[Current status and influencing factors for physicians in different departments prescribing novel hypoglycemic agent with cardiovascular benefits].

Objective: To investigate the knowledge, use and barriers when prescribing GLP-1RA and SGLT2i among cardiologists, endocrinologists and general practitioners, and explore the influencing factors that hinder the use of these medications. Methods: A questionnaire was conducted among physicians in the above departments in Peking University Third Hospital and health service institutions at all levels in its medical consortium. A total of 342 physicians were involved. Among them, 40.6% (139) were cardiologists, 28.9% (99) were endocrinologists and 30.4% (104) were general practitioners; 66.7% (270) came from Beijing while 33.3% (72) from other provinces. The survey included clinicians' knowledge and current use of GLP-1RA and SGLT2i, and the possible reasons that influenced the prescription of these medications. Medical therapies of physicians were investigated by simulating different clinical scenarios. The difference of measures among physicians in different departments was compared. Results: A total of 342 physicians were involved, with the average age of 40 (35, 46) years old and the average working time of 13 (7, 20) years. Among them, 40.6% (139) were male. 77.5% (265) physicians had comprehensive knowledge of SGLT2i and prescribed it, which was higher than that for GLP-1RA (70.5%, 241) (P<0.001). 21.1% (72) physicians prescribed SGLT2i more than 20 times per month, which was higher than that for GLP-1RA (8.2%, 28) (P<0.001). Endocrinologists had more knowledge and prescribed more GLP-1RA and SGLT2i compared with other physicians (both P values<0.001). 38.1% (53) cardiologists, 22.2% (22) endocrinologists, and 30.8% (32) general practitioners believed patients needed an endocrinologist to evaluate and adjust GLP-1RA, which was the primary barrier for the use of medications (P=0.042). 27.4% (38) cardiologists, 14.1% (14) endocrinologists, and 30.8% (32) general practitioners believed patients needed an endocrinologist to evaluate and adjust SGLT2i, which was the primary barrier for the use of medications (P=0.018). 21.6% (30) cardiologists, 45.5% (45) endocrinologists, and 31.7% (33) general practitioners believed side effects of SGLT2i was the primary barrier for the use of medications (P<0.001). For patients with unqualified glycemic control and cardiovascular complications, 65.4% (75) cardiologists, 69.7% (69) endocrinologists, and 43.3% (45) general practitioners chose the above medications (P<0.001). For patients with qualified glycemic control, combined with cardiovascular complications and diabetic organ damage, 35.3% (49) cardiologists, 52.5% (52) endocrinologists, and 25.0% (26) general practitioners chose the above medications (P<0.001). Conclusions: Physicians had more knowledge and prescription of SGLT2i than that of GLP-1RA. Endocrinologists had more knowledge and prescription of the above medications than other physicians. The side effect of medications was potential primary barrier for the use of the novel hypoglycemic agent with cardiovascular benefits. In clinical practice, most of physicians considered that high-risk patients with cardiovascular comorbidities need to be referred to cardiologist or endocrinologist to adjust clinical therapies.

Distribution of polycyclic aromatic hydrocarbons in aerosols and dustfall in Macao.

Polycyclic aromatic hydrocarbons (PAHs), widespread environmental pollutants, have been measured in aerosols and dustfall in Macao. In this paper, we compare concentration distributions and determine the partitioning of PAHs in aerosols and dustfall for different areas, sampling times and sampling heights. The results demonstrate that the concentrations of sigmaPAHs in aerosols and dustfall vary at the different sites and heights. The concentrations of sigmaPAHs and most of the individual PAHs in aerosols at night were higher than those in the daytime when using the unit of microg/g and lower than those when using the unit of microg m(-3). It is shown that the distribution of individual PAHs in aerosols differs significantly from that in dustfall.

[Spiral CT evaluation in diagnosis of endobronchial tuberculosis].

OBJECTIVE: To determine the value of spiral CT in diagnosis of endobronchial tuberculosis (EBTB) after analysing the spiral CT appearance. METHODS: Retrospective analysis of CT signs in 13 cases who were finally pathologically found suffering from EBTB via biopsy with bronchoscope. RESULTS: Five cases have signs of bronchial structure with obstructive atelectasis and pneumonia. Two cases have signs of irregular bronchial wall. Four cases have signs of scattering dot and patchy increase density in lung fields. Two cases' bronchi and lung tissues are normal. CONCLUSION: CT examination can determine the site and extent of EBTB and help the localization of bronchoscope.

[Clinical X-ray analysis for 20 atypical lung cancer].

OBJECTIVE: To analyze clinical X-ray features of atypical lung cancer, expected to improve the diagnosis for atypical lung cancer. METHODS: To collect 20 cases with lung cancer from Jan. 1987 to Jan. 2000, those patients were diagnosed as pneumonia infiltration tuberculosis or lymphoma by X-ray and CT scanning firstly. To analyse retrospectly theses cases and contrast with operation and pathology. RESULTS: All patients were verified as lung cancer after following reexamine and by pathology. CONCLUSION: The cases with sigle pathy shadow in the lung fields could not exclude lung cancer when they had hemoptysis or had no typical pneumoma signs.

[Ultrastructural changes in human endometrium with quinestrol compound].

PIP: Quinestrol compound as an once-a-month oral contraceptive (OC) pill has been used in China for 10 years. A clinical study on the endometrium of 9-year quinestrol compound uses reported, in 1981, a proliferation of endometrium in some users. This led to concern about the longterm safety of the OC. A further epidemiological study has been conducted to observe the micro-structural changes of endometrium. 11 cases who have taken the OC for 9-13 years and 13 controls who have discontinued the OC for 1-24 months after 2-11 years of use have been followed in the study. Mild cystic glandular hyperplasia was observed in 1 case. In comparison with normal endometrium, no obvious damage to tissue structure was observed in the case group. The differences in the case group were: 1) dilation of the endoplasmic reticulum and Golgi apparatus; 2) an increase in number of dark cells and degenerated structures in cytoplasm and 3) the disappearance of the nucleolar system during drug administration. Observation of endometrial biopsies of the control group indicated that the OC-induced endometrial structural changes would disappear in 3 or 4 months after cessation of the drug. The study concluded that longterm use of low-dose quinestrol compound did not induce obvious structural damage to the endometrium.^ieng