Various academic organizations, countries, and regions have established different concepts of metabolic syndrome, including the involvement of metabolic disorders, the threshold of its constituent elements,and the utility as a research or clinical tool, etc. Additionally, uncertainty of its pathogenesis, lack of uniform diagnosis definition, and some other factors lead to concept confusion and practical inconvenience of metabolic syndrome in public health prevention and in clinical diagnosis. Consensus and controversy of metabolic syndrome were both presented in recent years. Besides literature reviewing, further evidences are essential for appropriate understanding and distinguishing. The present article mainly introduces the new controversies concerning the concept of metabolic syndrome and the recent evidence of unifying trends in the diagnosis criteria of abdominal obesity in Asians.

Recently, more and more attention have been paid to the impact of maternal thyroid hormones on neuropsychologic development of offspring. In the first 20 weeks of gestation, neuropsychologic development of the fetus is mostly dependent on thyroxine from the mother. Limited epidemiological data showed that full-scale WISC IQs averaged 7 points lower among children born to mothers with undiagnosed thyroid deficiency during pregnancy, in comparison with control children. The main cause of subclinical maternal hypothyroidism is autoimmune thyroiditis. Data from basic studies have confirmed the impacts of maternal thyroid hormones on the neurodevelopmental outcomes of offspring. In a Chinese female population, the positive rate of thyroid autoantibodies was 11.0%, and the prevalence of postpartum thyroiditis was 11.9%. Hence, it is necessary to set up a screening schedule for subclinical hypothyroidism and autoimmne thyroiditis in pregnant women, which is of great value for the health of both women and children.

For the first time,the iodine-induced thyroid diseases group of China Medical University has finished a five-year prospective epidemiological study on the incidences of thyroid diseases in the three communities with various levels of iodine intake.The results indicated that increased incidences of subclinical hypothyroidism and autoimmune thyroiditis in the communities with more than adequate and excessive iodine intake.The individuals with positive thyroid autoantibodies at baseline more likely became hypothyroid due to more than adequate and excessive iodine intake.These adverse effects are mainly involved in the susceptible populations for thyroid diseases.Hence it appears to be reasonable that iodine supplementation should be conducted by localization and individualization.

In order to improve the management of drugs in hospital pharmacy, on the basis of pharmacological principles, we have worked out a classification and coding system with four layers and five digits. The codes are standardized in six aspects, namely, the catalogue of drugs in common use, the inventory of stock in storehouse and in hospital pharmacy, registration of inlet and output of stock in both departmernts, and the record of stock taking.

Objective: This study was to evaluate the effects of inhalation of nitric oxide combined with intravenous phenylephrine on the arterial hypoxemia and tissues acidosis in patient with tetralogy of Fallot. Method: The 34 pa tients were randomly divided into Ⅰ(n=17) and Ⅱ(n=17) groups. In both groups, when the patient's SpO_2 was less than 80%, the intervention began. In Ⅰ group,a bolus dose(1?g/kg) of phenylephrine was given intermittently, until the SpO_2 was large than 90% or blood pressure increased to 120%, of baseline. In Ⅱ group, inhalation of 20 ppm NC was combined with intermittent bolus of phenylephrine 1?g/kg. Result: The value of SpO_2, MAP and BE had no sig nificant differences between two groups at pre-treatment. In Ⅱ group, SpO_2 was higher, meanwhile MAP, the negative value of BE,the total dose of phenylephrine used were lower than those in Ⅰ group after treatment (P

In the complex interpersonal relationships,due to its specificities,the physician-patient relationship has drawn great attention from clinical doctors,patients and medical experts.The physician-patient communication is a skill.A harmonious physician-patient relationship can only be constructed by both the doctors and patients sharing their good faith and sincerity during their communication process.

Objective To compare target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia and intravenous combined with inhalation anesthesia in hemodynamic changes and side effects in elderly patients with laparoseopic cholecystectomy.Methods 56 ASA Ⅰ-Ⅱ patients aged ＞60 Y undergoing elective laparoscopie cholecystectomy were randomly divided into propofol-remifentanil target controlled infusion group (observation group)(n=28)and inhalation anesthesia group(using intravenous anesthesia was maintained with isoflurane inhalation)(n=28).HR,SBP,DBP,PETCO2,initial consciousness time,extubation time,side-effects were recorded at each time points.Results The change extent of HR and blood pressure in observation group was lower than inhalation anesthesia group.The initial recovery time,recovery time of spontaneous breathing and extubation time in the observation group Was better than anesthesia group(all P＜0.05).The side-effects in observation group were significantly lower than inhalation anesthesia group(all P＜0.05).Conclusion Laparoscopic cholecystectomy in elderly patients by target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia could significantly inhibit the stress response,and effectively maintain the stability of hemodynamic,and rapid postoperative recovery,fewer adverse reactions.It Was an ideal anesthesia methods in elderly patients with laparoscopic cholecystectomy.

Objective To explore the clinical effect and safety of bisoprolol combined with methimazole in treatment of hyperthyroidism.Methods 100 cases with hyperthyroidism were randomly divided into control group (methimazole treatment)50 case.$and treatment group(bisoprolol combined with methimazole treatment)50 cases.The therapeutic effect,serum levels of FT3,FT4 and s-TSH were observed.Results The total effective rate in treatment group 92.0% was significantly higher than 78.0%in control group(χ2=3.798,P＜0.05);The contents of TT3,TT4,FT3,FT4 after treatment were lower than before treatment(t=2.245,2.315,2.411,all P＜0.05);The contents of S-TSH was higher than before treatment(t=2.335,P＜0.05);Hyperthyroidism exponential integral in treatment group decreased significantly than the control group(t=2.312,P＜0.05).Conclusion The bisoprolol combined with methimazole treatment could efficiently improve clinical symptoms,raise therapeutic effect in patients with hyperthyroidism.

The research on hypothyroidism during pregnancy has been a hot field concerned by endocrinologists. This editorial highlights six aspects of consensus reached by American Endocrine Association in "Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline" in 2007. The appropriate diagnosis of thyroid dysfunction depends on gestational specific reference intervals of thyroid hormones, and otherwise the pregnant women with subclinical hypothyroidism will suffer from missed diagnosis. There are three types of subclinical thyroid disorders during pregnancy, namely subclinical hypothyroidism, hypothyroxinemia and simple positive thyroid peroxidase autoantibodies. The opinions on thediagnosis of these disorders are proposed in the context.

In many cancers the chronic inflammation caused by microorganisms can be observed, espe-cially in gastrointestinal system. Atrophic gastritis is thought to be a precancerous lesion. Studies have approved that Helicobacter pylori plays an important role in the genesis and development of gastric caner. It is now known to be responsible for inducing chronic gastric inflammation that progresses to atrophy, metaplasia, dysplasia and gastric cancer.