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.
Endocrinology is closely related to lipid metabolism. Lipotoxicity affects the abnormal function of various endocrine organs, and leads to diabetes, fatty liver, metabolic syndrome and other endocrine and metabolic diseases. It is an important strategy to prevent the lipid toxicity. Endocrine disorders can also cause dyslipidemia. Studies have found that thyroid and gonadal glands play an important role in lipid metabolism. Their molecular mechanisms are gradually revealed and will be a new therapeutic target for dyslipidemia. Lipid metabolism disorders play an important role in the development of endocrine and metabolic diseases.
ObjectiveTo investigate the role of multiple disciplinary team (MDT) during surgical treatment of renal secondary hyperparathyroidism (SHPT), and identify management points of Departments of Nephrology and Endocrinology.MethodsThe data of patients with chronic kidney disease undergoing surgical treatment for SHPT in West China Hospital of Sichuan University between January 2009 and December 2018 were retrospectively collected. We explained the surgical treatment of MDT in the management of renal SHPT, and compared the changes before and after the establishment of MDT.ResultsA total of 187 patients including 101 males and 86 females were enrolled, with an average age of (47.60±11.28) years old and median dialysis vintage of 7 years. Under MDT, the number of patients with parathyroidectomy increased [(8.50±5.10) vs. (59.50±2.12) patients/year, P<0.001] and the completion rate of preoperative examinations were greatly improved (P<0.001). The success rate of surgery was also increased (86.8% vs. 97.5%, P=0.010). Proportion of patients who were admitted to the Department of Nephrology was significantly increased (39.7% vs. 84.9%, P<0.001). Most patients after surgery were transferred to the Department of Endocrinology (5.9% vs. 77.3%, P<0.001) to manage postoperative complications and metabolic bone disease, and thus normalized the management of SHPT.ConclusionsThe MDT contributes to management of renal SHPT, which is worthy of popularization and spreading. The management of internal medicine departments during surgical treatment of SHPT based on MDT is important, because they can be helpful to complete preoperative examinations and preoperative preparation as well as to alleviate postoperative complications.
With the promoting of “the Belt and Road Initiative”, medical assistance to Xinjiang is one ofthe important tasks of public hospitals in China. West China Hospital of Sichuan University actively explores the“Huaxi-Karamay” model of multi-disciplinary group assistance and scientific and technological assistance to Xinjiang, and leverages the technical leadership and leading role of medical experts to improve the medical and health service capabilities of Karamay, especially in chronic diseases management. This article takes the People’s Hospital ofKaramay City in Xinjiang province as an example to discuss the exploration and practice of the new chronic diseasemanagement model of the endocrinology and metabolism center with medical assistance from West China Hospital ofSichuan University, aiming to provide a certain reference for the in-depth development of medical aid to Xinjiang in thefuture.