ObjectiveTo explore the effects of cytokines on Febrile seizures (FS) in children with febrile seizures (Febrile seizures), febrile seizures duration and prognosis, and to explore the correlation between cytokines and the clinical manifestations and prognosis of FS. MethodsA retrospective analysis was performed on 121 children with FS (77 cases in the simple FS group and 44 cases in the complex FS group) who were treated in the pediatrics department of the Maternal and Child Health Hospital of Inner Mongolia Autonomous Region from January 2021 to October 2022 as the experimental group, including 71 males and 50 females, with a male-to-female ratio of 1.42:1, according to the type of attack (93 cases in the comprehensive group, 44 cases in the complex FS group). The focal group (28 cases) and convulsion duration (91 cases in <5 min group and 30 cases in ≥5 min group) were divided into groups, and 127 cases of children with fever but no convulsions were compared with the control group. In addition, 121 children with FS were followed up for 1 year by neurology specialist outpatient department and telephone follow-up. According to the follow-up, they were divided into the first course group, the relapse group and the secondary epilepsy group, so as to further explore the correlation between cytokines and the prognosis of children with FS. ResultsExperimental group compared with control group: Serum IL-1β (1.38 pg/mL), IL-2 (2.26 pg/mL), IL-4 (1.53 pg/mL), IL-6 (10.51 pg/mL), IL-10 (3.09 pg/mL), IL-12p70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (46.56 pg/mL), IL-1β (1.38 pg/mL), IL-1β (1.26 pg/mL), IL-4 (1.53 pg/mL), IL-6 (10.51 pg/mL), IL-10 (3.09 pg/mL), IL-12P70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (46.56 pg/mL). IFN-α (25.92 pg/mL) levels were higher, and the differences were statistically significant (P<0.05). There was no significant difference between the simple group and the complex group (P>0.05). <5 min group compared with control group: serum levels of IL-2 (2.32 pg/mL), IL-4 (1.53 pg/mL), IL-6 (9.65 pg/mL), IL-12p70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (44.63 pg/mL), IFN-α (29.67 pg/mL) were higher, and the differences were statistically significant (P<0.05). Compared with control group, the levels of IL-2 (2.06 pg/mL), IL-6 (14.67 pg/mL), IL-12p70 (1.97 pg/mL), IFN-γ (58.56 pg/mL) and IFN-α (17.50 pg/mL) in ≥5 min group were higher, and the differences were statistically significant (P<0.05). ROC curve analysis showed that serum IFN-α had a high predictive value for FS onset, the cut-off point was 8.64pg/ml, and the sensitivity and specificity were 75.63% and 76.38%, respectively. There was no significant difference between the first course of disease group, relapse group and secondary epilepsy group. ConclusionSerum proinflammatory cytokines IL-1β, IL-2, IL-6, IL-12p70, TNF-α, IFN-γ, IFN-α and anti-inflammatory cytokines IL-4 and IL-10 are involved in the pathogenesis of FS. There was no correlation between the simplicity and complexity of serum cytokines. IL-2, IL-6, IL-12p70, IFN-γ, IFN-α were positively correlated with the duration of convulsion. When serum IFN-α>8.64 pg/ml, the possibility of FS attack increased.
ObjectiveTo explore the characteristics and treatment of intertrochanteric fracture, which the proximal part displaced forwardly and angularly.MethodsBetween March 2015 and March 2016, 40 patients with intertrochanteric fracture with forwardly and angularly displaced proximal part were treated with open reduction and intramedullary nailing fixation. There were 11 males and 29 females with the age of 56-87 years (mean, 75.7 years). The causes of injury included traffic accident in 1 case and fall in 39 cases. The body mass index was 18.9-33.8 kg/m2 (mean, 24.3 kg/m2). The time from injury to admission was 2-360 hours. The type of fracture according to AO-OTA classification was A1.2 type in 7 cases, A1.3 type in 1 case, A2.1 type in 6 cases, A2.2 type in 9 cases, A2.3 type in 12 cases, A3.2 type in 2 cases, and A3.3 type in 3 cases. The haemoglobin (Hb) value at admission and the lowest values before and after operation were recorded; the amount of transfused-blood during hospital stay and visible blood loss around operation were recorded. The short-form 36 health survey scale (SF-36) before injury and at 12 weeks after operation were recorded for evaluating the quality of living; the visual analogue scale (VAS) score at admission and at 2 days after operation were recorded for evaluating the degree of pain, the fracture union was evaluated by X-ray film and clinical examination, and the Harris hip scale were used to evaluate the injuried hip function at 12 weeks.ResultsThe lowest Hb value before operation was (99.10±16.48) g/L, which was significantly lower than that at admission［(114.33±14.93) g/L］(t=9.134, P=0.000). Eleven patients were treated with blood transfusion at amount of (520.00±269.98) mL before operation. The amount of transfused-blood during operation was (569.23±207.94) mL, and intraoperative blood loss was (373.08±154.68) mL. The lowest Hb value was (105.41±13.36) g/L after operation, and 8 patients were treated with second blood transfusion at amount of (500.00±185.16) mL. The reduction of fracture was rated as excellent in 16 cases, good in 18 cases, and poor in 6 cases according to the modified Baumgaertner criteria at 3 days after operation. Forty cases were followed up 12-15 weeks (mean, 12.8 weeks). No infection occurred. The VAS score at 2 days after operation was 3.2±0.5, which was significantly improved when compared with the value at admission (8.2±0.5) (t=37.500, P=0.000). At 12 weeks after operation, all the fractures healed; the Harris score was 82.5±6.9; and the SF-36 score was 51.4±11.5, which was significantly decreased when compared with the score before injury (54.9±11.5) (t=18.901, P=0.000). There were delirium in 4 cases, pneumonia in 8 cases, urinary infection in 5 cases, and venous thrombosis in 4 cases after operation. And all patients cured after corresponding treatment.ConclusionIntertrochanteric fracture with forwardly and angularly displaced proximal part is a type of unstable fracture, and it is difficult to reduction. It is necessary to achieve a good fracture reduction by means of auxiliary instrument. The anatomical alignment is the primary condition for the good effectiveness, and the anemia before and after the operation must be corrected.