Next generation sequencing technologies,providing high speed and throughput that contribute greatly to DNA sequencing,have many applications in clinical virology,including identification of novel or unsuspected viruses,evaluation of human viromes,investigation of viral genetic diversity and evolution,monitoring of antiviral drug resistance,and analysis of virus-host interaction.Meanwhile,due to the complexity in bioinformatics data processing and lack of quality management standards,further efforts and explorations need to be put in the application and quality management of NGS in clinical laboratory.

Objective To compare the results of emergency clinical training for medical students and to put forward some suggestions.Methods Toatlly 207 medical students of Grade 4 studied in the first people' s hospital of Shanghai Jiaotong university from 2009 to 2011 were divided into the traditional group (n =90 ) and the experimental group (n =117 ).The students in the experimental group participated in emergency clinical training in summer vacation while those in the traditional group did not.Questionnaires about their self-learning ability,clinical communicating ability and critical thinking ability after training the were conducted and the data were analyzed by descriptive statistical analysis.Results One hundred and five effective questionnaires were recovered from the experimental group,with the recovery rate 89.7％ and 62 effective questionnaires were recovered from the traditional group,with the recovery rate 68.9％.The scores about clinical communicating ability and critical thinking ability of the experimental group were significantly highcr than those of the traditional group [ (79.45 ± 9.354)vs.(75.87 ± 9.926),(263.38 ± 30.925 ) vs.(251.36 ± 23.679),P ＜ 0.05 ].However,there was no significant difference in scores about self-learning ability between the two groups [ ( 153.97 ± 23.725 ) vs.( 149.83 ± 13.891 ),P ＞ 0.05].Conclusion Emergency clinical training is helpful to improve medical students' clinical communicating ability and critical thinking ability.It is worth popularizing.

ObjectiveTo analyze the results of implementing the tutorial system for medical interns, and to put forward some suggestions. MethodsThe medical interns and the doetors selected as tutors were asked to do questionnaires to study the tutorial system's feasibility and effectiveness. Simultaneously, we adopted the Objective Structured Clinical Examination ( OSCE ) to assess its process and resuits. Results74.3％ of the students and 75.5％ of the doctors think that they need the tutorial system,73.2％of the students think that this system can train better clinical skills,67.9％ of the doetors think that they can review the knowledge learned through teaching. Implemented after one year, students' OSCE scores are improved. ConclusionTutorial system for medical interns has achieved preliminary success, and the preparatory work and related-system building need to be further improved.

Pancreaticoduodenal anastomotic dehiscence complicated with peritoneal hemorrhage following pancreaticoduodenectomy is a serious complication which threatens patients'life.Prevention and mangement of pancreaticoduodenal anastomotic dehiscence and peritoneal hemorrhage is the focus in the surgical treatment.Operation is the most reliable treatment for bleeding.While reoperation is difficult for most surgeons and the risk of fistula and rebleeding after reoperation exist.Some procedures will affect the endocrine and exocrine function of pancreas.We applied pancreaticojejunal bridge drainage for most patients with hemorrhage after pancreaticoduodenectomy.This procedure is easy,safe,and can protect the pancreatic function.

Objective To study the current situation of diagnosis and treatment of rudimentary uterine horn pregnancy through 4-cases report. Methods We made a clinical study of 4 cases of rudimentary uterine horn pregnancy admitted to our hospital between 1995 and 2005. Results Three patients had been undergone artificial abortion before they were admitted to our hospital. All the patients were asymptomatic. Ultrasonography was made in 3 cases. Two cases were diagnosed as rudimentary uterine horn pregnancy. Three patients were cured with surgery. Conclusions Rudimentary uterine horn pregnancy is rare and with atypical clinical manifestation in the first trimester. Although diagnosis before surgery is difficult, ultrasonography and MRI make a great role. Surgery is the most important therapeutic method.

Objective To evaluate the effect of combination of phacoemulsification and trabeculectomy on patients with cataract and glaucoma.Methods 19 patients(23 eyes)with co-existing glaucoma and cataract were treated with triple procedure by means of scleral tunnel flap.The mean follow-up period was(15.8 ±3.5)months.Results Compared with preoperative visual acuity,16(64%)of 25 eyes had a best corrected visual acuity of ≥0.6 at the last follow-up(0.1～1.0)(P＜0.01);The mean preoperative intraocular pressure(IOP)was(23.01 ±2.63)mmHg which decreased to(14.02 ±2.05)mmHg(P＜0.05 ,P ＜0.01)after treatment.Conclusion The triple procedure is effective for treating patients with co-existing cataract and glaucoma,which could enhance the visual acuity,control IOP and reduce complications.

Objective To evaluate the long-term outcome ofautologous epidermal grafting in vitiligo and its correlated factors. Methods A 1-5 year follow-up of 310 patients with vitiligo, who had been treated by autologous epidermal grafting, was carried out by questionnaires, phone interview, and clinical revisit. The relevance was estimated between the efficacy of the treatment and several factors, including the time length from the grafting to the follow up, patients' age and gender, location of lesions treated, Koebner phe-nomenon on the donor sites, and the combination therapy with narrow band-ultraviolet B (NB-UVB). Results Of the 310 patients, 161 were males and 149 females with an average age of 26.69±11.76 years; 98 had localized vitiligo, 123 segmental vitiligo, 62 scattered vitiligo, 27 generalized vitiligo. Totally, 24 recipient areas with 1266 sheets were evaluated. Among these sheets, 815 (64.38%) achieved complete repigmenta- tion, 167 obvious repigmentation, 117 some repigmentation, 167 no repigmentation, with a curative rate of 64.38% and total effective rate of 86.81%. Hyperpigmentation occurred in the recipient area of 76 (24.52%) patients, and donor area of 34 patients (10.97%), and hypopigmentation developed in the recipient area of 66 patients (21.29%). Relapse developed in the recipient areas of 30 patients, and new lesions in 12 patients (3.871%). Koebner phenomenon was noticed in the donor sites of 25 (8.064%) patients. The efficacy of autologous epidermal grafting was stable within two years after the therapy, but reduced with the time. Increased efficacy was observed in those sites with little mobililty and large fixity. For example, the best effi- cacy was observed in the legs and arms, followed by feet and hands, chest and back, face and neck, finally by waist and abdomen (P<0.01). NB-UVB exposure could improve the repigmentation. Koebner phe- nomenon in donor sites was associated with a reduced efficacy of epidermal grafting (P<0.05). Gender and age seemed unrelated to the efficacy. Conclusions Autologous epidermal grafting has a good long-term efficacy for the treatment of vitiligo, and transplanted location may be the most important factor affecting the efficacy.

[Objective]The paper was designed to introduce the Professor YE Jin's personal clinical experience which can provide an effective means for other pediatrician.[Method]By introducing the Professor YE Jin's personal clinical experience,we summarize the effective therapies about the infantile recurrent abdominal pain(RAP). [Result]According to the Professor YE Jin, the pathomechanism of RAP includes mainly cold stagnation, the indigestion, parasite and Qi stagnancy. RAP caused bycoldcan be treated from warming the middle-energizer and fending off the cold,RAP resulting from retention of food can be cured by removing the retention and invigorating the stomach, RAP incurred by ascaris can be cured by relieving ascariasis,expelling parasite and purgation simultaneously,and RAP resulting from Qi stagnation can be cured by soothing liver, regulating qi activity, rather than relieving pain merely. Based on the above-mentioned theory,she tends to use Liquorice and prefers Paeonia a lot in curing the disease, that is always effective in clinic as a result.The recurrence rate is also lower.One case was provided for verification.[Conclusion]Professor YE Jin thinks that warming the middle-energizer and fending off the cold, removing the retention and invigorating the stomach, the RAP can be improved the curative effect,and that can provide another idea for other clinicians.

An animal model of hemorrhagic shock is widely applied .It is an important platform to clarify the pathogenic mechanism, develop hemostasis materials , test first aid equipments and filter resuscitation medications .This paper summa-rizes the commonly used animal models of hemorrhagic shock at home and abroad , focusing on animal selection , model cre-ation, influencing factors , and fields of application in order to provide useful reference for model selection and application by medical practitioners and researchers .

Objective To investigate the effects of cinnamic acid to enhance the exercise endurance in mice .Methods Through the exhaustive swimming to establish mice exhaustive exercise model ,the mice were divided into control group ,exercise control group and exercise cinnamic group(n=10) ,the mice exhaustive swimming time were comparted ,blood lactic acid(LAC) lev‐els were used to explore the endurance of cinnamic acid in mice;the super oxide dismutase (SOD) ,malondialdehyde (MDA) and peroxidase (CAT) content in liver homogenates were used to detect mice endurance enhancement and antioxidant capacity of cin‐namic acid ,and expression of Na+ /K+‐ATP enzyme ,Ca2+ /Mg2+‐ATP enzyme on mice quadriceps by Western blot to further study its effect on improving exercise capacity in mice .Results Cinnamic acid significantly prolonged the swimming time of mice;Exercise cinnamic group compared with control group:although the LAC content in plasma elevated ,the difference was not statistically sig‐nificant(P>0 .05) ,SOD and CAT in liver homogenate was significantly decreased(P< 0 .05) ,MDA increased significantly(P<0 .01) ,CAT was decreased but with no statistically significant(P>0 .05) ,the expression level of Na+ /K+‐ATP enzyme and Ca2+ /Mg2+‐ATP enzyme decreased significantly (P< 0 .01) .Exercise control group compared with control group:the LAC content in plasma increased significantly(P<0 .01) ,SOD and CAT in liver homogenate was significantly decreased(P<0 .01) ,MDA increased significantly(P< 0 .01) ,expression level of Na+ /K+‐ATP enzyme and Ca2+ /enzyme Mg2+‐ATP decreased significantly (P<0 .01);Exercise cinnamic group exercise control group:the LAC content in plasma was significantly reduced(P<0 .01) ,SOD and CAT in liver tissue significantly increased(P< 0 .01) ,MDA decreased significantly(P<0 .01) ,CAT decreased significantly(P<0 .01) ,the expression level of Na+ /K+‐ATP enzyme and Ca2+ /Mg2+‐ATP enzyme decreased significantly(P<0 .05) .Conclusion Cinnamic acid has good oxidation resistances and anti‐fatigue ability .