Clinical analysis of 2860 cases of diabetes in pregnancy: a single-center retrospective study.

BACKGROUND: To investigate the epidemiological, clinical characteristics and outcomes of diabetes in pregnancy (DIP). METHODS: This single-center, retrospective study included 16,974 pregnant women hospitalized during 2018-2019. Among them, 2860 DIP patients were grouped according to diabetes type, glycemic status, and insulin use. Multivariate logistic regression analysis was conducted. RESULTS: The incidence of DIP [17.10%; pregestational diabetes mellitus (PGDM), 2.00% (type I, 0.08%; type 2, 1.92%); gestational diabetes mellitus (GDM), 14.85% (GDM A1, 13.58%; GDM A2, 1.27%)] increased annually. Premature birth, congenital anomalies, large for gestational age (LGA), neonatal asphyxia, neonatal intensive care unit transfer, hypertension, and puerperal infection were more common in DIP than in healthy pregnancies. The most common comorbidities/complications were hypertension, thyroid dysfunction, cervical incompetence, intrahepatic cholestasis, premature membrane rupture, oligo/polyhydramnios, and fetal distress. GDM incidence at ages ≥35 and ≥ 45 years was 1.91 and 3.26 times that at age < 35 years, respectively. If only women with high-risk factors were screened, 34.8% GDM cases would be missed. The proportion of insulin use was 14.06% (PGDM, 55%; GDM, 8.53%). Mean gestational age at peak insulin dose in DIP was 32.87 ± 5.46 weeks. Peak insulin doses in PGDM and GDM were 3.67 and 2 times the initial doses, respectively. The risks of LGA, premature birth, cesarean section, and neonatal hypoglycemia in PGDM were 1.845, 1.533, 1.797, and 1.368 times of those in GDM, respectively. The risks of premature birth and neonatal hypoglycemia in women with poor glycemic control were 1.504 and 1.558 times of those in women with good control, respectively. CONCLUSIONS: The incidence of adverse outcomes in DIP is high.

4-Nitro-3-(5-tetrazole)furoxan and its salts: synthesis, characterization, and energetic properties.

A series of new energetic salts based on 4-nitro-3-(5-tetrazole)furoxan (HTNF) has been synthesized. All of the salts have been fully characterized by nuclear magnetic resonance ((1)H and (13)C), infrared (IR) spectroscopy, elemental analysis, and differential scanning calorimetry (DSC). The crystal structures of neutral HTNF (3) and its ammonium (4) and N-carbamoylguanidinium salts (9) have been determined by single-crystal X-ray diffraction analysis. The densities of 3 and its nine salts were found to range from 1.63 to 1.84 g cm(-3). Impact sensitivities have been determined by hammer tests, and the results ranged from 2 J (very sensitive) to >40 J (insensitive). Theoretical performance calculations (Gaussian 03 and EXPLO 5.05) provided detonation pressures and velocities for the ionic compounds 4-12 in the ranges 25.5-36.2 GPa and 7934-8919 m s(-1), respectively, which make them competitive energetic materials.

Clinical analysis of diabetes in pregnancy with stillbirth.

We analyzed the clinical characteristics of patients with diabetes in pregnancy (DIP) associated with stillbirth and explored strategies to reduce its incidence. We retrospectively analyzed 71 stillbirths associated with DIP (group A) and 150 normal pregnancies (group B) during 2009 to 2018. The incidence of the following was higher in group A (P < .05): hypertensive disorders (38.03% vs 6.00%), placenta previa (14.08% vs 2.67%), placental abruption (5.63% vs 0.67%), fetal malformation (8.45% vs 0.67%), fasting plasma glucose (FPG) ≥ 7.0 mmol/L (46.48% vs 0.67%), 2-h postprandial plasma glucose ≥ 11.1 mmol/L (57.75% vs 6.00%), HbA1c ≥ 6.5% (63.38% vs 6.00%), and polyhydramnios (11.27% vs 4.67). The incidence of oligohydramnios (4.23% vs 6.67%) was lower in group A than in group B (P < .05). According to the gestational age at the time of stillbirth, Group-A cases were subgrouped into miscarriages (20-27+6 weeks), premature deliveries (28-36+6 weeks), and full-term deliveries (≥37 weeks). Age, parity, and DIP type did not differ among the subgroups (P > .05). Among patients with DIP, antenatal FPG, 2-h postprandial plasma glucose, and HbA1c were significantly associated with stillbirth (P < .05). Stillbirth was first detected at 22 weeks and typically occurred at 28-36+6 weeks. DIP was associated with a higher incidence of stillbirth, and FPG, 2-h postprandial plasma glucose, and HbA1c were potential indicators of stillbirth in DIP. Age (odds ratio [OR]: 2.21, 95% confidence interval [CI]: 1.67-2.74), gestational hypertension (OR: 3.44, 95% CI: 2.21-4.67), body mass index (OR: 2.86, 95% CI: 1.95-3.76), preeclampsia (OR: 2.29, 95% CI: 1.45-3.12), and diabetic ketoacidosis (OR: 3.99, 95% CI: 1.22-6.76) were positively correlated with the occurrence of stillbirth in DIP. Controlling perinatal plasma glucose, accurately detecting and managing comorbidities/complications, and timely termination of pregnancy can reduce the incidence of stillbirths associated with DIP.

Energetic salts based on dipicrylamine and its amino derivative.

Energetic salts based on dipicrylamine and its amino derivative were synthesized. All salts were fully characterized by multinuclear NMR spectroscopy ((1)H, (13)C), vibrational spectroscopy (IR), and elemental analysis. Ethylenediammonium di-DPA (DPA=dipicrylamine) and 1,3-diaminoguanidinium DPA were further confirmed by single-crystal X-ray diffraction. These salts exhibit reasonable physical properties, such as high densities (1.71-1.81 g cm(-3)), good thermal stabilities (T(d) =155-285 °C), and low solubilities in water. The impact sensitivity of 1-methyl-3,4,5-triamino-1,2,4-triazolium DPA is lower than that of 2,4,6-trinitrotoluene (TNT), and for some other energetic salts their impact sensitivities are comparable to that of TNT. Based on experimental densities and theoretical calculations carried out by using the Gaussian 03 suite of programs, all the salts have calculated detonation pressures (22.5-27.8 GPa) and velocities (7226-7917 m s(-1)) that exceed those of conventional TNT. The toxicities of these salts measured by luminescent bacteria toxicity tests are much lower than that of TNT, and two binary eutectic mixtures with melting points that fall between 70 and 100 °C were identified.

Nitrogen-rich energetic monoanionic salts of 3,4-bis(1H-5-tetrazolyl)furoxan.

3,4-Bis(1H-5-tetrazolyl)furoxan (H(2)BTF, 2) and its monoanionic salts that contain nitrogen-rich cations were readily synthesized and fully characterized by multinuclear NMR ((1)H, (13)C) and IR spectroscopy, differential scanning calorimetry (DSC), and elemental analyses. Hydrazinium (3) and 4-amino-1,2,4-triazolium (7) salts crystallized in the monoclinic space group P2(1)/n and have calculated densities of 1.820 and 1.764 g cm(-3), respectively. The densities of the energetic salts range between 1.63 and 1.79 g cm(-3), as measured by a gas pycnometer. Detonation pressures and detonation velocities were calculated to be 23.1-32.5 GPa and 7740-8790 m s(-1), respectively.