A significance of the status of macroorganism adaptive systems in the evaluation of lung tuberculosis peculiarities was confirmed by the investigation of lipid peroxidation process (LP) in this disease. Results of observation of 46 patients revealed a precise relationship between a therapy efficacy and LP activity. This fact allowed to consider MDA (that is a LP final product) level as a test for prognosis of a tuberculosis course and determination of the persons needing the poor tuberculosis course to be corrected. The results were confirmed by an assessment of gene products expression regarding the region responsible to anti-tuberculosis immunity itself and its intensity. Based on this information the immunological reactivity of tuberculosis patients was studied to estimate a prior correcting therapy. The complex treatment of 56 tuberculosis patients involved antioxidants, new immunocorrector Polyoxidony itself and its combination with lidase. The clinical and laboratory correlation found a clear differentiation of the relationship between those drugs’ clinical effectiveness and immune system restoration. This fact substantiated recommendations for the drugs’ differentiated application depending on peculiarities of lung tissue reaction and tuberculosis form and severity.

A conception of tuberculosis control at the end of XXth century and at the beginning of the XXIth one requires the treatment to be re-organized in order to increase its efficacy. Meanwhile protective psychological reactions are being developed in lung tuberculosis patients which de-adapt the personalities and not incline them to a long-term treatment. So, it is necessary to inform the patients about their disease in order to overcome this negative attitude to the treatment. The article sums up the psychological and social trial results and generalizes the experience of the «Phtysa-school» work. The basic aim of the «Phtysa-school» is to incline the patients to a long-term treatment and to reinforce their certainty of favorable outcome of the disease.

An assessment of the efficacy of bronchodilating therapy, which had been committed at the Federal programme for COPD patients management, was performed in lung tuberculosis patients with accompanying bronchial obstruction. Distinct advantages of modern inhaled therapy to traditional one were found. This led to significant reduction in respiratory signs and improvement in bronchial passability parameters. The data obtained allow these principles to be recommended for widespread use.

Opportunities to give help for chronic nonspecific pulmonary diseases (CNPD) patients and to organize a rehabilitation center were found in a pulmonology department of the anti-tuberculosis center № 17. Medical and technical measures were defined to give an effective care for bronchial asthma, chronic obstructive and non-obstructive bronchitis, acute pneumonia and pleurisy patients both specific and nonspecific etiology and in combined pathologies.

Measures of nonspecific intervention to lung tuberculosis process against the antibacterial therapy background were developed.

A patients’ admission to the anti-tuberculosis center № 17 from general medical practice organizations was arranged, so that there are no available medical institutions for treatment and rehabilitation of these patients.

Principal organizing aspects of the patients’ treatment and rehabilitation were determined in order to maintain the sanitation regimen.

The minimal diagnostic set, which is necessary for the treatment, was outlined. The optimal numbers of treatment and rehabilitation procedures were established for different nosologies.

The influence of the complex approach on delayed results of the CNPD patients’ treatment (over 3 -6 -12 months) was assessed.

The treatment and rehabilitation programme with the complex of physical methods was introduced involving exercise training, laser therapy, nebulized therapy, aeroionotherapy, massage, breathing training with a positive pressure at the end of the inspiration.

The article shows a scheme and treatment results for 88 adults with Candida bronchitis and pneumonia. Medoflucon (fluconazole) was included in a complex therapy as an etiotropic drug. As a result 66.7% of the Candida pneumonic patients and 74.7% of the Candida bronchitis ones recovered; 33.3% of the Candida pneumonic patients and 22.8% of the Candida bronchitis ones were improved.

An analysis was performed of results of complex radiological examination of 576 patients (346 males and 230 females) with different lung and pleura diseases. There were 76.6% of patients with various clinical forms of respiratory tuberculosis and post-tubercular changes of lungs, pleura and intrathoracic lymphatic nodes among them. The rest 23.4% of the patients had non-tubercular chest diseases.

Two hundred and seven patients (35.9%) having pleural syndrome were undergone ultrasonic examination of pleura, pleural cavities, subpleural lung zones. Ultrasonic signs of free and encapsulated effusion were studied including signs of pleural empyema of different eti-ologies and long-standing. A new ultrasonic diagnostic symptom of "air vacuoli" was found which had not been known before. It is an evidence of a pleural and bronchial fistula formation in chronic pleural empyema patients. Ultrasonic differential diagnostic features of pleura and lung volumetric processes were also established.

Persons exposed to inhaled radionuclides are at high risk for lung cancer, primarily, due to lung fibrosis development. This work studied lung fibrotic changes and lung cancer genetic markers in liquidators of the Chernobyl accident consequences. The study involved 33 men worked at the Chernobyl station area in 1986-1987, aged from 37 to 65 years (average 45.45±0.95; M±m), and 10 control group men comparable on the age, hazards, social and occupational status, lung pathology, but had never exposed to radiation.

Lung function tests, fibreoptic bronchoscopy, histological examination of lung and bronchi tissues biopsy specimens, and lung computed tomography were performed. Oncogene c-myc, Ki-67 proliferation marker, and a deletion in the short arm of the chromosome 3 were investigated in the bronchial epithelium.

The lung fibrosis was detected in 13 (42.4%) liquidators and in no-one of the control group. The liquidators also had more bronchial epithelium dysregenerative changes with significant prevalence of basement cell hyperplasia (0.58±.09 and 0.2±0.13 cases in the groups accordingly, p<0.05). Meanwhile the control group had no mild dysplasia at all and demonstrated severe dysplasia rather more frequently (0.2±0.13 vs 0.06±0.04 in the liquidators, p<0.05). The liquidators showed the 3p deletion in the bronchial epithelium cells more often (0.21±0.07 and 0.1±0.1 accordingly, p<0.05) and tended to show other genetic lung cancer markers quite more frequent either.

The correlation was found between the lung fibrosis and 3p deletion presence (r=0.45, p<0.05) and also between a pneumonia number anamnestically and Ki-67 expression in the liquidators’ group (r=0.46, p<0.05). The second patients’ group did not demonstrated such the correlaions.

Thus, chronic respiratory pathology liquidators develop lung fibrosis earlier than other patients with the similar lung pathology. Basement cell hyperplasia and some oncogenes (3p deletion, c-myc) encounter considerably more often in liquidators that likely to be poor prognostic signs for lung cancer occurrence. Therefore, the Chernobyl accident liquidators are at higher risk for lung cancer compared to the similar lung pathology patients without radiation exposure

A comparative analysis of tumor growth markers in lung cancer patients was performed during diagnostic work-up, treatment and the following observation of the patients. It was determined that the carcinoembryonic antigen (CEA) was not suitable for the initial screening and lung cancer detection because of its low specificity. TURTEST was reasonable to be used as a diagnostic and screening test. This method is easy to perform and could be applied in an outpatient department. TURTEST and skin response to autologous modified lymphocytes were effective in differentiated diagnosis of lung cancer and non-tumor lung diseases. The application of two tests simultaneously combined with other diagnostic techniques allowed to detect lung cancer in 96.6% of the cases. Each of these three markers can be used for postoperative monitoring of lung cancer patients and prognosing of the disease.

A clinical assessment of «Halixol» («Egis» firm) efficacy was performed in a complex therapy of 38 chronic obstructive bronchitis and bronchial asthma patients. The drug was included in a basic therapy for the patients having bronchial obstruction due to sticky mucus. It was administered in a dose of 90 mg daily three times a day for 2 weeks (every tablet contains 30 mg of ambroxole hydrochloride). The efficacy was evaluated based on clinical signs dynamics in a score (cough, a character and a volume of sputum, wheezing), PEF and FEV₁ parameters.

The «Halixol» application resulted in an improvement of expectoration, reduction in the cough and wheezing. A significant increase in the PEF and FEV₁ values was noted. The drug tolerance was good. We observed a skin rash as an adverse effect in one patient, and he was excluded from the trial. The patients and the doctors highly assessed «Halixol». Its advantage is a possibility to be combined with other medication for chronic obstructive bronchitis and bronchial asthma patients.

Twenty eight adults of both genders with chronic bronchitis participated in the open trial studying the influence of the local immune modulating drug IRS 19 with vaccine properties on polymorphonuclear leukocytes number, H₂0₂ concentration and myeloperoxidase activity in nasal washes. The polymorphonuclear leukocytes number increased from 4460±3960 to 10490±10950 cells per ml (p<0.02) after two months of IRS 19 use. This effect accompanied by the myeloperoxidase activity and the H₂0₂ concentration increase in 2.6 and 1.4 times, correspondingly (p<0.001). As the "polymorphonuclear leukocytes and myeloperoxidase – H₂0₂ – Clˉ " system is the first-line defence against pathogenic microorganisms, the changes mentioned above are likely to be one of the mechanisms enhancing the airways antibacterial immunity in response to the IRS 19 therapy.

Today formoterol fumarat (Foradil) is the most well-known long-acting ß₂-agnist worldwide. This review discusses characteristic features of the active substance, its comparison with other ß₂-agonists and its delivery as well. Specific pharmacologic characteristics of the drug are viewed to determine its place in the modern spectrum of antiasthmatic and bronchodilating medications. Study results demonstrating unique pharmacologic properties of formoterol are given: high effectiveness together with high ß₂-selectivity; high intrinsic activity; rapid starting the action; the effect duration. An intermediate lipophylity hypothesis is reported to explain the unique combination of formoterol pharmacologic properties compared with clear lipophylic agents, such as salmeterol.

Recent data evidence that formotero! (Foradil) is the most optimal and universal (in terms of the action rate and duration) bronchodilating drug which can be used as symptomatic means in mild bronchial asthma patients and as the first-line therapy for asthma control and nighttime attacks prevention, and as a preventing drug for bronchospasm development caused by different triggers. A joined application of the formoterol and inhaled medications is proved to be the most effective combination and is recommended by the majority of modern guidelines for severe asthma management.

Bronchial asthma is one of the leading healthcare problems. A sufficient experience regarding economic assessment of this disease has been accumulated worldwide. Bronchial asthma treatment cost differs depending  on healthcare system, but international practice shows that direct expenses greatly contribute to bronchial asthma treatment. A study investigating a cost of children bronchial asthma treatment was performed in Vladivostok city, Russia. It demonstrated that a total expense of a bronchial asthma patient’s family in 1996-1997 constituted 810-820 $ generally due to inpatient treatment and medication costs. Thus, the basic therapy should be formed by both clinically and economically effective drugs. Sodium nedocromil (Tailed, Aventis) is known all over the world more than 10 years. According to the multi-center studies results it has been proved as highly effective drug for bronchial asthma supporting therapy for adults and children. Nowadays a lot of data has also been accumulated confirming its economic effectiveness which is based on a reduction in the patients’ need in the urgency aid, drop in a frequency of hospitalizations and use of additional sympathomimetic drugs. There are publications evaluating the quality of life of bronchial asthma patients using Tailed which prove an increase in main kinds of their vital activity. This causes a growth of the patients’ social status under the background of the rational expenses.