater reduction in the membrane permeability, an increase in iron and chromium blood serum content, an improvement of the microcirculation due to the vascular component in the study group. These changes closely correlated with laboratory findings and lung function parameters.

This article showed study results of local nonspecific defense in patients with protracted pneumonia treated with a traditional therapy, T-activin and Glycerrhiza glabra extract. The study demonstrated that the traditional treatment did not normalize cell content of bronchoalveolar lavage fluid (BALF). The use of the T-activin decreased the segmented neutrophil number and enhanced the humoral protection. Compared with it the Glycerrhiza glabra extract reduced BALF neutrophil account and increased macrophages number, rise lysozyme and IgA levels and had antiphospholipase effect. These facts destined best effectiveness of the Glycerrhiza glabra with regard to the lung local protection system in protracted pneumonia patients.

Morphological features of pulmonary artery (PA) wall in rabbits and mechanisms of its cholinergic, histaminergic and adrenergic regulation were investigated. The PA structure in its upper part is of a blended type with light predominance of elastic elements and while branching it transforms to a muscular type.
A two-component dose dependent character is a peculiarity of the segment PA cholinergic regulation. A low-threshold component of relaxing action of pilocarpine has the endothelium-dependent origin. An important feature of PA histaminergic regulation is a direct contractile effect of histamine that is not inherent to the systemic circulation. The endothelium inhibits histamin-induced contraction of PA smooth muscles (SM). The basic feature of the PA adrenergic regulation are beta-adrenergic contractile effects on SM of the vascular wall. Activation of the cAMP-dependent signalling system in PA SM is able to cause constriction. So, the determined features of the PA tone regulation can be of great clinical and physiological significance.

In work the results of a magnetic-resonance tomography (MRT) of bodies of a thoracal cavity at 58 patients and computer tomography (CT) at 52 patients are submitted. The diseases of lungs were shown radiologycal by sets of syndomes of a cavity, shadows and dissimination. The resolving power of two methods, their sensitiviti and accuracy of diagnostics were estimated. The resolving power MRT was comparable to those CT in visualization of cavities and shadows posed in the central departments lungs, conceding it in recognition of the specified sets of syndromes localized in peripheric departments. MRT defined the sizes, form of shadow, presence lobules of a structure, intersections and fabric detritis much more precisely. In diagnostics of disseminated processes in lungs, in an estimation of a condition of a bronchial tree distal VII generation MRT considerably conceded CT.
MRT defined a germination tumours of a diaphragm, pericardium, esophagus, large bronchuses and vessels more precisely, had advantages before CT in diagnostics of the peribronchial forms of a cancer of large bronchuses. It is more effective in diagnostics of tumours of a mediastinum, celomic of cysts pericardium and paracardiac lipomas, it is better visualizes of change of a pleura and small quantities of a liquid in pleural of a cavity.
MRT had no specific attributes allowing to establish the true reason of diseases, to define fabric substratum of pathological formations. The sensitivity MRT was 93.0%, accuracy — 91.4%.

The article discusses problems of diagnosis and treatment of bronchial asthma (BA) and chronic obstructive bronchitis (COB) combined with ischaemic heart disease (IHD). A bifunctional monitoring method wasoffered which allowed evaluation of myocardial bioelectric activity under bronchial obstruction. It was shown that worsening of bronchial obstruction is accompanied by rising of myocardial ectopic activity in BA and COB patients irrespective of IHD. Besides that, the ischaemic myocardial disorders were enhanced in BA and COB when combined with IHD.

The article discusses a model of informative-and-consultative system (ICS) in pulmonology developed in Pulmonology Research Institute and intended for practitioners and medical students.
Modern medicine involves great knowledge. Pulmonology integrates a lot of specialties in such fields as respiratory failure, bronchial asthma, chronic obstructive pulmonary disease, etc. It is a problem for a medical student, a rising pulmonologist, a general practitioner and a specialist of another field of medicine to acquire constantly growing pulmonologic knowledge. The aim of this study was to develop a ICS structure adapted for the permanently enlarging and changing knowledge in pulmonology and handling it according to the evidencebased medicine.

In some patients with aspirin-induced asthma ingestion of aspirin and other non-steroid anti-inflammatory drugs is associated with development of severe bronchoconstriction. Similar symptoms may be induced in these patients by substances traditionally used as a preservative for the food industry and now as a carrier in some antiasthmatic dry powder inhalers (Benacort®, Russia, 1 dose: 200 mg of budesonide and 9,8 mg of sodium benzoate). The present study has assessed the safety of sodium benzoate in aspirin-induced asthma patients.

The article shows results of Russian multi-center trial of efficacy and safety of levofloxacin in moderate community-acquired pneumonia (CAP) patients took place from October, 2001, to November, 2002, at Moscow, Nizhny Novgorod, Samara, Ekaterinburg, Chelyabinsk, Tyumen and Irkutsk. The trial involved 77 patients (37 females and 40 males with the average age of 40.8±14.4 yrs) admitted to a hospital with the CAP. Levofloxacin was given in a standard dose of 500 meg once a day, the average length of the treatment was 9.2 days. The clinical efficacy of the single-therapy with levofloxacin was 98.7%. Adverse effects were noted in 4 cases (nausea was in 4 patients and headache was in 1 patient). The therapy was abolished in 1 case due to the adverse effects.

A randomized open study was performed to compare bronchodilating activity of fomroterol (Foradyl) and salbutamol in 48 children aged 5 to 12 yrs with exacerbation of moderate bronchial asthma. The efficacy was evaluated within first 30 min and subsequent 8 to 10 hrs using FVC, FEV₁, PEF values and bronchophonographic parameters. Formoterol was found to possess the bronchodilating effect rising equally but keeping longer than that of salbutamol. This fact allows to use formoterol as urgent therapy in mild and moderate bronchial obstruction.