A review on nondiabetic hypoglycemia from various causes: Case series report.

RATIONALE: Hypoglycemia is common in patients with glucose regulation disorders and related diabetic treatments but is rare in nondiabetic patients. Severe hypoglycemia can cause harm to patients' cognition, consciousness, central nervous system, cardiovascular and cerebrovascular system, and even death. However, the most fundamental way to control hypoglycemia is to identify the cause and deal with the primary disease. This article introduces 3 cases of nondiabetic hypoglycemia with different causes, aiming to improve our understanding of nondiabetic hypoglycemia and improve the ability of early diagnosis and differential diagnosis. PATIENT CONCERNS: Case 1 is a 19-year-old female with a history of recurrent coma, and magnetic resonance imaging and endoscopic ultrasound of the pancreas suggest insulinoma. Case 2 is a 74-year-old male with a history of viral hepatitis, and computerized tomography shows multiple nodules in the liver, which is diagnosed as liver cancer. Case 3 is a 39-year-old female with a history of taking methimazole, who tested positive for insulin antibodies, and was diagnosed with insulin autoimmune syndrome. DIAGNOSIS: All 3 patients were diagnosed with nondiabetic hypoglycemia, but the causes varied, and included insulinoma, non-islet cell tumor-induced hypoglycemia, and insulin autoimmune syndrome. INTERVENTIONS: Case 1 underwent pancreatic tail resection; case 2 refused anti-tumor treatment and received glucose injections for palliative treatment only; and case 3 stopped taking methimazole. OUTCOMES: After surgery, the blood sugar in case 1 returned to normal, and the blood sugar in case 2 was maintained at about 6.0 mmol/L. The symptoms of hypoglycemia gradually improved in case 3 after stopping the medication. LESSONS: Non-diabetic hypoglycemia requires further examination to clarify the cause, and the correct differential diagnosis can provide timely and effective treatment, improving the patient's prognosis.

Immune checkpoint inhibitor- and phosphatidylinositol-3-kinase inhibitor-related diabetes induced by antineoplastic drugs: two case reports and a literature review.

Immune checkpoint inhibitor (ICI)- and phosphatidylinositol-3-kinase inhibitor (PI3Ki)-related diabetes mellitus are common side effects of anti-tumor drug use that present mainly as hyperglycemia. Here, we present two case reports of diabetes mellitus caused by the use of tremelimumab and apalutamide, respectively, in cancer treatment, and a comprehensive, comparative review of the literature on these forms of diabetes. Case 1 presented with diabetic ketoacidosis and was diagnosed with ICI-related diabetes mellitus and treated with insulin. Case 2 was diagnosed with PI3Ki-related diabetes mellitus, and her blood glucose level returned to normal with the use of metformin and dapagliflozin. We systematically searched the PubMed database for articles on ICI- and PI3Ki-related diabetes mellitus and characterized the differences in clinical features and treatment between these two forms of diabetes.

Transient low T3 syndrome in patients with COVID-19: a new window for prediction of disease severity.

Objective: To investigate the relationship of low T3 syndrome with disease severity in patients with COVID-19. Methods: The clinical data of 145 patients with COVID-19 were retrospectively collected, and patients were divided into a low T3 group and a normal T3 group. Logistic regression models were used to assess predictive performance of FT3. Receiver operating characteristic (ROC) analysis was used to evaluate the use of low T3 syndrome in predicting critical disease. Kaplan-Meier analysis was used to analyze the impact of low T3 syndrome on mortality. Results: The prevalence of low T3 level among COVID-19 patients was 34.48%. The low T3 group was older, and had lower levels of hemoglobin, lymphocytes, prealbumin, and albumin, but higher levels of white blood cells, neutrophils, CRP, ESR, and D-dimer (all p<0.05). The low T3 group had greater prevalences of critical disease and mortality (all p <0.05). Multivariate logistic regression analysis showed that the Lymphocytes, free T3 (FT3), and D-dimer were independent risk factors for disease severity in patients with COVID-19. ROC analysis showed that FT3, lymphocyte count, and D-dimer, and all three parameters together provided reliable predictions of critical disease. Kaplan-Meier analysis showed the low T3 group had increased mortality (p<0.001). Six patients in the low T3 group and one patient in the normal T3 group died. All 42 patients whose T3 levels were measured after recovery had normal levels after discharge. Conclusion: Patients with COVID-19 may have transient low T3 syndrome at admission, and this may be useful for predicting critical illness.

Soft Porous Blade Printing of Nonfullerene Organic Solar Cells.

Developing scalable and robust processing methods with low material waste remains a challenge for organic solar cells (OSCs) to become a practical renewable energy source. Here, we present a novel low-cost processing approach termed as soft porous blade printing (SPBP), which uses a layer of soft porous material such as filter paper as the printing blade. The inherent porous microstructure of the blade offers high shear rates that facilitate the alignment, crystallization, and orientation of active materials during printing. Moreover, by eliminating the suspended liquid meniscus, SPBP relaxes the stringent requirement of gap control and enables continuous ink delivery for uninterrupted film fabrication with adjustable thickness. Higher photovoltaic performances are achieved in the SPBP-printed OSCs than those of the spin-coated counterparts for two nonfullerene-acceptor active-layer systems (Y6:PM6 and PTQ10:IDIC). Y6:PM6 cells printed by SPBP without any additive exhibit power conversion efficiencies up to 14.75%, which is among the highest reported to date for non-spin-coated OSCs.

Efficient Non-Fullerene Organic Photovoltaics Printed by Electrospray via Solvent Engineering.

Developing scalable processing methods with low material waste is still one of the remaining challenges for organic photovoltaics (OPVs) to become a practical renewable energy source. Here, we report the first study on printing active layers of OPVs containing non-fullerene acceptors (NFAs) by electrospray (ES). The properties of the solvent significantly influence the interfacial morphology of ES-printed organic thin-films, and solvent engineering is essential to facilitate the formation of efficient active-layer films. We introduce low-vapor-pressure non-halogen solvent o-xylene (OXY) into the high vapor pressure solvent of chloroform to form a binary solvent system with appropriate evaporation time, electric conductivity, and solubility. The characteristic times of the ES process using binary solvents are quantified to provide insights into the dynamic formation of thin films. A longer droplet evaporation time with decent solubility collectively decrease the roughness and domain size of the polymer/NFA blend films, thus increase the photocurrent and fill factor of the ES-printed OPV devices. The ES-printed active layers show enhanced crystallinity and phase separation of NFA molecules than the spin-coated films. The champion cell with an ES-printed PTB7-Th:FOIC active layer exhibits a power conversion efficiency of 9.45%, which is on par with the spin-coated cells and is among the highest of spray-deposited organic solar cells to date. This work demonstrates that ES is an effective method to prepare OPVs on NFAs.