Comparison of glycaemic control over 1 year with pioglitazone or gliclazide in patients with Type 2 diabetes.

AIMS: To compare long-term (1 year) efficacy and safety of pioglitazone and gliclazide in patients with Type 2 diabetes. METHODS: This was a double-blind, multicentre, comparative, parallel group trial in 283 patients with Type 2 diabetes, who were randomized to receive 1-year treatment with pioglitazone 30-45 mg/day or gliclazide 80-320 mg/day. Drug dose was titrated on the basis of self-monitored blood glucose (SMBG) measurements and HbA1c values. The 1-year changes in HbA1c, fasting blood glucose (FBG), insulin, HOMA-S (HOmeostatic Model Assessment) and SMBG were compared. In a subgroup of patients (n = 10), systemic glucose production and utilization were determined by a combination of isotopic (deuterated glucose) and clamp techniques. RESULTS: In both groups, there were similar decreases in HbA1c (pioglitazone: -0.79%; gliclazide: -0.79%) and FBG (pioglitazone: -1.0 mmol/l; gliclazide: -0.7 mmol/l), whereas the slope of the reduction of fasting blood glucose was different between groups (P = 0.004). Insulin levels as well as insulin resistance assessed using HOMA-S decreased significantly only after pioglitazone treatment (-11.94 pmol/l and -1.03, respectively, both P = 0.002 vs. baseline). A significantly greater reduction in systemic glucose production was observed in the pioglitazone group (-2.48 micromol/kg/min, P = 0.042) than in the gliclazide group (-1.02 micromol/kg/min). A few, mild adverse events occurred in both groups. CONCLUSIONS: A comparable decrease in HbA1c and FBG was observed with pioglitazone and gliclazide. However, with pioglitazone there was a continuous decrease in FBG over 1 year, whereas gliclazide failed to maintain a similar trend. This favourable effect of pioglitazone was due to its insulin-sensitizing effect and ability to decrease systemic glucose production.     

浙江省赛艇运动员的膳食调查

作者以３０名年龄１９～２５岁的浙江省赛艇运动员为对象，进行为期５天的膳食调查。结果表明，不同级别运动员总热量摄入都是充足的，但三大供能营养素的比例值得商榷，均存在脂肪摄入量过多，约占总热量的２８％～３９％，碳水化物摄入量偏低，约占总热量的４５％～５６％的情况。蛋白质供给良好。水溶性维生素和无机盐摄入量充裕，而维生素Ａ摄入不足，只占标准供给量的５４％～６９％。     

1987年石家庄市结核病流行病学抽样调查

对石家市结核病的流行情况进行了随机抽样调查,共抽取24个调查点(市区8个、郊县16个)35745人。调查结果:平均患病率及菌阳患病率为0.63％和1.27％,其中郊县与市区分别为0.67％和0.54％及1.60‰和0.42‰(Ρ<0.01);15岁以下儿童有卡痕者,其结素反应阳性率年龄曲线,在7岁和12岁表现为低谷;1～3岁卡痕检出率,市区与郊县分别为90.5％与35.4％(Ρ<0.01)。通过本调查表明,我市结核病患病率高于全国1985年调查的平均数值。     

Analysis of the degree of precision of a computer-assisted dietary survey method

A computer-assisted method for the registration of food intakes in real time according to a concise and simple procedure was subjected to a series of controls in order to assess precision. The method employs the 'portion' of a composite dish as unit of measure. The constancy of the portion was tested. The results show that the recipes of the diet of a subject may be stored and utilized in deferred time without loss of precision: data to be recorded in real time are then very limited. The length of period of analysis was also studied. The time of investigation should not be shorter than two weeks to obtain precise information on the feeding habits of an individual subject, whereas for a group of subjects the diary of a single day provides information of sufficient precision.     

How Can and Do Australian Doctors Promote Physical Activity?

Background.Physical inactivity is recognized as an important public health issue. Yet little is known about doctors' knowledge, attitude, skills, and resources specifically relating to the promotion of physical activity. Our survey assessed the current practice, perceived desirable practice, confidence, and barriers related to the promotion of physical activity in family practice.Methods.A questionnaire was developed and distributed to all 1,228 family practitioners in Perth, Western Australia.Results.We received a 71% response (n= 789). Family practitioners are most likely to recommend walking to sedentary adults to improve fitness and they are aware of the major barriers to patients participating in physical activity. Doctors are less confident at providing specific advice on exercise and may require further skills, knowledge, and experience. Although they promote exercise to patients through verbal advice in the consultation, few use written materials or referral systems.Conclusions.There are significant differences between self-reports of current practice and perceived desirable practice in the promotion of physical activity by doctors. Future strategies need to address the self-efficacy of family physicians and involve resources of proven effectiveness. The potential of referral systems for supporting efforts to increase physical activity by Australians should be explored.     

对一宗入境二级放射货包的监测结果分析

汕头卫生检疫局空港处对汕头航空口岸—宗入境二级货包的监测过程及对有关运输工作人员作了放射知识问卷调查。从中发现。运输单位货物存放设施落后。有关工作人员放射卫生知识欠缺，对放射污染可能造成的危害缺乏正确的认识。为此，笔者提出了自己的看法，以期对放射监测工作的进一步完善提供参考。     

一起阴囊皮炎爆发流行的调查与实验研究

本文报道了一起183例农民阴囊皮炎的爆发流行,发病率高达56.63%,不同的年龄、职业与发病率无显著差别,八月份为发病高峰。同时患有口角炎、舌炎并发症者占45.65%,取14例典型患者的阴囊鳞屑作真菌镜检,检出霉菌1例。85例患者经采用核黄素10mg,加复合维生素B10mg,每日两次连服七天进行试治,治愈率为96.47%(82/85),将19例患者与20例健康者对照,作4h尿中核黄素负荷试验比较,结果两者在统计学上具有显著性差别(u=2.11,P≤0.05)。经膳食营养调查,发现6~10月份核黄素供给不足47%。由此证明,发病与核黄素缺乏有关。     

Therapeutic traditions in type 2 diabetes — are they changing?

The utilisation of antidiabetic drugs reflects both the prevalence of diabetes and the different therapeutic traditions of physicians. A questionnaire survey to study attitudes to the use of oral antidiabetic drugs amongst physicians and possible changes in treatment habits was carried out in a representative sample of Finnish physicians (n=454) in 1992 and the results were compared with those of a similar survey carried out in 1985, and with drug utilisation statistics.The mean fasting blood glucose level at which a physician would start pharmacological treatment was 8.7 mmol·l^–1, which was significantly lower than in the 1985 survey. The responses to various case histories suggested a more active approach to pharmacological treatment compared to the 1985 survey. Insulin treatment especially seems to have gained in popularity. This change in attitude was paralled by an increase in the consumption of antidiabetic drugs in Finland during the observation period. The increase in use of oral drugs was steeper in Finland than in Norway and Sweden.Whether this active approach will improve the metabolic control and prognosis of patients with Type 2 diabetes, remains to be demonstrated.     

A survey of the use of special food products by diabetics

A food frequency of consumption questionnaire was completed by 137 diabetic outpatients attending the University of Wales Hospital in Cardiff, to provide information about the use of special dietary products.
Seventy-four per cent of the diabetics used special dietary products, the most popular of which were artificial sweeteners (45%) and preserves (47%), followed by squash (34%), sweets (31%) and chocolate (31%). Twenty per cent of diabetics consumed biscuits and tinned fruit. Cake and other products (e.g. jelly), were used by less than 10% of the respondents. Over half of all the diabetics consumed one or more products on a daily basis. The use of special products bore no significant relationship to the sex of the respondents, nor to the duration of the diabetes. However, a significantly higher proportion of the Insulin Dependent Diabetics (IDDM) group used dietary products compared with the Non-Insulin Dependent Diabetics (NIDDM) group. This can be explained largely by the differences in age between the diabetics; the under-18-year-old age group (who were all IDDM respondents) were the greatest users of sweets, chocolate and squash.
Forty-three per cent of diabetics who did not use special food products cited at least one reason for non-use. The reasons included dietetic advice (NIDDM respondents only), high cost, poor palatability, lack of availability and unsuitability for other members of the family.