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.

Objective As part of the basic for cost-benefit assessment in decision for environmental protection measures, health benefit from improvement of air pollution was provided through this study. Methods According to the results from many well-done studies of local, domestic, and international authoritative institutions on relationship of air pollution and health impact, E-R functions (Exposure-Response) in terms of total mortality and morbidity of respiratory diseases from acute and chronic effects associated with increase of unit air pollutants (each 100 ?g/m3 TSP and 10 ?g/m3 SO2) were identified. As a real practice, the excess (avoidable) number of deaths and patients of respiratory diseases associated with 100 ?g/m3 TSP and 10 ?g/m3 SO2 of air pollution were estimated for Fushun City in year of 2000. The costs of medical treatment, as well as the payment for labor days were investigated. The direct and indirect economic losses from corresponding diseases were calculated. As for the estimation of economic loss from excess deaths, three methods of evaluation were applied, i.e. labor capital method; value of statistics life (VOSL), namely the method of willing to pay (WTP); and value of life year (VOLY). Results The total economic benefit combined from above aspects resulting from decreasing 100 ?g/m3 TSP ranges over 1.4 hundred millions-3.4 hundred millions yuan, accounting for 0.75%-1.95% of total product value (GDP) of Fushun City in year of 2000. Methods and indices of monetary estimation for health impact of air pollution adapted to Liaoning city was suggested. As the author's point of view, the third method of VOLY was preferable, by which, 1.48 hundred millions yuan benefit was estimated, accounting for 0.85% of GDP. Conclusions Domestic E-R functions should be worked out for assessing economic loss due to environmental pullution.

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.

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 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.

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.

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 .