Objective To analyze the proportions of interhospital and intrahospital consultation cases of chief residents in the Department of Endocrinology and Metabolism in West China Hospital of Sichuan University, and summarize the distribution characteristics of endocrine and metabolic diseases in other specialized departments, in order to promote the routine work optimization and the cultivation of specialists in endocrinology and metabolism. Methods A total of 1 299 cases were completed by the chief residents in the Department of Endocrinology and Metabolism between July 2012 and June 2013. Distribution of departments, composition and distribution of consultation cases were analyzed retrospectively. The characteristics of endocrine and metabolic diseases were summarized, and the difference of endocrine and metabolic consultation demand was compared among different departments . Results Among the 1 299 consultation patients, there were 612 males (47.11%) and 687 females (52.89%) aged between 14 and 96 years averaging at 56.3. There were 747 (57.51%) interhospital consultation cases and 552 (42.49%) intrahospital consultation cases. The most common reason for emergency consultation was stress hyperglycemia in diabetic patients after surgery or trauma, followed by thyroid diseases and electrolyte disturbances. Most consultation applications were from the Emergency Department, and the consultation purpose was mainly blood glucose control. The main consultation purpose of surgical and gynecologic departments was perioperative assessment and treatment adjustment in patients combined with endocrine diseases such as diabetes and thyroid diseases. Meanwhile,the purpose of obstetric consultation was mainly treatment for patients with hyperthyroidism complicated with pregnancy, gestational diabetes treatment and perioperative blood glucose control. Conclusions Clinical consultation work is challenging, which also provides an excellent chance for chief residents to study and review professional knowledge and accumulate clinical experiences. Chief residents should have the knowledge of the proportions and distribution of consultation cases in order to optimize daily work. They should also summarize consultation experiences so as to promote their knowledge of diagnosis and treatment.
We analysed the profiles of teaching practice in clinical diagnostics for international students in recent three years in West China School of Medicine, Sichuan University. Teaching experiences and characteristics were summarized through the following five aspects:pre-service training for all teachers, textbook selection and lesson plan formulation, teaching style and problem-based learning, as well as teaching feedback. We aimed to improve the quality of medical education for international students. Our teaching practice can offer better clinical skills and correct clinical analysis ability for international students in West China School of Medicine, which should be a great help for their further career development.
Orlistat, which has a new mechanism of action, is currently the only approved weight-loss drug in China. In addition to controlling body weight, orlistat can significantly improve blood glucose, blood pressure, dyslipidemia, adiponectin, insulin concentration and other obesity-related biochemical indicators in patients with overweight/obese. Recently, orlistat was approved for weight management in patients with polycystic ovary syndrome. Although there are clinical trials supporting the good weight loss efficacy of orlistat, its long-term safety and effectiveness in obesity-related diseases still need to be further determined. This article provides a brief review of the new progress in the clinical efficacy and safety of orlistat, aiming to provide a reference for the more rational drug application.
Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus. Severe diabetic macular edema or proliferative retinopathy may lead to impaired vision or even blindness in diabetic patients. The glucagon-like peptide-1 receptor agonist (GLP-1RA) is now commonly used as novel glucose-lowering agents in the clinical management of type 2 diabetes, but the rapid glycaemic changes associated with the use of the GLP-1RA may aggravate the risk of an increase in the occurrence of short-term potential DR. Potential effects and mechanisms of DR include oxidative stress, vascular endothelial growth factor, inflammation, retinal neurodegeneration, and other cytokines.Whether GLP-1RA leads to the increased risk of DR remains controversial. More basic and clinical studies are needed with the aim of further clarifying the correlation between GLP-1RA and DR risk.
Pituitary Society released an international consensus statement on the diagnosis and management of prolactin-secreting adenoma (PRLoma) on September 5, 2023, providing recommendations based on the latest evidence-based approach for the screening, diagnosis, treatment and management of PRLoma. This consensus statement not only updated the clinical epidemiology, pathogenesis, clinical symptoms, complications, diagnostic criteria, and treatment progress of pituitary PRLoma, but also focused on special populations such as pregnant women, postmenopausal women, children/adolescents, transgender patients, as well as the treatment of special types such as cystic and invasive pituitary PRLoma. This article aims to help neurosurgeons, endocrinologists, and related healthcare professionals standardize the diagnosis and treatment of PRLoma by interpreting the updated section of the consensus.
ObjectiveTo investigate the clinical heterogeneity and auto-immunologic state in patients with diabetic ketosis (DK) or diabetic ketoacidosis (DKA). MethodsDiabetic patients who presented with DK/DKA were recruited from West China Hospital of Sichuan University from January 1, 2000, to December 31, 2008. We analyzed the clinical classification, biochemical profiles, and auto-immunologic state of the patients. ResultsAmong them, 257 (15.0%) patients had type 1 diabetes, while 883 (51.6%) with type 2 diabetes, and 515 (30.1%) could be typed as "atypical diabetes" or "untying diabetes". The average age of hospitalized patients with type 1 diabetes was (31.1±13.5) years, which was significantly lower than that of the type 2 diabetes patients [(58.1±13.2) years] (P＜0.001). The most common contributing factor for DK/DKA was infection, followed by noncompliance with therapy. Glutamic acid decarboxylase antibody positive rate was 4.37% in patients with "atypical diabetes", which was similar with type 2 diabetes group (2.69%, P=0.79), but lower than that of the patients with type 1 diabetes (13.79%, P＜0.001). ConclusionsWe conclude that DK or DKA can occur not only in type 1 diabetic patients but also in patients with type 2 diabetes under infection or stress condition. DK/DKA patients have a high clinical heterogeneity. The auto-immunologic state and β-cell function have significant implications for the diagnosis and classification of diabetes.