Objective To determine the trend in the causes of admission among diabetic patients in West China Hospital from 1996 to 2005. Methods The medical records of diabetic inpatients from January 1996 to December 2005 were retrieved, and half of them were randomly selected. A questionnaire was completed and SPSS13.0 software was used for statistical analyses. Results The most common causes of admission for diabetic patients were diabetic chronic complications (20.2%), infection (19.5%), hyperglycemic symptoms (11.7%), malignant tumor (8.9%) and diabetic acute complications (5.8%). The constituent ratios of diabetic macrovascular disease and malignant tumor as the admission causes tended to increase, while the constituent ratios of diabetic microvascular disease, hyperglycemic symptoms and diabetic acute complications tended to decrease. Infection remained as one of the main causes of admission among diabetic patients. Conclusion The main cause of admission to West China Hospital for diabetic patients from 1996 to 2005 was diabetic chronic complications.
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.
Objective To analyze the glucolipotoxicity effects of glucose combined with free fatty acid (FFA) on ketone production and ultrastructure of skeletal muscle, by exogenous elevating circulating glucose and FFA concentration. Methods Fifty Wistar rats were divided into high-fat-feed induced obesity group (OB group, n=40) and ordinary feed as normal control group (NC group, n=10). Circulating glucose and FFA levels were increased by infusion in high-fat-fed obese rats. The levels of serum lipid, plasma FFA and beta-hydroxybutyric acid were detected by the horizontal colorimetry, and the microstructure of skeletal muscle was observed by transmission electron microscopy, especially the changes of the mitochondrial structure. Euglycemic-hyperinsulinemic clamp with tracer infusion was performed to assess peripheral insulin sensitivity. Results The average weight and body fat ratio in the OB group was higher than that in the NC group (P<0.05). Insulin clamp test to assess peripheral insulin sensitivity showed that the steady-state glucose Infusion rate in the OB group during clamp test was significantly lower than that in the NC group [OB: (19.26±1.84) mg/(kg·min)vs. NC: (28.82±1.69) mg/(kg·min), P<0.05]. The mitochondrial denaturation of skeletal muscle in the OB group of rats was observed, and the swelling and crest permutation, the accumulation of lipid droplets and cavitation were formed, and hypertrophy of mitochondria were also seen after intralipid and glucose infusion, which was obvious in the combined infusion group. Conclusions By exogenous elevating circulating glucose and FFA concentration, the products of ketone body increases. The mitochondrial damage of skeletal muscle suggests that mitochondrial may be the potential target of glucoxicity and lipotocicity.
Multi-disciplinary team (MDT) is increasingly applied in oncology and refractory diseases. In recent years, MDT has also been applied in diagnosis and treatment of pituitary adenoma and related diseases. This review summarizes the advantages and characteristics of the MDT diagnosis and treatment mode, and analyzes the application and effect of the MDT diagnosis and treatment mode in the Center of Pituitary Adenoma and Related Diseases, West China Hospital, Sichuan University. So far, it has shown that MDT has advantages such as it is professional, full of collaborative interaction, and efficient and optimized. It is a platform of multi-disciplinary cooperation and resources in the diagnosis and treatment of difficult diseases. Case discussion in MDT mode is conducive to timely selection of the best treatment options for patients with pituitary adenoma and related diseases, providing a good learning platform for doctors with different professional backgrounds, and promoting the improvement of professional diagnosis and treatment level of doctors in related departments. The development of MDT will help us to use limited medical resources efficiently, promote the medical team to be more specialized, optimize the diagnosis and treatment process, and improve the effectiveness of the treatment, for benefiting more patients with pituitary adenomas and related diseases.