Objective To explore the efficiency and safety of sodium valproate intravenous therapy on refractory status epilepsy(RSE)by diazepam in Chinese adult.Methods Twenty-five patients of RSE,consecutively admitted to West China Hospital of Sichuan University from September 1999 to May 2007,received intravenous administration of sodium valproate after being refractory to intravenous diazepam and intramuscular phenobarbitone.The efficiency and side effect of sodium valproate were then evaluated.There were ten males and fifteen females with mean age of fifty-five years.The symptoms of status epilepticus(SE)included generalized tonic-clonic status epilepticus(GTCS)(14 cases),complex partial status epilepticus(CPS)(7 cases),simple partial status epilepticus(SPS)(2 cases)and myoclonic status epielepticus(MS)(2 cases).The primary diseases prior to SE were viral encephalitis(13 cases),withdrawal of antiepilepsy drug(AEDs)(5 cases),cerebral trauma and brain surgery(3 cases),cerebral infarction(2 cases),intoxication(1 case)and cerebral palsy(1 case).Among them nine patients had a history of epilepsy.Results Of all the 25 cases of RSE,twenty-two were controlled with sodium valproate within one hour,and consciousness recovered within next one hour.No significant changes were found in blood pressure,heart rate,respiratory rate and cardiac rhythm,and no encephalopathy occurred.On the other hand,the other three cases who failed to be controlled,frequency and duration of seizure were redured.Conclusions Although intravenous sodium valproate has not been approved to be the drug of first choice for SE therapy,but it is non-sedative anti-convulsion drug that can be safely used to stop different kinds of diazepam resistant SE efficiently without obvious side effect.In addition,a quick recovery of patients' consciousness may be expected within an hour afte RSE being controlled.

Objective To evaluate the effect of the distal humerus extremity comminuted fracture treated by double plates through oleeranon osteotomy. Method Twenty-eight patients with humerus extremity comminuted fractures were fixed by double plates through olecranon osteotomy followed by early functional exercise. Results All the cases were followed up 9-31 months. The curative effect was assessed by the method of modified Cassebaum rating system. The operation was excellent in 10 cases, good in 12 cases, fair in 5 cases, bad in 1 case. The excellent and good rate was 78.57%(22/28). Conclusion Treatment of humerus extremity comminuted fractures by double plates through olecranon osteotomy followed by early functional exercise are excellent with satisfactory functional recovery.

Objective To evaluate the efficacy and tolerability of zonisamide (ZNS) as add-on therapy in patients with refractory partial seizures.Methods In this Chinese muiticenter, double-blind, randomized, placebo-contrclled trial, ZNS was compared with placebo add-on therapy in 217 patients (intent-to treat (ITT) population) with uncontrolled partial-onset seizures.All patients entered a 3-month baseline period followed by a 4-week titration interval and a 12-week maintenance period.The starting dose of ZNS group was 100 mg/d, increased by 100 mg/d every week and reached the goal of 400 mg/d.The main outcome was measured by the median of the percentage of decreased seizure frequency.The secondary ouwomes points included the percentage of patients who had seizure attacks decreased by more than 50%,and adverse events.Results The median of the percentage of decreased seizure frequency in ZNS group was 33.33%, and the placebo group was 0.Thirty-eight patients (34.23%) experienced more than 50% reduction in the seizure frequency in ZNS group, compared with 19.81% of patients (21 cases) in the placebo group (χ2 =5.7159,P =0.0168) ; Moreover, 13 (11.71%) patients in ZNS group and 5 patients in placebo group were seizure free, 25 patients in ZNS group and 16 patients in placebo group who had seizure attacks decreased by more than 50%.The availability rate in ZNS group was higher than placebo group (34.23% vs 19.81%, U=2.4701, P=0.0135).The most common adverse events in ZNS group were drowsiness, fatigue, decreased appetite, gastrointestinal complaints, insomnia and constipation.Conclusion Zonisamide treatment was generally well tolerated and was associated with significant reductions in seizure frequency as adjunctive treatment for partial-onset seizures.

Objective　To investigate the response of multiple myeloma (MM) cells to arsenic trioxide (As2O3) and their possible mechanisms. Methods　Two MM-derived cell lines RPMI8226 and U266 cells were used as in vitro models. Cell apoptosis was assessed by morphology, flow cytometry, and DNA gel electrophoresis. Mitochondrial transmembrane potentials (△Ψm) were evaluated by measuring cellular Rhodamine 123 staining intensity. Protein expression was analyzed using Western blot. Results　Zero point one to 0.5?μmol/L As2O3 inhibited cell proliferation and 2.0?μmol/L As2O3 induced cell apoptosis, while 1.0?μmol/L As2O3 inhibited proliferation with a weak degree of apoptosis induction in RPMI8226 and U266 cell lines. As2O3-induced apoptosis was accompanied by mitochondrial transmembrane potentials (△Ψm) collapse and caspase-3 activation in the presence of intact membrane. Glutathione depleter buthionine sulfoximine enhanced, while disulfide bond-reducing agent dithiothreitol partially antagonized As2O3-induced △Ψm collapse and apoptosis in MM cells. All-trans retinoic acid (ATRA) could also induce apoptosis in RPMI8226 cells, but it did not show any cooperative effects with As2O3. Conclusion　As2O3 exerts apoptosis-inducing and growth-inhibiting effects on MM cells, and mitochondrium is a pivotal and common target of As2O3 for apoptosis induction.

AlM: To compare the duration of 0.25% ropivacaine used for sciatic nerve block between type 2 diabetic patients and non-diabetic patients, and to explore the factors affecting the duration of nerve block. METHODS: Sixty eight patients with unilateral lateral malleolus fracture who were to be treated with open reduction and internal fixation were selected from January 2021 to January 2022, aged 20-80 years old, ASA I-III, including 28 diabetic patients and 40 non-diabetic patients. All patients were given 0.25% ropivacaine 20 mL to the superior popliteal sciatic nerve under the guidance of ultrasound. The onset and duration of sensory block were evaluated by blunt needle stimulation. The onset and duration of motor block were evaluated by dorsiflexion and plantar flexion of the operated foot. The interval between the end of the operation and the patientls first request for analgesia was taken as the duration of nerve block analgesia. RESULTS: Compared with non-diabetic patients, the duration of sciatic nerve sensation, motor block and analgesia in diabetic patients were prolonged (P < 0.05). There was no significant difference in the onset time of sciatic nerve sensation and motor block between the two groups (P > 0.05). Linear regression analysis showed that diabetes mellitus, duration of diabetes mellitus, fasting blood glucose and glycosylated hemoglobin were factors affecting the duration of nerve block, and fasting blood glucose was not related to the duration of analgesia. CONCLUSlON: 0.25% ropivacaine can prolong the duration of sciatic nerve block in diabetic patients. The duration of diabetes, diabetes, fasting blood glucose and glycosylated hemoglobin are positively correlated with the duration of block.