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.

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.

Supporting Research for ＂Double Teachers＂ Team Construction of School-enterprise Cooperation Take Professional Tourism Management School-enterprise Cooperation ＂Double＂ Teachers Construction as An Example

This paper mainly studies cooperative education problems of tourism management professional school-enterprise cooperation. Since the 1990s, many universities have begun to explore the issue of school-enterprise cooperation in running schools, and tourism management major is one of the popular professional cooperative education, there has been various forms of cooperative education, both success and failure cases. Many scholars take in-depth research of the issues and come up with many innovative ideas. Currently, much tourism management major of higher colleges gradually embarked on the road of school-enterprise cooperation. This study is under the background of the booming Chinese tourism higher education, school-enterprises cooperation have continued deepen, from both theoretical and practical aspects have a deep thinking in tourism management professional school-enterprise cooperative education issues systems.

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).

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.

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.

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.

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].

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.

New Double Integrals Weighted Cebysev Type Inequalities

In the last years, the theory of integral inequalities are playing a very significant role in all fields of mathematics, many monographs have been devoted to this subject and present a very active and attractive field of research, the applications of integral inequalities have known a great development in many branches of mathematics in statistics, differential equations and numerical integration, The aim of this paper is to establish new extension of the weighted montgomery identity for double integrals then used it to establish new t^eby^evtype inequalities.

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.

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.

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.

On Turán type inequality with doubling weights and A weights

Let Hn be the set of real algebraic polynomials of degree n, whose zeros all lie in the interval [-1,1]. The well known Turán type inequalities tell us that forf（x）∈Hn, it holds ‖f＇‖≥C√n‖f‖. This note deals with the weighted Turán type inequalities with the weights having inner singularities under L^p norm for 0〈p≤∞. Our results essentially extend the result of Wang and Zhou （2002）, and the method used in this paper is simpler and more direct than that of Wang and Zhou （2002）. The results and methods have their own values in approximation theory and computation.

A Review ofTeachers’ written feedback in EFL Writing in China and Its Implications

The types of teachers’ written feedback and their effects have been the focuses of researches on feedback in EFL writing. This paper aims at providing some references and suggestions on the effective feedback types in EFL writing in China through reviewing the recent ten-year researches on teachers’ written feedback in EFL writing in China from the perspectives of feedback source, content, types and comments, and exploring the future development of the researches from research design, feedback types, and research perspectives and so on.Literature research shows that the answers remain controversial on which kind of feedback source, feedback content, feedback type, and feedback comments are the best to students in EFL writing. However, the supplementary roles of peer feedback and electronic feedback are well recognized; form-focused feedback combined with content-focused feedback is popular with the students; the demand for the degree of feedback directness and feedback comments varies with the level of students. Compared to the past, recent domestic researches on teachers’ feedback are more various in research methods, more diversified in research perspectives and extended more in research content. Future domestic research on teachers’ feedback needs to make efforts on designing the experiment, expanding the feedback content, combining different feedback types and broadening research perspectives in order to further verify the effectiveness of teachers’ written feedback.

液晶填充一维阶梯型Double-period结构局域模的调控特性

利用传输矩阵法研究了向列相液晶填充一维阶梯型Double-period第4代准周期结构局域模的电场方向、外界温度调控特性。通过改变电场方向和外界温度,研究该结构透射谱的调控特性。结果表明：温度一定时,液晶的有效折射率都随着夹角θ的增大而逐渐减小,局域模波长随夹角θ的增大而发生蓝移;当夹角θ接近54°时,向列相液晶的有效折射率与温度呈现近正比线性关系;夹角θ小于54°时,向列相液晶的有效折射率随温度升高而逐渐减小,局域模波长随外界温度（300~378.15K）的升高而发生蓝移;夹角θ大于54°时,随温度升高,向列相液晶的有效折射率先减小后增大,局域模波长先发生蓝移再发生红移。无论是外界温度升高还是电场方向夹角的增大,局域模的调控量始终是减小的,且局域模的调控量与液晶有效折射率差值成正比线性关系。

A Study of Teacher Feedback in Different English Class Types

This essay mainly focuses on the feedback move in IRF(initiate- response- feedback) to investigate the characters and functions of teacher feedback in different class types through classroom observation. The research finds that(1) teachers in different class types prefer to adopt evaluative feedback and use more positive feedback.(2) the proportion of each feedback is different in listening and speaking, reading and writing class. The implications are that English teachers in senior high school should adopt different feedback flexibly and consider what kind of feedback is more likely elicit the students' output in different class types.

Control over hysteresis curves and thresholds of optical bistability in different semiconductor double quantum wells

The effects of optical field on the phenomenon of optical bistability(OB) are investigated in a K-type semiconductor double quantum well(SDQW) under various parametric conditions. It is shown that the OB threshold can be manipulated by increasing the intensity of coupling field. The dependence of the shift of OB hysteresis curve on probe wavelength detuning is then explored. In order to demonstrate controllability of the OB in this SDQW, we compare the OB features of three different configurations which could arise in this SDQW scheme, i.e., K-type, Y-type, and inverted Y-type systems. The controllability of this semiconductor nanostructure medium makes the presented OB scheme more valuable for applications in all-optical switches, information storage, and logic circuits of all optical information processing.

How to Promote the Online Flow of High-Quality Teacher Resources under the"Double Reduction"Policy:An Analysis of Factors Influencing Teachers'Continuance Intention to Participate in Online After-School Teaching Services

Promoting the online flow of high-quality teacher resources has emerged as an important way to pursue coordinated progress in burden reduction and quality improvement under the"double reduction"policy.Based on the Open Online Tutoring Program of Secondary School Teachers(hereinafter referred to as"the open tutoring program")in City A,China,this study examined the factors influencing teachers'continuance intention to participate in the open tutoring program and their structural relationships,using a structural equation modeling analysis based on 1,159 sample data.The results show that:Firstly,teachers'reputation enhancement,perceived playfulness,perceived usefulness,and perceived ease of use have a positive effect on teachers'continuance intention to participate in online after-school teaching services.Secondly,online teaching efficacy has no direct effect on teachers'continuance intention,but rather impacts their reputation enhancement and beliefs about the value of the open tutoring program.Thirdly,social influence has a positive effect on teachers'reputation.Fourthly,perceived ease of use has a positive effect on teachers'perception of the value of the open tutoring program.In light of the above,relevant suggestions are proposed to encourage teachers to continue participating in online after-school teaching services.