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.

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.

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.

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.

With the method of endoscopic ultrasonography (EUS) and Color scale ultrasound, 156 patients with stomach and gallbladder diseases were examined, The features revealed by the EUS and color scale ultrasound for these diseases were compared with the pathological changes. The findings were that:the mean color quantity scale of benign gastric ulcer was higher than that of gastric cancer(p<0.01).The gallbladder stone was two color quantity scales higher than did polypoid lesions of gallbtadder(p<0.01).The color scale ultrasound can improve the clear degree of lesion pictures.The correct rates of diagnosis were no significant differences between color scale ultrasound and grev scale ultrasound.

Objective To evaluate the effect and safety of Houpo Paiqi Mixture(HPM)in treating early enteroparalysis classified as Qi-stagnation syndrome after abdominal non-gastrointestinal operation.Methods A multi-center,randomized,controlled study was carried out.The treatment group(n = 327)was treated with HPM(50 mL P.O,6 and 10 hours after operation)and the control group(n=108)with cisapride tablets(10 mg P.O,6 and 10 hours after operation).The course of treatment lasted 24 hours.Results A significant difference(P

Cocaine-and amphetamine-regulated transcript (CART), an endogenous neuropeptide, is widely distributed in human organs and tissues, such as brain, gastrointestinal tract and pancreas. It has a variety of important physiological functions, including eating and obesity, stress, mental anxiety, drug addition, and endocrine regulation. Previous studies have suggested that CART is widely distributed in the central nervous system, and it involves in the regulation of a variety of physiological processes and has some central protective effects. It is a potential neuroprotective agent. This article reviews the recent progress in research on the neuroprotective effect of CART on stroke and neurodegenerative disease and its mechanisms, as well as its therapeutic effect in central nervous system diseases.

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 To study the status quo and tendency of the utilization of antibiotics in our hospital in order to provide ref-erence for clinical rational drug use .Methods A retrospective analysis was performed on the consumption sum ,DDDs and defined daily cost(DDC) of antibiotics ,which taken from HIS system in drug storehouse from 2010 to 2013 .Results 2010~2013 ,the anti-microbial drug sales in proportion to the amount of drug sales were 35 .99% ,26 .47% ,14 .69% and 14 .52% respectively .Cephalo-sporins andβ-lactamase inhibitor have been in the forefront of the antimicrobial agents in the sales amount .The sales amount of Ce-foxitin sodium and Piperacillin/tazobactam has rapid grow th ,for three consecutive years of antimicrobial agents in the sales amount ordering frist and second .2010~2013 ,Cephalosporins and Macrolides antibiotics has been in the forefront on the sorting of DDDs . The DDDs of antifungal drugs increased year by year ,quinolones and nitroimidazoles was declining .The DDDs of Clarithromycin tablets ,Azithromycin enteric-coated capsules and Roxithromycin Capsules in the front row .2011-2013 ,the DDC of Cefuroxime in-creased the larger from 15 .37 to 68 .06 .Conclusion The antibacterial drug sales amount of drug sales amount is reduced year by year from 2010 to 2013 ,and the application of antimicrobial agents is given priority to Cephalosporins ,Antifungal drug sustained growth ,Macrolides antibiotics and Penicillins keep at a high level .