The detailed study devoted to instrumental diagnostic methods of bone tissue research was performed by authors. The main idea which is the basis for this work is the analysis and study of X-ray methods for examining bone tissue, highlighting their advantages. As a result of the work, we analyzed published scientific data in Russian and foreign literary sources, which addresses many instrumental methods of bone tissue research. After experiments a detailed description of the most common research methods related to the study of bone tissue was given, its structure and other functions. Analysis of the modern scientific data has shown that there is a great need to know the instrumental methods for studying human organs and systems, and their more accurate possibilities for identifying pathological processes, which will permit the use of the research method that in any particular case will be the most informative, which would provide timely diagnosis and its accuracy.

This study focuses on problems of treatment of proximal humeral fractures occurring against the background of osteoporosis. It presents statistics on osteoporosis and lower energy trauma among patients in the Russian Federation and abroad. The high susceptibility to osteoporotic changes in the bone structure of the male population of Russia compared to the global statistics of osteoporosis among men was emphasized. The main classifications used in the clinical practice of orthopedists and traumatologists allow to identify the type of fracture by clinical and anatomical basis and to structure the existing patient management tactics to achieve the most optimal result of treatment and restoration of limb function. There is an analysis of publications representing various methods of fracture treatment, which helps to use the most optimal methods of relevant fractures treatment.

Hemimegalencephaly (HME) is one of the extremely rare congenital malformations of cortical development (MCD). It belongs to the MCD group of mTOR-related pathologies and can be the result of various genetic disorders. One of the main clinical manifestations of HME is drug-resistant epilepsy requiring surgical treatment.Case report. This article describes a clinical case of HME in a 4-year-old boy with frequent generalized tonic-clonic seizures and drug-resistant epilepsy; also, he had speech development delay. MRI revealed a HME of the right frontal lobe. Stereotaxic laser disconnection of the large cortical dysplasia in the right frontal lobe of the brain was performed. Morphological features of focal cortical dysplasia type IIb (FCD IIb) were reported. No seizures were observed in the hospital follow up after the operation for 14 days. The whole exome DNA sequencing showed the presence of a heterozygous state _000008.10^G 68419028del / 633del, pGlu212LysfsTers of the CPA6 gene.Discussion. A feature of the case is the identified association of HME, morphologically represented by FCD IIb, with a previously unknown heterozygous state in the 6th exon of the CPA6 gene. This association allows to expand our understanding of changes in the activation of PI3K/AKT/mTOR pathway as a key link in the pathogenesis of congenital anomaly of cortical development.

Recurrences of benign peripheral nerves sheaths tumours (BPNST) after total resection were described in 2.6–11.0% of patients. The significance of the histological features of recurrent BPNST is still insufficiently studied.Aim. To compare the pathomorphological features of recurrent and non-recurrent BPNST (schwannomas and neurofibromas).Materials and methods. A retrospective assessment was made of 101 patients with BPNST with a degree of anaplasia corresponding not more than Grade I. Recurrence of BPNST developed in 13 (12.9%) cases. The study included patients with histological archive: the study group (n = 7) included patients with one or more relapses of BPNST, the control group included patients (n = 5) without relapses after surgery for 5 or more years. The main clinical characteristics were studied and histological examination was performed.Results. There were no differences between the groups in baseline characteristics (the type of tumour (schwannoma, neurofibroma), distribution by sex, age, localization, clinical symptoms). The relapse rate among patients with neurofibromas was 8 in 3 patients vs. 6 in 5 patients with schwannomas. In all cases of recurrent schwannomas and in one of neurofibroma, the histological pattern was predominantly monophasic with rhythmic structures like Verocay bodies with underlined pattern and nuclear hyperchromasia, in contrast to the control group, represented by tumours with a mixed type of structure with uniform alternation of various histological patterns (p < 0,05). Endothelial proliferation and lymphocytic infiltration in the stroma and perivascular area were more common in the relapse group (p < 0.05). Pathomorphological signs of anaplasia: cell-nuclear polymorphism, nuclear hyperchromasia, endothelial proliferation, mitosis, as well as minor signs of anaplasia: solidization, muirization of the fascicular pattern of a tumour and apoptotic bodies were found with the same frequency in both groups. With relapse, the capsule was lost, thinned, intermittent, and sometimes invaded the surrounding tissues.Conclusion. Tumours with the initial signs of anaplasia, such as endothelial proliferation, tendency to hypercellularity, and histological pattern with prominent Verocay bodies dominate among recurrent BPNST.