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A new strategy in selection of hormone therapy for endometrial proliferative process in postmenopausal patients 绝经后子宫内膜增生过程中激素治疗选择的新策略
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.24075/brsmu.2022.036
GM Savelieva, V.G. Breusenko, E. Kareva, G. Golukhov, D. Gutorova, AV Ovchinnikova, T. Ivanovskaya, KV Shcherbatyuk
The limited efficacy of hormone therapy for endometrial proliferative process (EPP) in postmenopausal patients and its side effects on the immune system functionalities have not been studied in detail. Here we assess the feasibility of hormone therapy for EPP in postmenopausal patients through evaluation of estradiol and progesterone receptor gene expression in endometrial tissue and peripheral blood mononuclear cells (PBMC). The study enrolled 92 postmenopausal patients with EPP, including 37 pts with glandular-fibrous polyps, 7 pts with non-atypical endometrial hyperplasia (EH), 8 pts with atypical endometrial hyperplasia (AEH), 31 pts with moderately differentiated adenocarcinoma and 9 pts with highly differentiated adenocarcinoma. The PBMC isolates and endometrial samples were tested for ER⍺, ERβ, mER, PRA, PRB, mPR and PGRmC1 expression by reverse real time polymerase chain reaction (RT–PCR). Differential changes in PBMC receptor profiles upon in vitro exposure to progesterone or mifepristone were determined for patients with endometrial polyps and healthy women. The results indicate elevated expression of ERα, ERβ, PRA, PRB, mPR and PGRmC1 by endometrial tissues in EH and elevated expression of mER, ER⍺ and PRA by PBMC in AEH, apparently reflecting suppressed functionalities of monocytes, macrophages, Т-cells and natural killer cells. Unaltered expression of the studied genes by PBMC in endometrial adenocarcinoma may reflect the incrementing tumor autonomy. In vitro, mifepristone inhibited ER⍺, ERβ, mPR, PGRmC1, PRA and PRB expression in PBMC isolated from patients with endometrial polyps. We suppose that such effects can mitigate the negative influence of sex steroid hormones on immunocompetent cells.
激素治疗绝经后患者子宫内膜增生过程(EPP)的有限疗效及其对免疫系统功能的副作用尚未得到详细研究。本文通过对绝经后EPP患者子宫内膜组织和外周血单核细胞(PBMC)中雌二醇和孕酮受体基因表达的评估,评估激素治疗的可行性。该研究纳入了92例绝经后EPP患者,其中37例为腺纤维息肉,7例为非典型子宫内膜增生(EH), 8例为非典型子宫内膜增生(AEH), 31例为中分化腺癌,9例为高分化腺癌。采用逆转录实时聚合酶链反应(RT-PCR)检测PBMC分离株和子宫内膜样品中ER、ER、β、mER、PRA、PRB、mPR和PGRmC1的表达。子宫内膜息肉患者和健康女性在体外暴露于黄体酮或米非司酮后,PBMC受体谱的差异变化被确定。结果表明,EH组子宫内膜组织中ERα、ERβ、PRA、PRB、mPR和PGRmC1的表达升高,AEH组子宫内膜组织中mER、ER 和PRA的表达升高,明显反映了单核细胞、巨噬细胞、Т-cells和自然杀伤细胞的功能受到抑制。PBMC在子宫内膜腺癌中未改变上述基因的表达,可能反映了肿瘤自主性的增强。在体外,米非司酮抑制子宫内膜息肉患者PBMC中ER、ER、β、mPR、PGRmC1、PRA和PRB的表达。我们认为这种作用可以减轻性类固醇激素对免疫活性细胞的负面影响。
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引用次数: 0
Intermembrane oligomerization of SARS-CoV-2 M-protein: possible role in viral budding 严重急性呼吸系统综合征冠状病毒2型M-蛋白的膜间寡聚:可能在病毒出芽中的作用
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.24075/brsmu.2022.029
E. Sokolinskaya, Lidia V Putlyaeva, AA Gorshkova, KA Lukyanov
Despite the extensive research spurred by the catastrophic effects of COVID-19 pandemic, precise molecular mechanisms of some stages in SARS-CoV-2 life cycle remain elusive. One of such stages is the detachment of viral particles during budding. Using confocal fluorescence microscopy, we observed formation of specific structures by endoplasmic reticulum in human cells expressing SARS-CoV-2 M-protein, implicating oligomerization of M-protein across parallel membranes. In our opinion, such intermembrane oligomerization may provide a driving force for pinching off the viral particles during SARS-CoV-2 budding.
尽管新冠肺炎大流行的灾难性影响刺激了广泛的研究,但SARS-CoV-2生命周期某些阶段的确切分子机制仍然难以捉摸。其中一个阶段是出芽过程中病毒颗粒的分离。使用共聚焦荧光显微镜,我们观察到表达严重急性呼吸系统综合征冠状病毒2型M-蛋白的人类细胞中内质网形成特定结构,这表明M-蛋白在平行膜上低聚。在我们看来,这种膜间低聚可能为在严重急性呼吸系统综合征冠状病毒2型出芽过程中掐断病毒颗粒提供驱动力。
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引用次数: 0
Isoforms of miR-148a and miR-203a are putative suppressors of colorectal cancer miR-148a和miR-203a的异构体是公认的癌症抑制剂
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-05-01 DOI: 10.24075/brsmu.2022.028
S. Nersisyan
MicroRNAs are short non-coding molecules which regulate translation in a gene-specific manner. MicroRNA isoforms that differ by few extra or missing nucleotides at the 5'-terminus (5'-isomiR) show strikingly different target specificity. This study aimed to identify functional roles of 5′-isomiR in colorectal cancers. Transcriptomic targets of microRNA isoforms were predicted using bioinformatics tools miRDB and TargetScan. The sets of putative targets identified for 5′-isomiR were integrated with mRNA and microRNA sequencing data for primary colorectal tumors retrieved from The Cancer Genome Atlas Colon Adenocarcinoma (TCGA-COAD) database. The network of interactions among miRNA, their targets and transcription factors was built using the miRGTF-net algorithm. The results indicate that microRNA isoforms highly expressed in colorectal cancer and differing by a single nucleotide position at the 5'-terminus have ≤ 30% common targets. The regulatory network of interactions enables identification of the most engaged microRNA isoforms. Anti-correlated expression levels of canonical microRNA hsa-miR-148a-3p and its putative targets including CSF1, ETS1, FLT1, ITGA5, MEIS1, MITF and RUNX2 proliferation regulators suggest an anti-tumor role for this molecule. The canonical microRNA hsa-miR-203a-3p|0 and its 5′-isoform bind different sets of anti-correlated putative targets, although both of them interact with genes involved in the epithelial-mesenchymal transition: SNAI2 and TNC.
microrna是一种短的非编码分子,它以一种基因特异性的方式调节翻译。不同的MicroRNA亚型在5'端(5'-isomiR)上有一些额外的或缺失的核苷酸,表现出明显不同的靶标特异性。本研究旨在确定5 ' -isomiR在结直肠癌中的功能作用。使用生物信息学工具miRDB和TargetScan预测microRNA亚型的转录组靶点。将鉴定出的5 ' -isomiR的假定靶点与从The Cancer Genome Atlas Colon adenocaroma (TCGA-COAD)数据库中检索的原发性结直肠癌的mRNA和microRNA测序数据进行整合。使用miRGTF-net算法构建miRNA及其靶标和转录因子之间的相互作用网络。结果表明,在结直肠癌中高表达的microRNA亚型,在5'端仅存在单个核苷酸位置的差异,具有≤30%的共同靶标。相互作用的调控网络使鉴定最参与的microRNA亚型成为可能。标准microRNA hsa-miR-148a-3p及其可能的靶标包括CSF1、ETS1、FLT1、ITGA5、MEIS1、MITF和RUNX2增殖调节因子的抗相关表达水平表明该分子具有抗肿瘤作用。标准microRNA hsa-miR-203a-3p|及其5 ' -异构体结合不同的抗相关推定靶点,尽管它们都与参与上皮-间质转化的基因SNAI2和TNC相互作用。
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引用次数: 0
Assessment of ocular manifestation frequency and quality of life in chronic myeloproliferative disorders 慢性骨髓增生性疾病眼部表现频率和生活质量的评估
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-05-01 DOI: 10.24075/brsmu.2022.027
E. Yunusova, T. Mukhamadeev, B. Bakirov
Chronic myeloproliferative disorders (CMPD) include hemoblastoses with abnormal proliferation of myeloid lineages and concomitant alterations in the peripheral blood indicators. The aim of this study was to assess the frequency and structure of ophthalmic complications as a quality of life factor in patients with CMPD. A group of patients with hemoblastoses of this type (n = 41) were surveyed using National Eye Institute Visual Function Questionnaire-25 along with a comprehensive examination by noninvasive ophthalmological techniques. The patients typically reported impaired visual acuity, visual discomfort and foreign body sensation in the eyes. Though many of the patients assessed their general health and vision as satisfactory, the vast majority (68.3%) expressed serious concerns about their visual abilities. The ophthalmological examination revealed various defects including refractive errors (61%), corkscrew dilation and tortuosity of conjunctival and retinal vessels (77.9%), recurrent subconjunctival hemorrhages (39%) and dilated optic nerve sheaths (36.6%). The survey data indicate that visual impairments significantly affect quality of life in patients with CMPD. Overall, the results underscore the importance of interdisciplinary approach in the management of patients with CMPD to enable early diagnosis and feasible correction of the ophthalmic component.
慢性骨髓增生性疾病(CMPD)包括骨髓谱系异常增殖的血母细胞增多症和伴随的外周血指标改变。本研究的目的是评估作为生活质量因素的CMPD患者眼科并发症的频率和结构。使用美国国家眼科研究所视觉功能问卷-25对一组此类血母细胞增多症患者(n=41)进行调查,并通过非侵入性眼科技术进行全面检查。患者通常报告视力受损、视觉不适和眼睛有异物感。尽管许多患者评估他们的总体健康状况和视力令人满意,但绝大多数(68.3%)对他们的视觉能力表示严重担忧。眼科检查发现各种缺陷,包括屈光不正(61%)、结膜和视网膜血管螺旋扩张和扭曲(77.9%)、复发性结膜下出血(39%)和视神经鞘扩张(36.6%)。调查数据表明,视觉损伤显著影响CMPD患者的生活质量。总的来说,研究结果强调了跨学科方法在CMPD患者管理中的重要性,以实现眼科成分的早期诊断和可行的纠正。
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引用次数: 0
Altered amino acid profiles of the “mother–fetus” system in COVID-19 新冠肺炎中“母婴”系统氨基酸谱的改变
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-05-01 DOI: 10.24075/brsmu.2022.025
N. Lomova, V. Chagovets, E. Dolgopolova, A. Novoselova, Uliana Petrova, R. Shmakov, V. Frankevich
Systemic nature of the human body response to SARS-CoV-2 requires dedicated analysis at the molecular level. COVID-19 during pregnancy affects maternal health and may entail complications in the early neonatal period and possibly long-term consequences for the offspring. The aim of the study was to assess the impact of COVID-19 on amino acid profiles in maternal venous blood, amniotic fluid and umbilical cord blood in order to develop a diagnostic panel accounting for possible consequences. The main group included 29 pregnant patients with a confirmed diagnosis of COVID-19 and the control group included 17 somatically healthy pregnant women. Amino acid profiles of the biological fluids were measured by high-performance liquid chromatography combined to mass spectrometry (HPLC-MS) and assessed in logistic regression models. The analysis revealed altered content of certain amino acids, their biosynthetic precursors and metabolites in the biological fluids collected from patients with COVID-19 possibly reflecting the development of systemic inflammatory reaction and associated changes in gene expression profiles. These findings may guide further research into health outcomes for neonates born from mothers infected with SARS-CoV-2 during pregnancy. The study may help to develop advanced recommendations and differential care protocols for pregnant women and newborns diagnosed with COVID-19.
人体对严重急性呼吸系统综合征冠状病毒2型反应的系统性需要在分子水平上进行专门分析。怀孕期间的新冠肺炎会影响产妇健康,并可能导致新生儿早期并发症,并可能对后代产生长期影响。该研究的目的是评估新冠肺炎对母体静脉血、羊水和脐带血中氨基酸谱的影响,以开发一个诊断小组来解释可能的后果。主要组包括29名确诊为新冠肺炎的孕妇,对照组包括17名身体健康的孕妇。通过高效液相色谱-质谱联用(HPLC-MS)测量生物流体的氨基酸图谱,并在逻辑回归模型中进行评估。分析显示,从新冠肺炎患者收集的生物液中,某些氨基酸、其生物合成前体和代谢产物的含量发生了变化,这可能反映了全身炎症反应的发展和基因表达谱的相关变化。这些发现可能会指导对妊娠期间感染严重急性呼吸系统综合征冠状病毒2型的母亲所生新生儿的健康结果的进一步研究。该研究可能有助于为诊断为新冠肺炎的孕妇和新生儿制定先进的建议和差异化护理方案。
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引用次数: 1
The role of genetic factors in familial case of acne 遗传因素在家族性痤疮中的作用
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-05-01 DOI: 10.24075/brsmu.2022.026
O. Demina, A. Rumyantsev, NN Potekaev
Acne is one of the most common dermatoses. A prominent genetic component for this disease has been reported and the manifestation in first-line relatives is considered an important risk factor. Here we present a clinical case illustrating the relevance of particular genetic polymorphisms mapped to NCF1, CD3E, ORAI1, IGHM and TAZ in patients with severe forms and burdened family history of the disease. Genetic examination identified the same allelic variants in five candidate target genes (NCF1, CD3E, ORAI1, IGHM and TAZ) in two closely related patients (father and son) with severe acne. The identified genetic configuration may interfere with the oxidase activity and promote defects in mitochondrial function along with reduced T cell proliferation and imbalanced immunoglobulin production. The findings may provide an important reference point for further clinical investigation and treatment of severe torpid dermatoses.
痤疮是最常见的皮肤病之一。据报道,这种疾病的一个突出的遗传因素,在一线亲属中的表现被认为是一个重要的危险因素。在这里,我们提出了一个临床病例,说明了与NCF1、CD3E、ORAI1、IGHM和TAZ相关的特定遗传多态性在患有严重形式和沉重的家族史的患者中的相关性。遗传检查在两例密切相关的严重痤疮患者(父子)中发现了5个候选靶基因(NCF1、CD3E、ORAI1、IGHM和TAZ)相同的等位基因变异。鉴定的遗传结构可能干扰氧化酶活性,促进线粒体功能缺陷,同时减少T细胞增殖和免疫球蛋白产生不平衡。本研究结果可为进一步临床研究和治疗重症迟钝性皮肤病提供重要参考。
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引用次数: 0
Transcriptional profiling of Mycobacterium smegmatis exposed to subinhibitory concentrations of G4-stabilizing ligands 暴露于低抑制浓度G4稳定配体的耻垢分枝杆菌的转录谱
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-05-01 DOI: 10.24075/brsmu.2022.024
MV Zaychikova, D. Bespiatykh, M. Malakhova, IN Bodoev, TS Vedekhina, V. Veselovsky, KM Klimina, AM Varizhuk, E. Shitikov
The spread of Mycobacterium tuberculosis drug resistance accentuates the demand for anti-tuberculosis drugs with a fundamentally new mechanism of action without conferring cross-resistance. G-quadruplexes (G4, non-canonical DNA structures) are plausible new drug targets. Although G4-stabilizing ligands have been shown to inhibit mycobacterial growth, the exact mechanism of their action is uncertain. The aim of this study was to assess a possible correlation between putative G4 elements in a model mycobacterial strain M. smegmatis MC2155 and transcriptomic changes under the action of subinhibitory concentrations of G4 ligands BRACO-19 and TMPyP4. We also planned to compare the results with corresponding data previously obtained by us using higher, inhibitory concentrations of these ligands. For BRACO-19, we identified 589 (316↑; 273↓) and 865 (555↑; 310↓) differentially expressed genes at 5 µМ and 10 µМ, respectively. For TMPyP4, we observed the opposite trend, the number of differentially expressed genes decreased at higher concentration of the ligand: 754 (337↑; 417↓) and 702 (359↑; 343↓) for 2 µМ and 4 µМ, respectively. Statistical analysis revealed no correlation between ligand-induced transcriptomic changes and genomic localization of the putative quadruplex-forming sequences. At the same time, the data indicate certain functional specificity of the ligand-mediated transcriptomic effects, with TMPyP4 significantly affecting expression levels of transcription factors and arginine biosynthesis genes and BRACO-19 significantly affecting expression levels of iron metabolism and replication and reparation system genes.
结核分枝杆菌耐药性的传播加剧了对抗结核药物的需求,这种药物具有一种全新的作用机制,不会产生交叉耐药性。G-四链体(G4,非经典DNA结构)是可能的新药靶点。尽管G4稳定配体已被证明能抑制分枝杆菌的生长,但其确切作用机制尚不确定。本研究的目的是评估模型分枝杆菌菌株耻垢分枝杆菌MC2155中推定的G4元素与G4配体BRACO-19和TMPyP4亚抑制浓度作用下的转录组变化之间的可能相关性。我们还计划将结果与之前使用这些配体的更高抑制浓度获得的相应数据进行比较。对于BRACO-19,我们确定589(316↑; 273↓) 和865(555↑; 310↓) 分别在5µМ和10µМ处差异表达的基因。对于TMPyP4,我们观察到相反的趋势,在更高浓度的配体下,差异表达基因的数量减少:754(337↑; 417↓) 和702(359↑; 343↓) 分别为2µМ和4µМ。统计分析显示配体诱导的转录组变化和假定的四链体形成序列的基因组定位之间没有相关性。同时,数据表明配体介导的转录组效应具有一定的功能特异性,TMPyP4显著影响转录因子和精氨酸生物合成基因的表达水平,BRACO-19显著影响铁代谢和复制修复系统基因的表达。
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引用次数: 0
Development of a recombinant oncolytic poliovirus type 3 strain with altered cell tropism 细胞嗜性改变的重组溶瘤性脊髓灰质炎病毒3型毒株的研制
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-01 DOI: 10.24075/brsmu.2022.023
Вестник Ргму, VESTNIKRGMU.RU Hamad, A. Soboleva, P. Vorobyev, K. Vasilenko, P. Chumakov, A. Lipatova, A. Lipatova
Diffuse gliomas are incurable, prevalent, and aggressive central nervous system tumors. Therefore, the development of selective oncolytic viral strains for malignant neoplasms is highly relevant. This study aimed to create an oncolytic virus based on a vaccine strain of poliovirus type 3 with natural antitumor activity. To achieve this goal, we replaced the internal ribosome entry site (IRES) of poliovirus with the corresponding fragment of human rhinovirus 30. The resulting recombinant oncolytic strain RVP3 retained the serotype of poliovirus type 3, as confirmed by virus neutralization micro-test with specific antiserum. In addition, the oncolytic efficacy of RVP3 was assessed in vitro on a broad panel of cell cultures. According to the results, RVP3 has changed its tropism, losing the ability to replicate in conditionally normal cell lines of embryonic astrocytes and embryonic fibroblasts while retaining the ability to replicate in tumor cells.
弥漫性胶质瘤是不可治愈的、普遍存在的、侵袭性的中枢神经系统肿瘤。因此,开发用于恶性肿瘤的选择性溶瘤病毒株是高度相关的。本研究旨在以具有天然抗肿瘤活性的3型脊髓灰质炎病毒疫苗株为基础,创造一种溶瘤病毒。为了实现这一目标,我们用人类鼻病毒30的相应片段取代了脊髓灰质炎病毒的内部核糖体进入位点(IRES)。所得到的重组溶瘤菌株RVP3保留了脊髓灰质炎病毒3型的血清型,如用特异性抗血清进行的病毒中和微试验所证实的。此外,在广泛的细胞培养物上对RVP3的溶瘤功效进行了体外评估。根据结果,RVP3改变了其向性,失去了在胚胎星形胶质细胞和胚胎成纤维细胞的条件正常细胞系中复制的能力,同时保留了在肿瘤细胞中复制的功能。
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引用次数: 1
Regenerative effects of Gly-His-Lys and Gly-His-Lys-D-Ala peptides in infected skin wounds Gly-His-Lys-D-Ala肽对感染性皮肤创伤的再生作用
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-01 DOI: 10.24075/brsmu.2022.014
K. Rakhmetova, E. Mishina, A. Vorvul, I. Bobyntsev, Maksim E. Dolgintsev, A. Bezhin
Skin wound healing mechanisms and new ways of improving their efficiency represent an important focus in medicine. In this regard, regulatory peptides, which exhibit physiological polyfunctionality and modulate cell growth and differentiation, are of special interest. This study evaluates the effects of Gly-His-Lys (GHK) and Gly-His-Lys-D-Ala (GHK-D-Ala) peptides in the infected skin wound healing. The wounds were modeled in rats (n=150) by full-thickness dorsal skin defects. The peptides were administered intracutaneously at daily doses of 0.5 or 1.5 µg/kg. The healing was assessed on days 3, 7, and 10 by histomorphometric examination of the wounds with adjacent intact skin. GHK-D-Ala administered at daily doses of 0.5 µg/kg had pronounced positive effect on regeneration processes in the wound, as indicated by significantly reduced numbers of granulocytes and lymphocytes with increased representation of fibroblastic lineages and macrophages, and the resulting higher cellular index (p < 0.05–0.001). At higher doses of GHK-D-Ala (1.5 µg/kg), the beneficial effects were less pronounced. According to the comparative morphological examination, the highest positive effect was achieved with 0.5 µg/kg of GHK-D-Ala. Thus, local administration of the GHK peptide with extra D-alanine at carboxy-terminus significantly mitigated the inflammatory reaction and facilitated the healing of infected skin wounds in rat model.
皮肤伤口愈合机制和提高其效率的新方法是医学界的一个重要焦点。在这方面,表现出生理多功能性并调节细胞生长和分化的调节肽特别令人感兴趣。本研究评估了Gly-His-Lys-D-Ala(GHK-D-Ala)肽和Gly-His-Lis-Lys(GHK)肽在感染性皮肤伤口愈合中的作用。通过全层背侧皮肤缺损在大鼠(n=150)中建立伤口模型。肽以每天0.5或1.5µg/kg的剂量经皮给药。在第3、7和10天,通过对邻近完整皮肤的伤口进行组织形态计量学检查来评估愈合情况。GHK-D-Ala每日剂量为0.5µg/kg,对伤口的再生过程有显著的积极影响,表现为粒细胞和淋巴细胞数量显著减少,成纤维细胞谱系和巨噬细胞的代表性增加,从而产生更高的细胞指数(p<0.05–0.001),有益效果不那么明显。根据比较形态学检查,0.5µg/kg GHK-D-Ala的阳性效果最高。因此,在大鼠模型中,局部施用GHK肽和羧基末端额外的D-丙氨酸显著减轻了炎症反应,并促进了受感染皮肤伤口的愈合。
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引用次数: 0
Chronic non-treated posterior fracture-dislocation of the shoulder 慢性非治疗性肩后骨折脱位
IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-01 DOI: 10.24075/brsmu.2022.022
K. Egiazaryan, DS Ershov, D. Badriev, DY Soshnikov
Posterior fracture-dislocations often remain undiagnosed at initial medical attendance. In dislocation, the head of the humerus extends beyond the glenoid to form a zone of impaction, which “fixes” it. The injury is almost unidentifiable in standard frontal X-ray images. Meanwhile, continued fixation of the humerus in the state of posterior dislocation leads to a rapid progression of the traumatic impaction over up to 50% of the articular surface area. The associated damage to the articular lip of the scapula, rupture of the rotator cuff muscles, symptoms of shoulder instability after relocation, and severe pain syndrome require advanced treatments for this type of injury. Here we report a clinical case of anatomical neck fracture of the humerus with displaced consolidation, combined to posterior dislocation. To avoid subacromial impingement, instead of correcting the position of the head, we abandoned the reposition and performed an osteotomy with distal displacement of the greater tubercle of the humerus.
后部骨折脱位通常在初次就诊时仍未得到诊断。在脱位中,肱骨头部延伸到关节臼之外,形成一个撞击区,“固定”它。在标准的额骨X光图像中,这种损伤几乎无法识别。同时,在后脱位状态下继续固定肱骨会导致创伤性嵌塞在高达50%的关节表面积上迅速发展。肩胛骨关节唇的相关损伤、肩袖肌肉断裂、移位后肩部不稳定症状和严重疼痛综合征需要对此类损伤进行高级治疗。在此,我们报告了一例肱骨解剖颈骨折合并移位固结并后脱位的临床病例。为了避免肩峰下撞击,我们没有校正头部的位置,而是放弃了复位,并进行了肱骨大结节远端移位的截骨术。
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引用次数: 1
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Bulletin of Russian State Medical University
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