The aim of this study is to evaluate the effectiveness of a smart non-invasive blood glucose monitor prototype during pregnancy through clinical validation.The monitor utilizes near-infrared spectroscopy combined with AI big data analysis of photoelectric volumetric pulse wave data to achieve non-invasive monitoring of blood glucose in women during pregnancy.The research team developed a monitor that employs a sensing chip,effectively overcoming the problems of weak signals and individual differences in non-invasive blood glucose monitoring.The user experience is enhanced by visualizing the test results on the accompanying cell phone APP(application)of the smart non-invasive pregnancy blood glucose monitor.Clinical validation revealed that the non-invasive monitoring data for pregnant women aged 20～30 years significantly differed from those obtained via traditional blood glucose measurement methods,whereas no significant difference(P<0.05)was observed for pregnant women aged 31～42 years.The study concluded that further calibration of the monitor and an expansion of the sample size are necessary to enhance consistency with invasive glucose monitoring results.

A 45-year-old male patient was treated with canagliflozin 100 mg once daily orally for type 2 diabetes mellitus due to poor blood sugar control. On the 4th day of medication, the patient developed slight abdominal distension and fatigue; on the 5th day, the patient felt nausea and general fatigue, and the color of urine became dark brown. The laboratory tests showed serum creatinine (Scr) 136 μmol/L, blood urea nitrogen (BUN) 9.7 mmol/L, urine protein (+), and urinary occult blood (++). Acute kidney injury induced by canagliflozin was considered. Canagliflozin was stopped, and acarbose 50 mg (before meal), 2 Haikun Shenxi capsules (海昆肾喜胶囊), and 3 Jinshuibao capsules (金水宝胶囊) orally thrice daily were given. After 2 days of drug withdrawal, the symptoms of nausea and fatigue disappeared, and the color of urine was normal. After 5 days of drug withdrawal, laboratory tests showed fasting blood glucose 5.6 mmol/L, Scr 112 μmol/L, BUN 8.5 mmol/L, urine protein (-), and urine occult blood (-). After 19 days of drug withdrawal, the patient′s renal function indexes were all within the normal range, and no discomfort symptoms recurred.

Objective:To analyze the clinical characteristics of pulmonary hypertension (PH) induced by dasatinib.Methods:The relevant databases at home and abroad (as of December 31, 2020) were searched and the case reports on PH induced by dasatinib were collected. Clinical information including patient′s basic characteristics, dasatinib dose, occurrence time of PH, clinical manifestations, interventions, and outcomes were collected and analyzed by descriptive statistical method.Results:A total of 25 patients from 24 case reports were enrolled in the study, including 16 males and 9 females, aged from 23 to 73 years with an average age of 50 years. There were 22 patients with chronic myeloid leukemia (CML) and 3 with acute lymphoblastic leukemia (ALL); the dose of dasatinib was 140 mg daily in 14 patients, 100 mg daily in 7 patients, 70 mg daily in 2 patients, and unknown in 2 patients. Time from dasatinib application to PH occurrence was 10 days to 144 months, with a median time of 37 months. The clinical symptoms included varying degrees of dyspnea in 24 patients, edema in 8 patients, hepatomegaly in 5 patients, jugular vein dilatation in 5 patients, cough in 3 patients,and chest tightness in 3 patients, chest pain in 2 patients, and fatigue in 1 patient. Pleural effusion and/or pericardial effusion were found in 20 patients by chest CT, chest X-ray or echocardiography. Cardiac function was graded as Ⅳ in 8 patients, Ⅲ in 9 patients, and Ⅱ in 4 patients according to WHO classification method, and the grade was unknown in 4 patients. Right cardiac catheterization and/or echocardiography showed elevated mean pulmonary artery pressure and/or systolic pulmonary artery pressure in 25 patients. Twenty-four patients stopped dasatinib following the doctor′s advice after the diagnosis of PH, of which 22 patients were treated with phosphodiesterase 5 inhibitor, endothelin receptor antagonist, diuretic, and glucocorticoid, and the other 2 patients were not given special intervention; one patient took dasatinib intermittently by himself. Nineteen patients were switched to other tyrosine kinase inhibitors. After discontinuation of dasatinib and giving symptomatic treatments for 1 week to 36 months (mean 7 months), 17 patients were improved, 7 were partially improved, and 1 had unknown outcome.Conclusions:Dasatinib-related PH was more common in patients with CML, occurred more in male patients, and had a median occurrence time of 37 months after drug administration. The main clinical manifestation was dyspnea, often complicated with pleural effusion or pericardial effusion. After dasatinib withdrawal and specific treatments, most patients could be improved.

A 45-year-old male patient was treated with canagliflozin 100 mg once daily orally for type 2 diabetes mellitus due to poor blood sugar control. On the 4th day of medication, the patient developed slight abdominal distension and fatigue; on the 5th day, the patient felt nausea and general fatigue, and the color of urine became dark brown. The laboratory tests showed serum creatinine (Scr) 136 μmol/L, blood urea nitrogen (BUN) 9.7 mmol/L, urine protein (+), and urinary occult blood (++). Acute kidney injury induced by canagliflozin was considered. Canagliflozin was stopped, and acarbose 50 mg (before meal), 2 Haikun Shenxi capsules (海昆肾喜胶囊), and 3 Jinshuibao capsules (金水宝胶囊) orally thrice daily were given. After 2 days of drug withdrawal, the symptoms of nausea and fatigue disappeared, and the color of urine was normal. After 5 days of drug withdrawal, laboratory tests showed fasting blood glucose 5.6 mmol/L, Scr 112 μmol/L, BUN 8.5 mmol/L, urine protein (-), and urine occult blood (-). After 19 days of drug withdrawal, the patient′s renal function indexes were all within the normal range, and no discomfort symptoms recurred.

Objective:To analyze the clinical characteristics of pulmonary hypertension (PH) induced by dasatinib.Methods:The relevant databases at home and abroad (as of December 31, 2020) were searched and the case reports on PH induced by dasatinib were collected. Clinical information including patient′s basic characteristics, dasatinib dose, occurrence time of PH, clinical manifestations, interventions, and outcomes were collected and analyzed by descriptive statistical method.Results:A total of 25 patients from 24 case reports were enrolled in the study, including 16 males and 9 females, aged from 23 to 73 years with an average age of 50 years. There were 22 patients with chronic myeloid leukemia (CML) and 3 with acute lymphoblastic leukemia (ALL); the dose of dasatinib was 140 mg daily in 14 patients, 100 mg daily in 7 patients, 70 mg daily in 2 patients, and unknown in 2 patients. Time from dasatinib application to PH occurrence was 10 days to 144 months, with a median time of 37 months. The clinical symptoms included varying degrees of dyspnea in 24 patients, edema in 8 patients, hepatomegaly in 5 patients, jugular vein dilatation in 5 patients, cough in 3 patients,and chest tightness in 3 patients, chest pain in 2 patients, and fatigue in 1 patient. Pleural effusion and/or pericardial effusion were found in 20 patients by chest CT, chest X-ray or echocardiography. Cardiac function was graded as Ⅳ in 8 patients, Ⅲ in 9 patients, and Ⅱ in 4 patients according to WHO classification method, and the grade was unknown in 4 patients. Right cardiac catheterization and/or echocardiography showed elevated mean pulmonary artery pressure and/or systolic pulmonary artery pressure in 25 patients. Twenty-four patients stopped dasatinib following the doctor′s advice after the diagnosis of PH, of which 22 patients were treated with phosphodiesterase 5 inhibitor, endothelin receptor antagonist, diuretic, and glucocorticoid, and the other 2 patients were not given special intervention; one patient took dasatinib intermittently by himself. Nineteen patients were switched to other tyrosine kinase inhibitors. After discontinuation of dasatinib and giving symptomatic treatments for 1 week to 36 months (mean 7 months), 17 patients were improved, 7 were partially improved, and 1 had unknown outcome.Conclusions:Dasatinib-related PH was more common in patients with CML, occurred more in male patients, and had a median occurrence time of 37 months after drug administration. The main clinical manifestation was dyspnea, often complicated with pleural effusion or pericardial effusion. After dasatinib withdrawal and specific treatments, most patients could be improved.

A 42-year-old male patient, who suffered serious wound pollution due to falling after drinking, received an intravenous infusion of levofloxacin hydrochloride injection 0.2 g dissolved in 0.9% sodium chloride injection 250 ml to prevent infection. When the first dose of levofloxacin was infused intravenously for about 2 minutes (about 4 ml), the patient suddenly developed dyspnea, restlessness, and agitation. His heart rate was 120 beats per minute, breath rate was 26 times per minute, blood pressure was undetectable, and blood oxygen saturation was 0.80. Levofloxacin was immediately discontinued and antiallergic therapy such as epinephrine and dexamethasone was given. Two minutes later, the patient′s heart rate dropped to 50 beats per minute, breathing decreased to 8 times per minute, and cyanotic appeared on the skin. Anaphylactic shock and type 2 respiratory failure were diagnosed and cardiopulmonary resuscitation, tracheal intubation, balloon assisted ventilation, and norepinephrine etc. were given immediately. Three hours later, the patient developed dark urine and elevated creatine kinase (CK), myoglobin, alanine aminotransferase, aspartate aminotransferase, and serum creatinine (Scr). His peak value of CK was 17 160 U/L, myoglobin was >3 000 μg/L, and peak value of Scr was 492 μmol/L. Rhabdomyolysis with acute kidney injury was considered. The symptomatic and supportive treatments such as hemofiltration, plasma infusion, correction of acidosis, and fluid replacement were given. Ten hours later, the patient′s blood pressure returned to normal, ventilator assisted breathing was continued, and the patient′s condition was gradually improved. Thirty-four days later, the levels of myoglobin, CK and Scr returned to within the normal range. Thirty-eight days later, the patient returned to spontaneous breathing and the ventilator was withdrawn.

A 42-year-old male patient, who suffered serious wound pollution due to falling after drinking, received an intravenous infusion of levofloxacin hydrochloride injection 0.2 g dissolved in 0.9% sodium chloride injection 250 ml to prevent infection. When the first dose of levofloxacin was infused intravenously for about 2 minutes (about 4 ml), the patient suddenly developed dyspnea, restlessness, and agitation. His heart rate was 120 beats per minute, breath rate was 26 times per minute, blood pressure was undetectable, and blood oxygen saturation was 0.80. Levofloxacin was immediately discontinued and antiallergic therapy such as epinephrine and dexamethasone was given. Two minutes later, the patient′s heart rate dropped to 50 beats per minute, breathing decreased to 8 times per minute, and cyanotic appeared on the skin. Anaphylactic shock and type 2 respiratory failure were diagnosed and cardiopulmonary resuscitation, tracheal intubation, balloon assisted ventilation, and norepinephrine etc. were given immediately. Three hours later, the patient developed dark urine and elevated creatine kinase (CK), myoglobin, alanine aminotransferase, aspartate aminotransferase, and serum creatinine (Scr). His peak value of CK was 17 160 U/L, myoglobin was >3 000 μg/L, and peak value of Scr was 492 μmol/L. Rhabdomyolysis with acute kidney injury was considered. The symptomatic and supportive treatments such as hemofiltration, plasma infusion, correction of acidosis, and fluid replacement were given. Ten hours later, the patient′s blood pressure returned to normal, ventilator assisted breathing was continued, and the patient′s condition was gradually improved. Thirty-four days later, the levels of myoglobin, CK and Scr returned to within the normal range. Thirty-eight days later, the patient returned to spontaneous breathing and the ventilator was withdrawn.

A 56-year-old female patient received epalrestat 50 mg thrice daily orally because of the diagnosis of diabetic peripheral neuropathy. After 3 times of epalrestat treatment that day (about 10 hours after the first medication), the patient developed red papules on the face and patch-like erythema on the head and neck. On day 2 of epalrestat treatment, the rashes were progressively aggravated and the patient was diagnosed with erythema multiforme-type drug eruption. Considering that it might be caused by epalrestat, the drug was replaced by lipoic acid injection and symptomatic treatments with dexamethasone, vitamin C injection, and calcium gluconate injection were given. Three days later, the patient′s allergic symptoms were alleviated. Anti-allergic drugs were phased out gradually while the other drugs were continued. Six days later, the patient had no discomfort and was discharged from the hospital. At 20 days of follow-up, the rashes did not recur.

A 56-year-old female patient received epalrestat 50 mg thrice daily orally because of the diagnosis of diabetic peripheral neuropathy. After 3 times of epalrestat treatment that day (about 10 hours after the first medication), the patient developed red papules on the face and patch-like erythema on the head and neck. On day 2 of epalrestat treatment, the rashes were progressively aggravated and the patient was diagnosed with erythema multiforme-type drug eruption. Considering that it might be caused by epalrestat, the drug was replaced by lipoic acid injection and symptomatic treatments with dexamethasone, vitamin C injection, and calcium gluconate injection were given. Three days later, the patient′s allergic symptoms were alleviated. Anti-allergic drugs were phased out gradually while the other drugs were continued. Six days later, the patient had no discomfort and was discharged from the hospital. At 20 days of follow-up, the rashes did not recur.

A 30-year-old male patient received pancreatin enteric-coated capsules 0.45 g thrice daily with meals for chronic pancreatitis.On day 9 of medication,the patient developed discomfort in the right first metatarsophalangeal joint.The next day,his symptoms were aggravated,manifested by metatarsophalangeal joint pain and swelling.Laboratory tests showed an increase of uric acid (477 μmol/L),which was considered to be gouty arthritis induced by pancreatin enteric-coated capsules.Then the drug was discontinued and symptomatic treatments such as alkaline urine and analgesics were given.On day 5 of drug withdrawal,the swelling of the right metatarsophalangeal joint was markedly alleviated and the tenderness was significantly relieved.On day 8 of drug withdrawal,swelling and pain in the patient's right metatarsophalangeal joint disappeared and his uric acid level was 430 μmol/L.The patient was discharged.At 2 weeks of follow-up,his uric acid returned to normal.