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Objective To summarize the current status and trend of hypoglycemic agents of diabetic inpatients in different departments of Chinese PLA General Hospital.Methods The clinical data of diabetic patients admitted to Chinese PLA General Hospital from January 2000 to May 2014 were collected(those hospitalized in the department of endocrinology were excluded).A total of 10 041 patients were selected by stratified random sampling.The type of hypoglycemic agents in different departments and the variation on anti-hyperglycemic drugs with time were retrospectively analyzed.Results Of all the patients in non-endocrinological wards, 50.2% were treated with insulin, 36.9% with metformin, 21.3% with α-glycosidase inhibitor, and 18.9% with sulfonylureas.Metformin, α-glucosidase inhibitors, pre-mixed 30R, and insulin glargine were more commonly used than other anti-hyperglycemic agents, accounting for 36.9%, 21.0%, 14.0%, 8.7%, respectively.Metformin, sulfonylureas, α-glucosidase inhibitor, and different types of insulin were more widely applied in internal medicine while insulin therapy was more frequently used in surgical department.During the past 15 years, the proportions of insulin, glinides, α-glucosidase inhibitor, and thiazolidinediones application were gradually increased, while the proportions of sulfonylureas and metformin treatment were on the decline trend.Conclusion Most of the inpatients were treated with oral antidiabetic drugs.Metformin, α-glucosidase inhibitor, pre-mixed 30R, and insulin glargine were the most frequently prescribed agents for the inpatients.
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Objective To assess the significance of insulin tolerance test(ITT) in clinical diagnosis of adult growth hormone deficiency(GHD).Methods Eighty-two patients with an established diagnosis of adult GHD [53males,29 females,mean age (30.9 ± 12.3) years (18-65 years)] were reviewed retrospectively for evaluating the GH response to ITT in the General Hospital of the People' s Liberation Army.Control data for peak GH after ITT were obtained in 15 healthy subjects [9 males,6 females,mean age (26.7 ± 5.6) years (22-41 years)].Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) were used to evaluate the diagnostic cut-off point of peak GH and GH increment response to ITT.Results (1) Mean peak GH response to ITT was significantly higher in 15 controls compared with 82 patients (the median 14 μg/L vs 0.62 μg/L,P =0.001).The cut-off point of the peak GH(chemiluminescent immunoassay,CLIA) response to ITT in adult GHD was 4.935 μg/L (AUC 0.993).(2) Mean GH increment was significantly higher in 15 controls compared with 82 patients (the median 13.17 μg/L vs 0.19 ug/L,P＜0.001).The cut-off point of the GH increment was 4.088 μg/L(AUC 0.937),with a 91.5％ sensitivity and 100％ specificity.(3) The peak GH showed even higher diagnostic value than the GH increment after ITT.(4)The above mentioned cut-off points (peak GH less than 4.935 μg/L and 5 μg/L) had a coincidence with a 95.1％ sensitivity and 100％ specificity,respectively.Conclusion The current guidelines for the diagnosis of adult GHD based on the optimal cut-off point of the peak GH(CLIA) response to ITT less than 5 μg/L turned to be of reliable diagnostic value in our country.
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Objective Several previous studies have shown androgens deficiency in men with CHF, and 2 studies on the prognostic significance of serum levels of androgens in CHF patients have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHF. Methods A total of 175 elderly (age≥60 years) men with CHF were recruited. Total testosterone (TT) and sex hormone binding globulin (SHBG) were measured, and free serum testosterone (eFT) was calculated. The median follow-up time was 1262 days. Results During follow-up 54 (30.9%) patients died. TT and eFT deficiency was found in 21.7% (38/175) and 27.4% (48/175) patients, respectively. Both TT and eFT were inversely associated with LVEF and NT-proBNP (all P<0.01). Kaplan-Meier curves for patients in low, medium and high tertiles according to TT and eFT level showed significantly different cumulative survival rate (both P<0.01 by log-rank test). However, after adjustment for clinical variables, there were no significant associations between either TT or eFT levels or survival time (OR=0.97, 95% CI, 0.84-1.12, P=0.28; and OR=0.92, 95% CI, 0.82-1.06, P=0.14, respectively). Conclusion Our study showed that although levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity, they are not independent predictors for mortality.
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The old term of PADAM is "male climacteric" or "andropause" with the synoym of "ADAM" or " late hypogonadism".The serum level of testosterone in male progressives declined after the age of 40 while SHBG increased.At age of 70,around 30% of the total testosterone and 40% of the free testosterone lost.The diagnosis of PADAM is based on the low serum level of androgen and the presence of related symptoms.The basic treatment for PADAM is androgen supplementation(TST).Testosterone undecanoate is a common agent for this purpose.The skin patch or gel of testosterone are also recommended.The benefits of TST are improvement of sexual function,increase of lean body mass,decrease of body fat,enhancement of bone formation and cognition function,and decreased the risks of suffering from type 2 diabetes and cardiovascular disease.On the way of TST,it is necessary to monitor erythrocytes,liver function,prostate digital examination and serum PSA regularly.
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Objective To examine the expressions of estrogen receptor α (ERα), estrogen receptor β (ERβ) and pituitary-specific truncated estrogen receptor product-1 (TERP-1) in diethylstilbestrol (DES) induced prolactinoma of rats. Methods Ovariectomised Wistar rats were subcutaneously implanted with an implant containing 20 mg DES. Rats were implanted with a blank implant as controls. Eight weeks later, serum prolactin level of rats was measured by RIA. Prolactin immunoreactive cells of anterior pituitary were detected by immunohistochemistry assay. ERα, ERβ and TERP-1 mRNAs in pituitaries were examined by RT-PCR. Results Serum prolactin levels, pituitary weights and pituitary prolactin immunoreactive cell countings in experimental group rats were all obviously higher than those in control group (P＜0.001 respectively). ERα, ERβ and TERP-1 mRNAs were all transcripted in DES induced rat prolactinomas. ERα and TERP-1 mRNA levels were significantly higher in experimental group than those in control group (P＜0.001 and P＜0.05). Conclusion Estrogen plays a direct role in regulating pituitary prolactin cells through estrogen receptors. Further functional studies will be required to determine whether coexpression of ER variants along with normal ER confers a pathophysiological role in pituitary hormone regulation and (or) tumor cell proliferation.
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Erectile dysfunction(ED)is an age-related disease.Diabetes mellitus makes its prevalence even higher.In the present article,physiology,etiology,diagnosis and therapy of the disease is reviewed.
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Objective To in ve stigate quantitatively the expression of pituitary transcription activator (Pit) -1 mRNA in different types of human pituitary adenomas by RT-PCR. Methods Samples were obtained from 35 patients who had unde rgone therapeutic surgery for pituitary adenomas. The type of pituitary adenomas was determined according to serum hormone levels and clinical features, and the grade and the stage of pituitary adenomas were depended on imaging and operatio n observation. Expression of Pit-1 mRNA of pituitary adenomas was assayed by RT -PCR. Results Thirty five patients with pituit ary adenomas consisted of 13 cases with PRL adenomas, 6 cases with GH adenomas, 2 cases with GH/PRL mixed adenomas, 11 cases with clinically non-functioning ad enomas and 3 cases of ACTH adenomas. Pit-1 mRNA was expressed in all PRL, GH an d GH-PRL mixed adenomas and in some non-functioning adenomas (9/11). No Pit-1 mRNA expression was found in ACTH adenomas. Pit-1 mRNA levels in PRL, GH or GH /PRL mixed adenomas were similar and all higher than that in non-functioning ad enomas (all P
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Water deprivation and loading tests were performed in a patient with sustained hypernatremia and hypodypsia. Results suggested that the regulation of ADH release was still retained despite of the raised threshold, being consistant with the diagnosis of essential hypernatremia. The hypernatremia of this patient was partially improved by dihydrochlorothiazide and desmopression acetate (DDAVP).
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Objective:To study the changes of testicular steroidogenic acute regulatory protein (StAR), 17?-hydroxys-teroid dehydrogenase (17?-HSD) and aromatase (P450arom) in elder SD rats, exploring the effects of aging on testicular steroidogenic function. Methods:The young male rats and old male rats were treated with human chorionic gonadotropin (hCG) for 3 times and then rat serum testosterone(T) and estradiol(E2) levels were determined by chemiluminescentenzyme immunoassay(CLIA) and the mRNA levels of StAR, 17?-HSD Ⅲ and P450arom were determined by RT-PCR. Results: (1) The levels of serum T and 17?-HSD Ⅲ mRNA of old SD rats were significantly lower than those of young rats before and after hCG stimulation (P
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In this study the role of acute administration of naloxone on LH pulse in normal adult men was evaluated. In 4 volunteers, blood samples were drawn at 10-min intervals for 10 hours both before and after administrating naloxone respectively for measurment of LH by RIA. The administration of naloxone resulted in an increase in LH pulse frequency from 5. 50?0. 50 to 8. 25?1. 09 (P
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After 3 weeks of administration of 100 mg clom phene citrate daily, four idiopathic infertile men showed that the mean level of basal LH (from 18.6?0.2 IU/L to 54.7?0.6IU/L)and LH pulse frequency (from 3.5?0.1 pulses / 8h to 6.3?0.3 pulses / 8h) were significantly higher than that in control peroid (both P
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Three patients with prostatic carcinoma who experienced bilateral orchidectomy 2 to 12 weeks ago were examined, and each patient accepted intramuscular injection of estradiol benzoate (E2B) in dose of 1 mg daily for 7 days. Blood sampe was drawn in an interval of 10 min was done for LH pulse analysis before and after the injection for a period of 7h. The results showed that the mean serum LH level decreased significantly from 177,58?3.20 to 174.70?7.60, 138.30?5.83 to 132.02? 5.77 and 145.88? 3.82 to 142.80? 3.65U / L, respectively (P
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ART was determined in 104 cases of diabetics with a computerized kinemometer. It was found that of the intervals SD, SP, and VP, a delay of one of them appeared in 41 cases, two in 8 cases and all threein 15 cases. In addition, the reflex was lost in 13 cases. The abnormality of ART was positively related to peripheral diabetic neuropathy and decrease or loss of knee reflex(both p
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Patients with thyrotoxicosis had a normal circadian rhythm of ACTH and F,but the level of serum F was lower than controls due to excessive degradation.The responsiveness of ACTH to dexamet-hasone suppression or insulin hypoglycemic stimulation was normal.Whereas the circadian secretion of ACTH and F was also normal in patients with primary hypothyroidism,and the concentration of F was inreased with normal ACTH level.There were stunted responses of ACTH to suppressing and stimulating tests,which were thought to be due to the fact that the corticotropes were impaired by hypertrophy or hyperplasia of thyrotropes in primary hypothyroidism.