Gestational diabetes mellitus combined with fulminant type 1 diabetes mellitus, four cases of double diabetes: A case report

BACKGROUND Fulminant type 1 diabetes mellitus(FT1DM)that occurs during pregnancy or the perinatal period is known as pregnancy-related FT1DM(PF),always without history of abnormal glucose metabolism.Here,we present four patients who developed FT1DM during treatment but were first diagnosed with gestational diabetes mellitus(GDM).CASE SUMMARY The clinical data of four patients with GDM combined with FT1DM admitted to our hospital between July 2018 and April 2021 were collected,and the patients and their infants were followed up.All patients were diagnosed with GDM during the second trimester and were treated.The blood glucose level elevated suddenly during the third trimester and then were diagnosed with FT1DM.Two patients had an insulin allergy,and two had symptoms of upper respiratory tract infection before onset.One patient developed ketoacidosis,and three developed ketosis.Two patients had cesarean section deliveries,and two had vaginal deliveries.The growth and development of the infants were normal.C-peptide levels were lower than those at onset,suggesting progressive impairment of islet function.The frequencies of the DRB109:01,DQB103:03,DQA103:02,DPA101:03,DPA102:02,DPB105:01,DRB401:03,G 01:01,and G 01:04 human leukocyte antigen(HLA)-G alleles were high in the present study.CONCLUSION In comparison with pregnancy-associated FT1DM(PF),patients with GDM combined with FT1DM had an older age of onset,higher body mass index,slower onset,fewer prodromal symptoms,and less acidosis.The pathogenesis may be due to various factors affecting the already fragileβ-cells of GDM patients with genetically susceptible class II HLA genotypes.We speculate that GDM combined with FT1DM during pregnancy,referred to as“double diabetes,”is a subtype of PF with its own unique characteristics that should be investigated further.

Treatment of Complex Proximal Tibial Fractures (Types V &VI of Schautzker Classification) by Double Plate Fixation with Single Anterior Incision

Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).

Integration and Optimization of Railway Engineering Laboratory Resources under the Background of"Double First Class"

With the continuous development of China's social economy,it has correspondingly promoted the development of the railway engineering experimental career,and has made tremendous progress in the cultivation of railway engineering experimental talents.At the same time,there are still many problems in the development of rail transit in the construction of"double first-class".Only by solving the existing problems can we further promote the smooth development of the training of railway engineering experimental talents.Therefore,the article mainly analyzes the problems and countermeasures of railway engineering experimental training,combined with the status and role of laboratories in the training of talents under the background of"double first-class",according to the society's demand for first-class engineering talents,we reformed and explored laboratory resource integration and optimization.

Preparation of spiro-type quaternary ammonium salt via economical and efficient synthetic route as electrolyte for electric double-layer capacitor

A spiro-type quaternary ammonium salt, spiro-(1,1′)-bipyrrolidinium tetrafluoroborate(SBP-BF4) was successfully prepared by an economical and efficient three-step process comprising the cyclization reaction of 1,4-dibromobutane and pyrrolidine, and subsequent ion exchange pathway with KOH followed by neutralization reaction via HBF4 in the system of ethanol solution. 1H NMR, 13 C NMR, FI-IR and XPS analyses showed the structure of SBP-BF4. The as-obtained SBP-BF4 was dissolved in AN and used as the electrolyte for supercapacitor. Electrochemical measurements demonstrate that, compared with commercial electrolyte TEMA-BF4/AN, SBP-BF4/AN exhibits high ionic conductivity, lower resistance and improved cycling performance, which is due to its smaller ion size and stable symmetry structure.

Double-directional control bolt support technology and engineering application at large span Y-type intersections in deep coal mines

Under deep and complex geological conditions,severe deformation occurs at intersection points of Y-type roadways with large cross sections during engineering projects in coal mines,especially at junction arches.Based on in-situ investigations and theoretical studies,we have summarized typical forms of destruction and identified high stress and unrestricted support at both sides of junction arch as its main causes.In this study,we also presented double-directional control bolt support technology for a large Y-type span intersection,applied to deep intersection engineering in the Jiahe Coal Mine,which has proved effective.

EFFICIENCY ANALYSIS OF DOUBLE CRANK RING-PLATE-TYPE PIN-CYCLOIDAL GEAR PLANETARY DRIVE

From the general formula for calculating the efficiency of planetary geartrains, the efficiency of the double crank ring-plate-type pin-cycloidal gear planetary drive isderived. To prove the theory, an experimental study has been conducted. The tested value of theefficiency of a sample set of the new-type drive in the experiment agrees with the calculated one.It shows that the new-type drive is of not merely high bearing capacity, but also quite highefficiency.

ON DOUBLE SINE AND COSINE TRANSFORMS,LIPSCHITZ AND ZYGMUND CLASSES

We consider complex-valued functions f ∈ L^1 （R^2＋）, where R＋ ：= [0,∞）, and prove sufficient conditions under which the double sine Fourier transform fss and the double cosine Fourier transform fcc belong to one of the two-dimensional Lipschitz classes Lip（a,β） for some 0 〈 α,β ≤ 1; or to one of the Zygmund classes Zyg（α,β） for some 0 〈 α,β ≤ 2. These sufficient conditions are best possible in the sense that they are also necessary for nonnegative-valued functions f ∈ L^1 （R^2＋）.

Double filtration plasmapheresis for pregnancy with hyperlipidemia in glycogen storage disease type Ia:A case report

BACKGROUND Glycogen storage disease type Ia(GSDIa) is an autosomal recessive inborn error of carbohydrate metabolism that is caused by deficiency of the enzyme glucose-6-phosphatase(G6Pase),leading to disturbed glycogenolysis and gluconeogenesis.Patients with GSDIa show severe fasting hypoglycemia,hyperlipidemia,hyperlactacidemia,and hyperuricemia,which are associated with fatal outcomes in pregnant women and fetuses.CASE SUMMARY Herein,we report the case of a 24-year-old female who on her first visit to the hospital,presented with pregnancy combined with extremely high hyperlipidemia and hyperlactic acidosis with anemia,and frequent hypoglycemia occurred during the treatment.Genetic tests revealed a mutation in the G6Pase gene(G6PC) at 17q21,the patient was finally diagnosed with glycogen storage disease type Ia for the first time after 22 years of inaccurate treatment.She has been treated with a continuous double filtration plasmapheresis(DFPP) strategy to remove blood lipids,and a cornstarch diet therapy.The patient did not develop pancreatitis during the course of the disease and a healthy baby girl weighing 3 kg was delivered.CONCLUSION Patients with GSDIa may be misdiagnosed as epilepsy.DFPP can be used to control hyperlipidemia in GSDIa patients during pregnancy.

On Fatou Type Convergence of Convolution Type Double Singular Integral Operators

In this paper, some approximation formulae for a class of convolution type double singular integral operators depending on three parameters of the type(T_λf)(x, y) = ∫_a^b ∫_a^b f(t, s)K_λ(t-x,s-y)dsdt, x,y ∈(a,b), λ ∈ Λ [0,∞),(0.1)are given. Here f belongs to the function space L_1( <a,b >~2), where <a,b> is an arbitrary interval in R. In this paper three theorems are proved, one for existence of the operator(T_λf)(x, y) and the others for its Fatou-type pointwise convergence to f(x_0, y_0), as(x,y,λ) tends to(x_0, y_0, λ_0). In contrast to previous works, the kernel functions K_λ(u,v)don't have to be 2π-periodic, positive, even and radial. Our results improve and extend some of the previous results of [1, 6, 8, 10, 11, 13] in three dimensional frame and especially the very recent paper [15].

Mathematical Model and Geometrical Model of Double Pitch ZN-type Worm Gear Set Based on Generation Mechanism

The current researches on the tooth surface mathematical equations and the theory of gearing mainly pay attention to the ordinary type worm gear set（e.g., ZN, ZA, or ZK）. The research of forming mechanism and three-dimensional modeling method for the double pitch worm gear set is not enough. So there are some difficulties in mathematical model deducing and geometry modeling of double pitch ZN-type worm gear set based on generation mechanism. In order to establish the mathematical model and the precise geometric model of double pitch ZN-type worm gear set, the structural characteristics and generation mechanism of the double pitch ZN-type worm gear set are investigated. Mathematical model of the ZN-type worm gear set is derived based on its generation mechanism and the theory of gearing. According to the mathematical model of the worm gear set which has been developed, a geometry modeling method of the double pitch ZN-type worm and worm gear is presented. Furthermore, a geometrical precision calculate method is proposed to evaluate the geometrical quality of the double pitch worm gear set. As a result, the maximum error is less than 6′10–4 mm in magnitude, thus the model of the double pitch ZN-type worm gear set is available to meet the requirements of finite element analysis and engineering application. The derived mathematical model and the proposed geometrical modeling method are helpful to guiding the design, manufacture and contact analysis of the worm gear set.

A New Type of Double-Lumen Catheter to Replace Current One in RCA

Objective: To replace the peripheral venous puncture for blood sampling with taking blood samples extracorporally from arterial line before predilution during RCA-CRRT performed. Methods: A new type of double-lumen femoral catheter was used instead of the current tubes. The new type of double-lumen tube had a greater distance from the inner venous ports to the inner arterial ports than current tubes. The minimum distance from the venous port to the arterial port was greatly lengthened. Replacement solution contained citrate, zero Ca2+, zero bicarbonate, low Na+. Blood samples were synchronously collected from the arterial line before the infusion of citrate replacement fluid and from the peripheral vein. The iCa concentration data of two groups were analyzed to observe the difference between iCa concentration levels in the arterial line and in peripheral vein;the anticoagulant effect of RCA and possible complications were observed, such as bleeding, clottings and hypocalcaemia. Results: 28 times of RCA-CRRT were performed on17 AKI and CRF patients with active bleeding or at the high risk of bleeding;336 blood samples were collected. Statistics showed that the difference of iCa concentration between arterial line group and the peripheral vein group was not significant (P = 0.9), there is a high degree of similarity between the iCa concentration of arterial line blood and the peripheral venous blood. None of the patients developed citrate toxicity or metabolic alkalosis. None induced bleeding, or bleeding aggravated. No obvious clotting occurred. Systemic calcium concentration was achieved in the ideal range. Conclusion: In clinical practice, the data of iCa concentration from arterial line can be used to replace that from peripheral vein when the new type of double-lumen femoral catheter is placed in femoral vein. RCA-CRRT therapy is safe and effective.

New Pyrometer with Double Y-type Optical Fibers

Abstract: A new pyrometer, which can solve the affection of emissivity change in temperature measuring, has been developed by double Y - type optical fibers. The mathematical model of the new pyrometer is presented and the errors of the new pyrometer are analyzed.

Interlayer distance effects on absorption coefficient and refraction index change in p-type double-δ-doped GaAs quantum wells

In the framework of the Thomas–Fermi(TF) approach, a model for the p-type double-δ-doped(DDD) system in Ga As is presented. This model, unlike other works in the literature, takes into account that the Poisson equation associated with the system is nonlinear. The electronic structure is calculated for heavy and light holes. The changes in the electronic structure result of the distance d between the doped layers are studied. In particular, the relative absorption coefficient as well as the relative refractive index change is calculated as a function of the incident photon energy for heavy holes. The effect of the interlayer distance exhibits, in the absorption coefficient, a red shift of the peak position and a decrease in amplitude when the distance increases. In addition, the relative refractive index change node has a red shift as well as the interlayer distance increases. The calculations show that the effect of the separation between layers has a greater influence on the linear terms. These results are very important for theoretical calculations and engineering of optical and electronic devices based in δ-doped Ga As.

Research and Exploration on the Construction of Double Qualified Teachers in Software Engineering

In order to solve the problem of insufficient integration of school-enterprise supervisors in the current school-enterprise cooperation model,this article introduces the ideas and results of the construction of a team with double-qualified instructors majored in software engineering.Specifically,the integration of production and education are carried out in three stages,i.e.,enterprise cooperation courses,enterprise internship,and graduation design(internship),by taking the software engineering major of the School of Information and Software Engineering of the University of Electronic Science and Technology of China as a case study.

An Improved Double-Threshold Method Based on Gradient Histogram

This paper analyzes the characteristics of the output gradient histogram and shortages of several traditional automatic threshold methods in order to segment the gradient image better. Then an improved double-threshold method is proposed, which is combined with the method of maximum classes variance, estimating-area method and double-threshold method. This method can automatically select two different thresholds to segment gradient images. The computer simulation is performed on the traditional methods and this algorithm and proves that this method can get satisfying result. Key words gradient histogram image - threshold selection - double-threshold method - maximum classes variance method CLC number TP 391. 41 Foundation item: Supported by the National Nature Science Foundation of China (50099620) and the Project of Chenguang Plan in Wuhan (985003062)Biography: YANG Shen (1977-), female, Ph. D. candidate, research direction: multimedia information processing and network technology.

On the structure and representations of non-balanced quantum doubles

For a field k and two finite groups G and X, when G acts on X from the right by group automorphisms, there is a Hopf algebra structure on k-space （kX°P）＊ kG （see Theorem 2.1）, called a non-balanced quantum double and denoted by Dx（G）. In this paper, some Hopf algebra properties of Dx （G） are given, the representation types of Dx （G） viewed as a k-algebra are discussed, the algebra structure and module category over Dx（G） are studied. Since the Hopf algebra structure of non-balanced quantum double DX （G） generMizes the usual quantum double D（G） for a finite group G, all results about Dx（G） in this paper can also be used to describe D（G） as a special case and the universal R-matrix of Dx （G） provides more solutions of Yang-Baxter equation.

Hyperglycemia promotes overexpression of SR-BII isoform of the scavenger receptor class B type I in type 2 diabetes mellitus: A study in Juana Koslay City, San Luis, Argentina

The scavenger receptor class B type I (SR-BI) is a high-density lipoprotein (HDL) receptor involved in reverse cholesterol transport. Some studies reported the association to be stronger in the presence of diabetes. The full length gene encoding SR-BI is comprised in 13 exons that are alternatively spliced to produce two major transcripts: the full length SR-BI and the splice variant SR-BII, in which exon 12 is skipped. Considering that type 2 diabetes status is characterized by changes in the concentration of plasma lipids, modifications in lipoprotein size and composition, which may be important modulators of the SR-BI expression;the aims of the study were to examine the influence of SR-BI polymorphism (rs838895) on lipid profile and SR-BI mRNA expression in a population of diabetic patients living in Juana Koslay City. Blood samples were drawn from controls (n = 40) and Type 2 diabetic patients (n = 66) and DNA and total RNA were obtained. SR-BI mRNA expression was measured by RT-PCR and SR-BI polymorphism was detected by Tetra Primer ARMSPCR. Compared to controls, diabetic patients had higher fasting serum glucose, glycated hemoglobin, triglycerides, total cholesterol, lowdensity lipoprotein cholesterol, and lower highdensity lipoprotein cholesterol. SR-BI mRNA expression was lower in T2DM when compared to controls, suggesting that the hyperglycemia presents in T2DM patients down-regulates SR-BI mRNA expression. Interestingly, we found that decreased SR-BI expression resulted in markedly increased plasma LDL concentrations in T2DM subjects, and the overexpression of SRBII isoform is responsible for the markedly increased plasma LDL-c concentrations. The polymorphism (rs838895) did not modify the mRNA level of SR-BI in leucocytes from control and diabetic patients. This study provides novel evidence suggesting that hyperglycemia may affect reverse cholesterol transport by controlling SRBI expression in diabetic patients. LDL cholesterol levels are associated with low SR-BI mRNA expression in T2DM.