Objective To explore the clinical characteristics of rotavirus associated mild encephalopathy/encephalitis with reversible splenial lesion(RAMERS).Methods RAMERS cases were collected from December 2017 to January 2018 at the Department of Neurology,Jiangxi Children's Hospital.The clinical and electroencephalogram characteristics of 14 patients with RAMERS were retrospectively investigated.Data was analyzed by using SPSS 19.0 software.Results Fourteen cases of RAMERS were tested,9 males,and 5 females,with the average age of (27.00 ±6.45) months,and all cases suffered from the generalized tonic-clonic seizures,57.14％ (8/14 cases) had cluster seizure (at lest 2 times/day),convulsions occurred (3.14 ± 1.29) days after gastroenteritis,and 64.29％ (9/14 cases) had pathologic fever (38 ℃ or higher).The background of electroencephalogram(EEG) was characterized by nonspecific rhythmic slow waves in 10 cases (71.43 ％,10/14 cases),normal in 3 cases (21.43 ％,3/14 cases),and interictal EEG performed in 1 case(7.14％,1/14 cases) which was characterized by focal discharges of spikes in the forehead,central,and all of the EEG manifestations go back to normal after 2 weeks.Twelve patients' brain MRI showed solitary splenium of corpus callosum lesion,and two showed splenium of corpus callosum and bilateral symmetry white matter lesion.Conclusions RAMERS is a special type of reversible splenial lesion syndrome,which occurs predominantly in infants and young children.It is characterized by gastroenteritis,benign infantile convulsion,cluster seizure and nonspecific rhythmic slow waves in the background of EEG.Prognosis is usually excellent.Head MRI reexamination is not recommended as a routine procedure to avoid overtreatment.

Objective To classify idiopathic macular epiretinal membrane (IMEM) on the basis of OCT and its application value in predicting visual acuity of patients after operation.Methods Totally 29 patients (30 eyes) with IMEM admitted in Shenzhen Eye Hospital from February 2013 to May 2016 were included in this study and divided into 4 levels based on the morphologic change of macular fovea by preoperative OCT examination.All the patients were given minimally invasive vitrectomy for stripping macular epiretinal membrane (MEM),and examined for best corrected visual acuity (BCVA) and central foveal thickness (CFT) 6 months after surgery.Results As the grading increased,the patient's macular foveal became disorganized,the appearance of the macular membrane was presented and the loss of macular foveal was more obvious.There was significant difference between preoperative and postoperative LogMAR BCVA (all P ＜ 0.01).Preoperative and postoperative LogMAR BCVA was increased with the grading,and the difference was statistically significant (all P ＜ 0.05),suggesting that patients with high-level epiretinal membranes suffered from poor visual acuity.The difference between preoperative and postoperative LogMAR BCVA was the largest in patients with grade Ⅱ idiopathic macular degeneration,and the difference was statistically significant compared with other levels (all P ＜ 0.001).It is suggested that BCVA of grade Ⅱ patients has the greatest improvement after operation.Apart from grade Ⅲ patients,there was no significant difference in CFT among the patients with other levels before and after operation (all P ＞ 0.05).The preoperative and postoperative CFTs between patients were increased with the grading,and the differences were statistically significant (all P ＜ 0.001),suggesting that the higher the level was,the larger the macular thickness.Conclusion The classification of IMEM based on OCT examination images not only helps to predict the postoperative visual acuity and CFT recovery but also the timing of operation in patients with idiopathic macular degeneration.

Objective To study the effect of operating rooms of two different cleanliness on surgical site infection (SSI)in neurosurgical craniocerebral operation,provide reference for the prevention and control of SSI.Methods Neurosurgical craniocerebral operation undertaking in grade I and II operating rooms in a hospital between July 2015 and July 2016 was performed retrospective study,patients in grade I operating rooms were as control group and those in grade II operating rooms were as trial group,occurrence of SSI was compared between two groups of pa-tients.Results A total of 454 patients undergoing craniocerebral operation were investigated,212 patients were in control group (grade I operating rooms)and 242 in trial group (grade II operating rooms).Patients in control group had 25 cases of SSI,incidence of SSI was 11.79%;trial group had 31 cases of SSI,incidence of SSI was 12.81%. Nine cases of SSI were superficial incision infection,there was no deep incision infection,the other 47 cases of SSI were intracranial infection(organ space infection).There was no significant difference in the incidence of SSI be-tween two groups of patients(P＞0.05).Conclusion Grade I and II cleanliness operating rooms have no direct effect on SSI in patients undergoing neurosurgical craniocerebral operation,comprehensive prevention and control mea-sures should be taken to prevent the occurrence of SSI.

Objective To evaluate the efficacy of corpus cavernosum flushing combined with surgical shunt in the treatment of low-flow priapism(LFP).Methods We retrospectively reviewed 10 cases of LFP patients who were diagnosed and treated in our hospital from August 2010 to March 2017.The ages were from 28 to 67 years old,with average ages 44.8 years old,and the duration of erectile pain was 19 to 264 hours,with mean time 58.3 hours.Both doppler ultrasonography and analysis of blood gas indicated LFP.Comprehensive strategies were car-ried out to treat these patients.Results One case with chronic granulocytic leukemia(CGL) gave up treatment and died of acute transforma-tion three months later.Successful detumescence was achieved by combination of cavernosal flushing and different operation procedures for all of the other 9 cases.The follow-up duration ranged from 6 months to 12 months,which exhibited 3 cases with partial erectile dysfunction(ED) and 2 cases with complete ED respectively.Conclusion With the combination of cavernosal flushing and surgical shunt procedures,penis detumescence was successfully achieved.Treatment strategies should be carried out immediately as soon as LFP was diagnosed.

ObjectiveTo investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.

METHODSTotally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.

RESULTSTesticular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).

CONCLUSIONSMicro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.

OBJECTIVEShellfish are recognized as important vehicles of norovirus-associated gastroenteritis. The present study aimed to monitor norovirus contamination in oysters along the farm-to-fork continuum in Guangxi, a major oyster production area in Southwestern China.

METHODSOyster samples were collected monthly from farms, markets, and restaurants, from January to December 2016. Norovirus was detected and quantified by one-step reverse transcription-droplet digital polymerase chain reaction (RT-ddPCR).

RESULTSA total of 480 oyster samples were collected and tested for norovirus genogroups I and II. Norovirus was detected in 20.7% of samples, with genogroup II predominating. No significant difference was observed in norovirus prevalence among different sampling sites. The norovirus levels varied widely, with a geometric mean of 19,300 copies/g in digestive glands. Both norovirus prevalence and viral loads showed obvious seasonality, with a strong winter bias.

CONCLUSIONThis study provides a systematic analysis of norovirus contamination 'from the farm to the fork' in Guangxi. RT-ddPCR can be a useful tool for detection and quantification of low amounts of norovirus in the presence of inhibitors found particularly in foodstuffs. This approach will contribute to the development of strategies for controlling and reducing the risk of human illness resulting from shellfish consumption.

Objective To compare cortical bone screwing and Endobutton plating for the treatment of ankle joint fracture complicated with injury to the distal tibiofibular syndesmosis. Methods Fifty-eight pa-tients with ankle joint fracture and injury to the distal tibiofibular syndesmosis were treated at Department of Orthopedic Surgery, The Affiliated Hospital to Guangdong Medical University from January 2014 to June 2016. Half of them were treated by conventional cortical bone screwing. They were 16 males and 13 females with an average age of 43.2 ± 4.1 years. The other half were treated by Endobutton plating. They were 15 males and 14 females with an average age of 44.1 ± 3.9 years. The 2 groups were compared in terms of intraoperative bleed-ing, operation time, tibiofibular clear space ( TBCS ) , tibiofibular overlap ( TBOL ) , the American Orthopedic Foot Ankle Society (AOFAS) ankle-hindfoot scale and complications. Results The cortical bone screwing group needed significantly shorter operation time (63.4 ± 5.4 min) than the plating group (89.6 ± 6.2 min) ( P ＜0.05) . There were no significant differences between the 2 groups in intraoperative bleeding ( 68.9 ± 6.3 mL versus 67.4 ± 6.4 mL ) , TBCS ( 4.6 ± 0.3 mm versus 4.7 ± 0.3 mm) , TBOL ( 7.5 ± 0.4 mm versus 7.4 ± 0.4 mm ) , good to excellent rate by AOFAS score ( 72.4% versus 75.9%) , or rate of complications ( 6.9% versus 10.3%) ( P ＞ 0.05 ). Conclusion Since cortical bone screwing and Endobutton plating show no signifi-cant difference for the treatment of ankle joint fracture complicated with distal tibiofibular syndesmosis injury, a proper surgical procedure should be decided according to the specific conditions of the patient.

OBJECTIVETo explore the clinical efficacy and partial mechanism of medicinal-cake-separated moxibustion for senile osteoporosis.

METHODSSixty cases of senile osteoporosis were randomly divided into an observation group and a control group according to the random digits table, 30 cases in each one. The two groups were both treated with basic treatment of western medicine. The acupoints included four groups:① Dazhui (GV 14), Dazhu (BL 11) and Ganshu (BL 18); ② Zhongwan (CV 12), Danzhong (CV 17) and Zusanli (ST 36); ③ Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4); ④ Shenque (CV 8) and Guanyuan (CV 4). Each group of acupoints was selected for one treatment. The observation group was treated with medicinal-cake-separated moxibustion, and the medicinal cake was consisted of fructus psoraleae (30 g), prepared rehmannia root (30 g), atractylodes (30 g), codonopsis pilosula (30 g), epimedium herb (20 g), rhizoma curculiginis (20 g), syzygium aromaticum (5 g) and cinnamon (5 g). The control group was treated with wheat-flour-cake moxibustion. Each acupoint was treated with 5 moxa cones in the two groups. The treatment was given once every other day for six months. The symptom score, lumbar and hip bone mineral density (BMD), serum type Ⅰ procollagen amino-terminal propeptide (PINP) and serum β-type Ⅰ collagen carboxy-terminal peptide (β-CTX) were observed before and after treatment.

RESULTSAfter treatment, the symptom score and serum β-CTX were significantly lowered (all<0.05), while the lumbar and hip BMD and serum PINP were significantly increased (all<0.05) of the two groups. After treatment, the symptom score and serum β-CTX in the observation group were significantly lower than those in the control group (both<0.05), while the lumbar and hip BMD and serum PINP in the observation group were significantly higher than those in the control group (all<0.05).

CONCLUSIONSThe medicinal-cake-separated moxibustion has significant efficacy for senile osteoporosis, which is superior to wheat-cake-se-parated moxibustion.

Eight compounds were isolated from the rice fermentation of Streptomyces sp. CPCC 202950 by a combination of various chromatographic techniques including column chromatography over silica, Sephadex LH-20, flash C₁₈, and reversed-phase HPLC. Their structures were identified as 3-[(3'-amino-3'-oxoprop-1'-en-2'-yl)oxy]benzamide (1), m-hydroxybenzamide (2), leptosphaepin (3), 5-methyluracil (4), feruloylamide (5), p-hydroxyphenylacetoamide (6), vanillamide (7), cyclo (L-val-L-ala) (8). Among them, 1 was a new benzamide analogue, and 2 was a new natural product. In the preliminary assays, none of the compounds 1-8 exhibited obvious inhibition of HIV-1 protease activity, and toxic with the Hela, HepG2, and U2OS cells. (IC₅₀ > 10 μmol•L⁻¹).