Objective:To explore the clinical features and surgical outcomes of greater trochanteric fractures of the femoral neck in children.Methods:A retrospective study was conducted to analyze the 5 children with greater trochanteric fracture of the femoral neck who had been treated at Department of Pediatric Orthopaedics, Fuzhou Second General Hospital from January 2011 to December 2020. There were 1 boy and 4 girls, with an age of (11.0±1.9) years. By the Delbet classification, all were type Ⅲ fractures. The time from injury to operation was (4.4±2.1) days. The children were treated with cannulated screws (1 case) or fixation with a pediatric hip plate (4 cases). The clinical features of such fractures were analyzed; the fracture union time and hip function and complications at the last follow-up were recorded.Results:The clinical features of greater trochanteric fractures of the femoral neck in children were: (1) involvement of 2 anatomic sites in a narrow region, (2) comminuted fractures, and (3) all Delbet type Ⅲ fractures. The follow-up time was (22.8±6.0) months. All the 5 children obtained bony union. The union time was (5.2±1.8) weeks for greater trochanteric fractures, and 8.0 (8.0,10.0) weeks for femoral neck fractures. Follow-up observed no necrosis of the femoral head, premature closure of the femoral head epiphysis, hip varus deformity, or length disparity between the lower limbs. Premature closure of the greater trochanteric epiphysis occurred in 2 children after surgery. According to the Ratliff scoring, the hip function was excellent in 3 cases and good in 2.Conclusions:Greater trochanteric fractures of the femoral neck in children are a special kind of proximal femoral comminuted fractures that affect 2 anatomic sites in a narrow region and belong all to Delbet type Ⅲ fractures. Open reduction and internal fixation with cannulated screws or a pediatric hip plate is a safe and effective treatment for such fractures.

Gitelman syndrome is a rare disease.It is easy to be misdiagnosed and missed diagnosis due to the diverse clinical symptoms.A girl with long-term hypokalemia,who presented with intermittent pain of lower limb muscle and physical retardation,was treated in Xiangya Hospital,Central South University.Laboratory examination confirmed the severe hypokalemia and metabolic alkalosis.Gene sequencing indicated SLC12A3 gene mutation and the patient was finally diagnosed as Gitelman syndrome.Patients with chronic hypokalemia and metabolic alkalosis need to conduct gene sequencing to confirm the diagnosis.Gene therapy is expected to be the most effective treatment for this disease.

The suspected severe fever with thrombocytopenia syndrome ( SFTS) cases of pharyngeal swab detection of severe fever with thrombocytopenia syndrome virus ( SFTSV) , to discuss the possibility of spread of respiratory tract. According to the suspected cases of inclusive criteria from national Ministry of Health issued " National guideline for prevention and control of severe fever with thrombocytopenia syndrome (2010)". May to September in 2013, we collect serum and throat swab of 72 suspected SFTS cases from the sentinel surveillance hospital in SFTS high?incidence area ( Xinyang, He′nan Province) . Real?time RT?PCR and ELISA methods for the detection of SFTSV were used in this study. In 72 suspected SFTS cases, 52 (72?2%) were detected positive, 46 were positive for RT?PCR, 6 were positive for ELISA. In 52 SFTSV positive cases, 4 ( 7?7%) cases were found with positive nuclei acid of SFTSV in throat swab samples. in 20 SFTSV negative cases, all the throat swab samples from the patients were also negative. The 4 SFTSV positive cases were severe, with cough and the highest viral load of up to 108 copies/mL. SFTSV can be detected in the throat swabs from patients, and the positive rate of throat swabs is much lower than that of serum samples. The feasibility of detecting SFTSV is disputable. SFTS patients with positive throat swab samples possessed the high viral load and cough symptoms, which may increase the risk of SFTSV transmission through the respiratory tract.