Effect of maternal pregestational diabetes mellitus on congenital heart diseases.

BACKGROUND: The increasing population of diabetes mellitus in adolescent girls and women of childbearing age contributes to a large number of pregnancies with maternal pregestational diabetes mellitus. Congenital heart diseases are a common adverse outcome in mothers with pregestational diabetes mellitus. However, there is little systematic information between maternal pregestational diabetes mellitus and congenital heart diseases in the offspring. DATA SOURCES: Literature selection was performed in PubMed. One hundred and seven papers were cited in our review, including 36 clinical studies, 26 experimental studies, 31 reviews, eight meta-analysis articles, and six of other types. RESULTS: Maternal pregestational diabetes mellitus poses a high risk of congenital heart diseases in the offspring and causes variety of phenotypes of congenital heart diseases. Factors such as persistent maternal hyperglycemia, oxidative stress, polymorphism of uncoupling protein 2, polymorphism of adiponectin gene, Notch 1 pathway, Nkx2.5 disorders, dysregulation of the hypoxia-inducible factor 1, and viral etiologies are associated with the occurrence of congenital heart diseases in the offspring of mothers with pregestational diabetes mellitus. Treatment options including blood sugar-reducing, anti-oxidative stress drug supplements and exercise can help to prevent maternal pregestational diabetes mellitus from inducing congenital heart diseases. CONCLUSIONS: Our review contributes to a better understanding of the association between maternal pregestational diabetes mellitus and congenital heart diseases in the offspring and to a profound thought of the mechanism, preventive and therapeutic measurements of congenital heart diseases caused by maternal pregestational diabetes mellitus.

Analysis of the Outcomes of 73 Patients with Exogenous Positive Insulin Anti-Body.

Objective: This study aimed to discuss adjusting the treatment plan for patients with type 2 diabetes mellitus (T2DM) who are positive for exogenous insulin antibody (IA). The outcome of patients who are IA-positive with an adjusted treatment plan was considered. Methods: The treatment plan for patients with IA-positive T2DM was adjusted to oral medication or long-acting insulin + oral medication. Insulin antibody, C-peptide, and insulin were re-examined before treatment and at 1, 3, 6, 12, 18, and 24 months after treatment. The time of IA-negative seroconversion and its indexes, including blood glucose, C-peptide, and insulin, were recorded and analyzed. Results: After adjusting the treatment plan for 2 years, in 73 patients, 57 had IA-negative seroconversion, and 16 had positive IA. The blood glucose, C-peptide, insulin, glycosylated hemoglobin (HbA1c), and the daily dose of insulin in the seroconversion group and the non-seroconversion group decreased compared with before the adjustment of the treatment plan (P < 0.05). The negative seroconversion rate within 2 years was related to the insulin concentration before treatment. Conclusion: Patients with IA-positive T2DM need to adjust their treatment plans in time. Even if IA does not turn negative within 2 years after adjusting the treatment plan, the levels of blood glucose, C-peptide, insulin, and HbA1c along with the insulin dosage would be significantly improved, which can benefit patients. The higher the fasting insulin and 2-hour insulin values before adjusting the treatment plan, the longer the time required for IA to turn negative.

Giant retroperitoneal lipoma presenting with abdominal distention: A case report and review of the literature.

BACKGROUND: Retroperitoneal lipomas are extremely rare tumors and tend to be large in size (> 10 cm) when diagnosed, causing various clinical manifestations. Preoperative diagnosis of retroperitoneal lipomas is difficult. There is a lack of relevant information about the management and prognosis of these benign tumors due to limited reports. CASE SUMMARY: A 53-year-old woman who complained about progressive abdominal distention and aggravating satiety was referred to the gynecological outpatient department of Peking Union Medical College Hospital. Computerized tomography (CT) revealed an immense mass with fat density, measuring 28.6 cm× 16.6 cm in size. Adjacent organs, including the intestinal tract and uterus, were squeezed to the right side of the abdomen. An exploratory laparotomy was performed with suspicion of liposarcoma. Intraoperatively, a giant yellowish lobulated mass was found occupying the retroperitoneum and it was removed by tumor debulking. Postoperative histopathological results confirmed the diagnosis of retroperitoneal lipoma. CONCLUSION: Retroperitoneal lipoma is a very rare condition and is difficult to differentiate from well-differentiated liposarcoma. Radiographic investigations, especially CT and magnetic resonance imaging, are important for preoperative diagnosis. Surgical resection is the fundamental treatment, which is difficult due to its size and relation to neighboring structures.

Highly Efficient Cooperative Catalysis of Single-Site Lewis Acid and Brønsted Acid in a Metal-Organic Framework for the Biginelli Reaction.

A unique 3D framework containing three different types of nanoscale polyhedron cages was constructed by incorporating dinuclear [M2(µ2-OH)(COO)4] (M = Co, Ni) secondary building units and pyridyl-carboxylic-acid-supported tetracarboxylates. The assembled complexes possess isolated bifunctional single-site Lewis acid and Brønsted acid and can be used as highly efficient heterogeneous catalysts for the solvent-free Biginelli reaction with a high turnover frequency value of 338.4 h-1. Interestingly, a variety of 3,4-dihydropyrimidin-2(1 H)-ones have been obtained in high yields and short times.

Superhydrophobic/Superoleophilic MOF Composites for Oil-Water Separation.

A universal strategy is developed to construct metal-organic framework (MOF)-based superhydrophobic/superoleophilic materials by the reaction of activated MOFs and octadecylamine. In particular, S-MIL-101(Cr) composite can efficiently separate chloroform, toluene, petroleum ether, and n-hexane from water with excellent oil-water separation performance, with potential application in the environmental field.

Zwitterionic Covalent Organic Frameworks as Catalysts for Hierarchical Reduction of CO2 with Amine and Hydrosilane.

Controllable hierarchical reduction of carbon dioxide (CO2) to selectively afford versatile chemicals with specific carbon oxidation state is important but still remains a huge challenge to be realized. Here, we report new zwitterionic covalent organic frameworks ([BE] X%-TD-COFs), prepared by introducing betaine groups (BE) onto the channel walls of presynthesized frameworks via pore surface engineering methodology, as the heterogeneous organocatalysts for CO2 reduction. The adjustable density of immobilized BE groups as well as good preservation of crystallinity and porosity inherited from their parent COFs endow [BE] X%-TD-COFs with highly ordered catalytic site distribution and one-dimensional mass transport pathway in favor of catalysis. By controlling the reaction temperature and amount of CO2, [BE] X%-TD-COFs present high activity in catalyzing reduction of CO2 with amine and phenylsilane (PhSiH3) to produce formamides, aminals, and methylamines, respectively, with high yield and selectivity. Furthermore, high stability and insolubility bring excellent reusability to [BE]X%-TD-COFs with well-maintained catalytic performance after four cycles of use. Notably, this is a novel example that COFs are developed as heterogeneous catalysts for hierarchical two-, four-, and six-electron reduction of CO2 with amines and PhSiH3 to form C-N bonds as well as afford C+II, C0, and C-II species efficiently and selectively.