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 explore the clinical features of benign paroxysmal positional vertigo (BPPV) in patients of 40 years old or younger. Methods The clinical features of 40 patients (age ≤40 years) with BPPV admitted from August 2009 to July 2011 were retrospectively analyzed, and compared with that of 286 middle and old-aged patients (age >40 years) with BPPV admitted in the same period. Results The incidence of BPPV in young patients showed a relatively higher incidence (12.3%), with the sex ratio of male to female 1:3 and a mean age of 32.1±6.2 years. The mean latent period of vertigo attack was 1.2±1.3 seconds, and 10 patients (25%) showed no obvious latent period. The median duration of vertigo was 10s. The posterior semicircular canal was involved in 27 patients (67.5%). Cupulolithiasis was found in 6 patients, and all the otolithiasis was found to involve the posterior semicircular canal. The proportion of BPPV with no obvious latency was higher in the young patients than in the middle and old-aged patients (25.0% vs 11.5%, χ2=5.554, P=0.018), but no significant difference in sex ratio, the course of disease, the ratio of involved semicircular canal, the latency and the duration of vertigo attack was found between two groups (P>0.05). Conclusions The incidence of BPPV is relatively higher in youth, more common in females, and the posterior semicircular canal is commonly involved. Compared with the middle and old-aged patients with BPPV, the proportion patients with no obvious latency of vertigo attack in young patients is higher, and the incidence of cupulolithiasis involving posterior semicircular canal is higher in the youth.

目的探讨推拿加腰背肌训练治疗非特异性下腰痛的作用机理。方法200例非特异性下腰痛(NLBP)患者分为4组:空白组、训练组、推拿组、推拿加训练组,各50例。在治疗开始和治疗4周后,对4组患者进行肌酸激酶(CK)、乳酸脱氢酶(LDH)、超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量的测定及目测类比定级法(VAS)评定。结果4组患者的CK、LDH、SOD和MDA含量以及VAS指数均有不同程度的改善。组间比较,推拿加训练组的CK、LDH、SOD和MDA含量以及VAS指数均明显优于其他3组(均P<0.01)。结论中医推拿技术结合主动功能训练治疗NLBP具有明显的康复疗效。

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

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 investigate the relevance of liver function and neurobehavior of offspring of SD rats ex-posed to sodium valproate in the second trimester. Methods 30 SD rats at 12. 5 d of pregnance were randomly di-vided into three groups: low-dose group (300 mg/kg VPA was injected into abdominal cavity), high-dose group (600 mg/kg VPA);control group (normal saline). The offspring of low-dose groupe were grouped as VPA-low-dose;the offspring of high-dose groupe were grouped as VPA-high-dose; and the offspring of control group were grouped as control group. Then, we tested the liver and neurological function of each group of offspring, respective-ly, and analyzed their relevance. Results The levels of serum total protein and albumin of the high-dose group were considerably lower than these of the low-dose group which were significantly lower than these of control group ( P<0. 01 for both total protein and albumin);the levels of ALT, AST and blood ammonia of the high dose group were drastically higher than these of the low dose group, which were dramatically higher than these of control group ( P<0. 01 ) . The duration and of stereotyped movement disorder in experimental group was markedly longer than this of the control group, while this of the high-dose group was notably longer than this of the low-dose group ( P<0. 01 );the frequency of the stereotyped movement disorder of experimental group was significantly more than this of the control group, while this of high-dose group was obviously more than this of the control group (P<0. 01). In the Morris water maze, the escape latency of the high-dose group was remarkably longer than this of low-dose group, which was observably longer than this of control group (P<0. 01);the swimming distance of the high-dose group was tremendously shorter than this of low-dose group, which was considerably shorter than this of control group ( P<0. 05 , P<0. 01 ) . Correlation analysis of liver function and neural behavior showed that the neurobe-havioral abnormalities were negatively correlated with level of total protein and albumin, and were positively related with the level of blood ammonia, ALT and AST ( P<0. 01 ) . Conclusion The VPA exposure in the second tri-mester leads to the decrement of serum albumin and total protein and to the increment of AIL, AST and blood am-monia;and it also causes the neurobehavioral abnormalities of offspring. The reduction of synthesis of liver albumin and the rise of ALT, AST and blood ammonia can influence the neurobehavioral abnormalities. And there were both of the factors which result in the neurobehavioral abnormalities of offspring exposured to VPA in the second trimes-ter.

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.

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]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.