Guidelines of the American Thyroid Association (ATA) proposed two diagnostic criteria for subclinical hypothyroidism during the first trimester of pregnancy:criterion 1 was based on the pregnancy-specific TSH reference range and criterion 2 on serum TSH＞2.5 mIU/L level with normal serum FT4.According to the results of the Subclinical hypothyroidism during early pregnancy study,author proposed that criterion 2 is not appropriate for Chinese pregnant women because the TSH concentration has become significantly higher in whole Chinese population.By using criterion 2,the prevalence may be as high as 27.8％,which may result in over-diagnosis and over treatment.

Objective To analyze distribution of human papilloma virus(HPV) subtypes in women infected by HPV in Guigang area ,and to determine the dominant type in this region .Methods 21 genital HPV genotypes were screened in 13 156 women in out‐patient clinic in Guigang area from July 2013 to July 2014 by using rapid flow‐through hybridization technique of nucleic acid mole‐cules ,and high‐risk HPV detection and typing was carried out for screening cervical cancer .Results A total of 4 682 HPV‐positive women were identified and the infection rate was 35 .59% .All of 21 genetypes were checked out ,dominated by single infection .The percentages of HPV genotypes from high to low was HPV‐52 (16 .28% ) ,HPV‐16 (14 .01% ) ,HPV‐58 (8 .48% ) ,HPV8304 (7 .58% ) ,HPV‐6(6 .79% )and HPV‐11(5 .72% ) .Conclusion The dominant genetype of HPV of women in this area is HPV‐52 .

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.

Guidelines on the Diagnosis and Treatment of Thyroid Nodules and Differentiated Thyroid Carcinomas is written by Chinese Society of Endocrinology,Chinese Society of General Surgery Endocrinology Group,China Anti-Cancer Association Head and Neck Tumor Professional Committee,and Chinese Society of Nuclear Medicine.The guideline has systematically established a series of standards related to thyroid nodules.It reflects the scientific spirit of multidisciplinary cooperation and mutual understanding.

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.

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.

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.

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.