Thyroid diseases are often accompanied with dyslipidemia.In me past,low level of myroid hormone(TH) was considered a main factor in causing elevated level of blood cholesterol in hypothyroid patients.However,some clinical features can not be explained by this traditional theory. For example,in subclinical hypothyroid cases,both levels of thyroid-stimulating hormone (TSH) and serum total cholesterol (TC) increase,while TH level remains normal.From this phenomenon,we speculate that in case with hypothyroidism,not only there is a relationship between serum TC and TH levels,but also serum TC level change is related to TSH in some way,which has not been noticed.The purpose of this paper is to review the new and most advanced progress in the research of TSH and cholesterol.

Objective To compare the effect of music and music plus non- nutritive sucking interventions on the newboms' pain caused by heel lance. Methods 75 neonates from the neonatal intensive care unit (NICU) whose gestational age=28 weeks were randomly separated into the music group,the music plus non-nutritive sucking group and the control group. The newboms' crying and grimacing,heart rate (HR), oxygen 9at-uration(SpO2) changes and times of crying 90 seconds after heel lance were observed. Results The cry-ing and grimacing time,the convalescence time of HR and SpO2 in the two intervention groups were significantly shorter than the control group.And the amplitude of HR, SpO2 changes was also significantly smaller than the control group.The crying and grimacing time and the convalescence time of HR and SpO2 in the music plus non-nutritive sucking group were significantly shorter than the music group. Conclusions Music or music plus non-nutritive sucking can ease newboms' pain caused by heellance.Music plus non-nutritive sucking can strengthen the music ther-apy's analgesic effect.

Objective To explore and analyze the application and problems of esophageal cancer radical opera-tion by thoracoscopy combined with laparoscopy. Methods From July, 2011 to December, 2014, clinical data of 40 patients undergoing esophageal cancer radical operation by thoracoscopy combined with laparoscopy were analyzed retrospectively. Results Except 2 cases being relayed to assisted small thoracic incision because of 1 case with clear tumor invading to trachea and 1 case with obvious tumor invasion to thoracic aortic artery, the remaining 38 cases were successfully completed operation. There were 2 cases with postoperative anastomotic fistula in the neck, 2 cases of anastomotic stenosis and 1 case of hoarseness, there was no perioperative death. Follow-up was within 36 months, 2 patients died 10 months and 24 months after surgery respectively, due to tumor local recurrence. 1 patient with supraclavicular lymph node metastasis underwent local radiation therapy. The remaining was all survival with re-lapse-free. Conclusions Esophageal cancer radical operation by thoracoscopy combined with laparoscopy is a good method with safety and reliability, minimal invasion, fast recovering, and satisfied recent curative effect. It is worthy of applying clinically.

Objective To investigate the effect of pregnancy-induced hypertension (PIH) syndrome on the blood lipid level of neonate. Methods Eighty neonates, whose mother had PIH, were enrolled and divided into three groups according to the 6th version of diagnostic standard from published Obstetrics and Gynecology:gestational hypertension group (PIH group 1 ,n = 30) ,mild pre-eclampsia group (PIH group 2,n =30),serious pre-eclampsia group (PIH group 3,n =20) ,and 40 infants with healthy mother were enrolled as normal control group. The blood lipid was measured by automatic biochemical analyzer. Results (1) The TG levels of the cord blood were (0.28±0. 10)mmol/L in PIH group 1,(0.33 ±0.09)mmol/L in PIH group 2,(0.39 ±0.06) mmol/L in PIH group 3,and (0. 23 ±0. 07)mmol/L in normal control respectively. TG levels were significantly higher in PIH groups compared to normal control,and the TG concentration increased gradually with the mothers' gestational hypertension (F = 2. 765, Ps <0. 05). (2)The HDL-C levels of the cord blood were (0. 61 ±0. 23) mmol/L in PIH group 1, (0. 54 ± 0. 25) mmol/L in PIH group 2, (0.47 ± 0. 15) mmol/L in PIH group 3, (0. 65 ±0. 14) mmol/L in the normal contral respectively;and the ApoA levels of the cord blood were (0. 63 ±0.24)g/L in PIH group 1 ,(0. 59 ±0. 16)g/L in PIH group 2, (0.53 ±0.21)g/L in PIH group 3,(0.69 ±0. 12)g/L in the normal contral respectively. Both index were significantly higher in PIH groups compared to normal control, and the concentrations decreased gradually with the mothers' gestational hypertension (F=2.783,P<0.05;F=2.831,P<0.05). (3)The TC levels of the cord blood were (1.41 ± 0. 37) mmol/L in PIH group 1, (1. 51 ±0.45) mmol/L in PIH group 2, (1. 56 ±0. 56) mmol/L in PIH group3, (1. 36 ±0.41) mmol/L in the normal contral respectively;and the LDL-C levels of the cord blood were (0. 79 ±0. 26)mmol/L in PIH group 1,(0. 80 ±0. 18)mmol/L in PIH group 2,(0. 82 ±0. 30)mmol/L in PIH group 3,(0.74 ±0. 18) mmol/L in the normal contral respectively. The data showed that the cord blood TC and LDL-C levels of PIH were higher than normal control and increased gradually with the mothers'gestational hypertension, but they didn' treach the significant level (F = 0. 695,P>0. 05;F = 0. 483,P>0. 05). (4)The LPA levels of the cord blood were (24. 50 ± 12. 01) g/L in PIH group 2, (22. 68 ± 9. 50) g/L PIH group 3,which were lower than normal control (25.70 ±11.90) g/L, and the LPA levels of the cord blood were higher in PIH group 1(33.46 ± 20. 10)g/L,while the differences didn't reach significant level compared among four groups (F = 1.480,P> 0.05). Conclusion The unhealthy intrauterus condition of PIH lead abmoral fat metabolism in fetus, and itmight get worse along with the severity of the mother's gestational hypertension. We presumed that the neonates of PIH mothers would be more prone to have coronary heart disease,atherosclerosis and abnormal fat metabolism related disease compared with newboms from normal control group.

Objective To compare the effects of remifentanil infused at different rates on median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion and determine the optimum infusion rate of remifentanil when used for fiberoptic bronchoscopy in pediatric patients.Methods Eighty-four ASA Ⅰ or Ⅱ pediatric patients,aged 7 months-3 years,scheduled for elective fiberoptic bronchoscopy,were randomly assigned into 3 groups (n =28 each):normal saline group (group C),remifentanil infused at 3 ng· kg-1 ·min-1 group (group R1) and remifentanil infused at 5 ng· kg-1 · min-1 group (group R2).Responses to LMA insertion were defined as body movement and/or bucking during insertion.The initial target plasma concentrations of propofol were 5.2,4.8 and 4.4 μg/ml in groups C,R1 and R2,respectively.The target plasma concentration of propofol was determined by up-and-down sequential allocation.Each time the target plasma concentration increased/decreased by 0.2μg/ml.EC50 and 95 ％ confidence interval of propofol blunting responses to LMA insertion were determined by probit method.Results EC50 (95 ％ confidence interval) of propofol was 5.03 (4.92-5.12) μg/ml,4.71 (4.58-4.84) μg/rnl and 4.46 (4.20-4.94) μg/ml in groups C,R1 and R2,respectively.There was no significant difference in EC50 of propofol between groups R1 and C (P ＞ 0.05).EC50 of propofol was significantly lower in group R2 than in groups C and R1 (P ＜ 0.05).Conclusion The infusion rate of remifentanil should not be lower than 5 ng· kg-1· min-1 when combined with propofol in pediatric patients undergoing fiberoptic bronchoscopy.

BACKGROUND: Diabetic morbidity can predict its progress tendency. National diabetic morbidity has been increased compared with previous level at present.OBJECTIVE: To compare the diabetic morbidity between populations with impaired glucose tolerance or normal blood glucose tolerance to analyze its correlative influencing factors.DESIGN: A cluster sampling survey in two communities of Liuzhou City Guangxi Zhuang Autonomous Region based on adults.SETTING: Department of endocrinology in a university hospital.PARTICIPANTS: Diabetic morbidity was investigated in 4 relative big unit communities of Liuzhou City between July and August 1994. The resident population of the communities was 11 886, which were all adults between 20 and 75 years old and lived in Liuzhou City for more than 5 years. Populations with either impaired glucose tolerance or normal blood glucose tolerance in 2 of the 4 unit communities were followed up in October 1999. Totally 9 230 individuals should be checked and 6 020 subjects were actually checked with the response rate of 65.22% (quite a few cases lost followed up due to unemployment and retirement, etc. ) . Inclusion criteria: Finally 5 539 subjects with complete data of two surveys entered into statistics. There were 5 237 normal individuals and 266 individuals with impaired glucose tolerance. And there were 3 177 males including 110 individuals with impaired glucose tolerance with an average age of(40 ± 12) years old, and 2 362 females including 156 individuals with impaired glucose tolerance with an average age of(41 ± 10) years old. Exclusion criterion: secondary diabetes.METHODS: Totally 5 539 subjects(including individuals with normal blood glucose or impaired glucose tolerance) who confirmed without diabetes in 1994 survey for diabetic morbidity in 2 unit communities of Liuzhou City Gugangxi Zhuang Autonomous Region received recheck in 1999 including blood glucose, body mass index(BMI), blood pressure and blood fat to analyze the impacts of each factor on diabetic morbidity.bidity among correlative risk factors.RESULTS: Totally 5 539 individuals were included into statistics. A totally of 46 of 5 237 normal individuals developed diabetes with the annual percent of conversion of 0.19%, while 50 of 226 individuals with impaired glucose tolerance developed diabetes with the annual percent of conversion of 3.84%, which had 20.9 times of correlative risk significantly higher than normal individuals(x2 = 1 063.1, P < 0. 000 1).CONCLUSION: The risk of diabetes is higher in individuals with impaired glucose tolerance than normal individuals. Age, BMI, hypertension, fasting blood glucose, blood glucose, and 1 hour blood glucose in Glucose tolerance test are risk factors of diabetic morbidity.

Objective To explore the application value of the modified hypotonic method of intestinal system contrast ultra-sonography in elder patients with small intestinal diseases .Methods Group A were 28 patients with small intestine disease and 8 patients who was found abdominal mass suspected source of intestinal tumors by routine abdominal ultrasound inspection .We con-trast the mannitol intestinal system contrast ultrasound with modified hypotonic method of intestinal system ultrasound contrast , and compare with gastrointestinal ,gastrointestinal barium meal contrast ,then contrast the results of pathology .Group B were 37 patients ,with definite diagnosis with duodenal ulcers ,polyps ,the descending part of the diverticulum ,who respectively treated with drinking water method and modified hypotonic method of intestinal system ultrasound contrast ,then carry the two methods into comparison .Results The nidus detection increase from 9 to 12 in group A ;the nidus detection increase from 13 to 33 in group B . The modified hypotonic method of intestinal system contrast ultrasonography ,which eliminate intestinal gas more obvious and relax the intestinal lumen more sufficient than conventional contrast ,can improve the nidus detection rate .Conclusion The modified hy-potonic method of intestinal system contrast ultrasonography could be as a routine inspection method for elder small intestinal dis-ease paitents .

Objective To discuss training of the nurses in outpatient blood collection room with the digital training modular of blood sample collection to improve the quality of blood sample collection. Methods Nurses were trained with the digital training modular by multimedia,group discussion to impmve the quality of blood sample collection continuously. Results The unqualified blood sample rate in the same season after training were statistically different compared with that before training. Conclu-sions Training the nurses in outpatient blood collection room with the digital traimg modular of blood sample collection have actual direction value to improve the quality of blood sample collection.

Objective To observe effects of intranasal sufentanil on analgesia.Methods Eighty-two patients,who scheduled for selective thyroidectomy were randomly divided into the observed group and the control group with 41 cases in each group.In the observed group,patients received intranasal sufentanil 20 μg before the incision about 10 minutes,then administered local infiltration with 0.5% lidocaine.In the control group,patients received water for injection which was placebo instead sufentanil.By double blind method observed verbal mting scale(VRS)score.The values of NBP,HR,SpO2 and respiration rate(RR)were recorded before intranasal drugs and 5,10,20,40,60 min after intranasal drugs.The amount of local anesthetic,the size of thyroid gland,the time of operation and the satisfaction were compared between the two groups.Nausea vomiting and pruritus were also observed in order to assess the safety of intranasal sufentanil.Results All patients completed the operation successfully.The RR in the observed group decreased to(13.1±0.5),(13.8±0.6),(13.8±0.8)times/min after intranasal sufentanil 10,20,40 min,and had significant difference with those before intranasal drugs(P＜0.05),anastated after 60 min.VRS score of the observed group was(2.0±0.4)scales,less than the control group,and had significant difference when the surgeon was dissecting thyroid gland(P＜0.05).The amount of local anesthetic in the observed group was(42.5±6.9)ml,less than the control group(63.7±4.3)ml(P＜0.05).The satisfaction had significant difference between the two groups(P＜0.05).Conclusion Intranasal sufentanil for analgesia is a safe and useful technology.

Objective To design and apply the digital training modular for nurses in blood sample collection in order to improve the quality of blood sample collection.Methods Based on the principle of evidence-based nursing,the records of unqualified blood samples in the clinical laboratory department were analyzed.Then,the modular of examination item list,tube choosing,volume of blood sample,patient preparation and theoretical foundation,influential factors of the quality of blood collection,and quality information were designed and applied to train nurses.Results After training,the unqualified rate of blood samples was significantly decreased from 0.56% to 0.34% (P<0.01).Conclusion The application of digital training modular of blood sample collection can improve the quality of blood collection.