Objective] To conclude Yan Zhongqing clinical academic experience. [Methods] Discussed in terms of etiology and pathogenesis, treatment, therapies of Yan Zhongqing teacher using classical treatment of insomnia clinical experience, herbal prescription summed up its characteristics, citing the case evidence. [Results] Yan Zhongqing teacher believes that the main pathogenesis of this disease is not paying for the yin yang, and heart, lung, liver, kidney closely linked to inadequate blood deficiency and liver yang common causes of insomnia are caused clinically. The main syndromes of heart and lung deficiency heat, heart and kidney Huo, heart and liver blood deficiency, lack of liver stagnation of liver-yang, etc., are used to support the heart and lungs, cooling heat; yin and clearing fire, balance between kidney and heart; Yin and Yang blood, Anshen; liver qi, yang Yixin of the law, and achieves better therapeutic effect on clinical practice. [Conclusion] With appropriate clinical prescription of Mr. Yan, the treating method has clinical value.

Objective To investigate the method and application of measurement uncertainty in clinical biochemical tests .Meth-ods The synthetic uncertainty and expanding uncertainty of 13 emergency biochemical tests items were compared between Hitachi 7600 and Beckman DXC800 automatic biochemical analyzer by usingmodel method.The test items included aspartate aminotrans-ferase ,total protein ,albumin ,glucose ,urea ,creatinine ,creatine kinase ,lactate dehydrogenase ,amylase ,potassium ,sodium ,calcium and chloride .Results Measurement uncertainty of aspartate aminotransferase and lactate dehydrogenase were 3 .66% and 3 .51%respectively ,which were the top two on Hitachi 7600 analyzer ;measurement uncertainty of calcium and creatinine were 4 .00% and 3 .90% respectively ,which were the top two on Beckman DXC800 .Compared between the two analyzers ,the test item with the lar-gest difference of measurement uncertainty was sodium(2 .62% ) ,and the second was creatinine(2 .40% ) .The difference of meas-urement uncertainty of the 13 emergency biochemical test items between the two analyzers were relatively small .Conclusion The two analyzer both have good performance ,Model methodis suitable for the evaluation of regular test items′measurement uncer-tainty in clinical biochemical laboratory .

Objective We sought to summarize the experience in nursing the patients of Robertsonian translocation receiving pre-implantation genetic diagnosis (PGD).Methods Thirty-eight patients with Robertsonian translocation received PGD.These patients received health education and psychological nursing except for routine therapy and nursing.Results All these patients had no obvious negative emotion and complied with the therapy.Nine patients were successfully pregnant and pregnancy rate was 23.7％,7 of them delivered healthy neonates.Conclusions Health education,psychology nursing together with controlled ovarian stimulation,egg retrieval and embryonic transplantation can reduce negative emotion,improve compliance of therapy,and benefit the process of PGD and clinical outcomes.

Objective To compare the accuracy of intraocular lens(IOL)power calculations by using 6 formulas(SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ)in different axial lengths of the eye,in order to improve the accuracy of predicating IOL powers for patients after cataract surgery.Design Retrospective comparative clinical analysis.Participants 169 patients(169 eyes)with age-related cataract underwent regular phacoemulsification and posterior chamber IOL implantation.Methods 169 eyes with cataract were divided into five groups according to the axial lengths:AXL≤22mm,22mm28.4mm.The axial lengths and keratometry of the 169 eyes were measured with A-mode ultrasound before operation,and the actual postoperative refraction was measured with the methods of computer and retinoscopy optometry when patients could gain best corrected visual acuity one month after surgery or later.Inputting the axial lengths,keratometry and IOL powers into A-mode ultrasound,the predicted postoperative refraction was calculated with SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ formulas,and the differences of predicted and actual postoperative refractions in different axial lengths were compared.Main Outcome Measures The absolute value with the differences of the predicted and actual postoperative refractions,i.e.absolute predicted errors.Results(1)Comparing the difference of predicted and actual postoperative refraction,there was no statistical significance between the five formulas in the groups of axial length(AXL)≤22mm,22mm28.4mm,but the average absolute predicted error of Haigis and SRK-T formulas is significantly smaller than SRK-Ⅱand Binkhorst-Ⅱ formulas.Conclusions In existing sample size,there was no obvious influence on postoperative refraction when using other five formulas except Binkhorst-Ⅱ.But in the extremely long AXL group,Haigis and SRK-T formulas have some ascendancy over the other formulas.

Objective To investigate the effect of malignant tumor on neuromuscular block of cisatracurium. Methods Sixty ASA Ⅰ or Ⅱ patients with head and neck neoplasms (15 cases with benign tumor, 45 with malignant tumor), aged 18-64 yr, were randomly divided into 4 groups ( n = 15 each): Ⅰ benign tumor group (group B,3 × ED95 ); Ⅱ -Ⅳ different dose cisatracurium group (group C1 (2 × ED95 ), C2 (3 × ED95 ) and C3 (4 ×ED95)). Neuromuscular block was assessed with accelerograph F (TOF-watch SX). Single stimulation of ulnar nerve was used. Anesthesia was induced with TCI of propofol (target plasma concentration 3 μg/ml) and remifentanil (target effect-site concentration 3 ng/ml). Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg in group B, and with cisatracurium 0.10, 0.15 and 0.20 mg/kg in group C1, C2 and C3 respectively. The onset time, clinical duration, time for recovery of T/Tc to 75 % and recovery index were recorded. Results The clinical duration, time for recovery of T/Tc to 75 % and recovery index were significantly longer in group C2 than in group B (P ＜ 0.05). The onset time was significantly shorter, while the clinical duration and time for recovery of T/Tc to 75% were significantly longer in group C2 and C3 than in group C1 , and in group C3 than in group C2 ( P ＜0.05) .Conclusion The duration of action and recovery times of cisatracurium were prolonged in patients with malignant tumor.

Objective To investigate the effects of hypertension on left atrial myocardial properties by strain and strain rate(SR)imaging.Methods A total of 56 consecutive patients with hypertension were divided into 2 groups:33 with normal LVMI and 23 with left ventricular hypertrophy.These patients and 20 controls underwent transthoracic echocardiography,strain and SR imaging examination.Atrial strain and SR values of hypertensive patients were compared with those of controls.Results When compared with the controls,early diastolic SR(ESR)was significantly decreased in hypertensive patients(P＜0.01-0.001),with time to peak late diastolic SR corrected for heart rate(TASRe)significantly increased in normal LVMI subgroup(P＜0.05).Moreover,late diastolic SR(ASR)were significantly decreased(P＜0.05)in hypertensive patients with left ventricular hypertrophy as compared with normal LVMI.Conclusions Enlargement of left atrium leads to increased reservoir function in hypertensive patients,which compensates for the deterioration of conduit function.The duration of atrial systole may be prolonged to meet the need of ventricular filling in consequence of lower left atrial booster pump function.Noninvasive quantification of left atrial function by SR imaging enables evaluation of left atrial dysfunction due to hypertension.

Objective To investigate training of the ultrasound-guided modified Seldinger technique(MST)for cannulation of PICC.Method Twenty-nine nurses trained with the traditional training on ultrasound-guided MST during December 2009 to December 2011 were set as control group and another 29 nurses trained with the systematic training during December 2011 to December 2013 were as experiment group.The training effect were compared between the two groups after 2 months training.Results The theoretical knowledge in the experiment group was improved significantly compared with the control group. Moreover, the success rate of catheterization in the experiment group was 100.0%,significantly higher than that in the control group(both P<0.01).Conclusion Systematic training system is more effective than the traditional training.It can improve the nurses’technical and theoretical knowledge on ultrasound-guided MST for PICC.

Objective To investigate the risk factors of mild cognitive impairment (MCI) in patients with type 2 dia-betes (T2DM), and the clinical evidence for the early diagnosis and treatment thereof. Methods A total of 217 T2DM pa-tients were divided into T2DM with MCI group (n=92) and T2DM with normal cognitive function(NMCI) group (n=125). Mon-treal cognitive assessment scale (MoCA) and activities of daily living scale (ADL) were used to assess the functional status in two groups of patients. The general clinical data and biochemical indicators were obtained and compared in two groups. Re-sults There were statistical differences in age, smoking history, education status, high sensitive C reactive protein (hs-CRP), coronary heart disease, hypertension, glycated hemoglobin A1c (HbA1c) and T2DM history between two groups. Re-sults of univariate logistic regression analysis showed that old age, longer course of T2DM, smoking history, higher hs-CRP and HbA1c, complicated with coronary heart disease and hypertension were risk factors for T2DM with MCI, while the higher education status was a protective factor. Multiple logistic regression analysis showed that old age and longer T 2DM history were risk factors, and the higher education was a beneficial factor for T2DM with MCI. Conclusion Many risk factors may play a part in T2DM with MCI. Early detection and prompting medical attention may help prevent and decrease the preva-lence of MCI in patients with T2DM.

Department of General Medicine in Zhongshan Hospital,Fudan University was founded in 1994,which was the only unit established in a tertiary hospital in the country at that time,engaged in clinical practice,teaching and research of general practice.Zhongshan Hospital won the second prize of National Teaching Achievement in 2014 forExploration and innovation of training system of general practitioners in China,which contributed to development of standardized training system of general practitioners suitable to China's national conditions.This article summarizes the experience in training general physician,development of disciplines and enhancing influence of Zhongshan Hospital over years,hopefully it will be of reference value for medical educators.

Thirty mothers of four dadys later after delivery with agalactia, whose babies needed additional milk over one third of physiological needs, or agalorrhea were chosen to take 125 g of MUYINGLE divided into 3 parts a day for observing its lactigenous effect, and thirty other agalactous mothers, who might chose any kind of traditional Chinese lactagogue foods to eat, as control group. Those subjects whose babie's additional milk was less than one fourth or half of physiolgical needs for agalactia or agalorrhea respectively after four days with MUYINGLE were effectual. The results showed that the lactagogue efficacious rate of MUYINGLE and control group were 86. 7% and 33. 3%, respectively. The lactagogue effects were significant difference between the two groups (P