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ObjectiveHypoglycemia is a sporadic and serious adverse reaction of trimethoprim-sulfamethoxazole (TMP-SMX) due to its sulfonylurea-like effect. This study explored the clinical characteristics, risk factors, treatment, and prognosis of TMP-SMX-induced hypoglycemia.MethodsCase reports and series of TMP-SMX-induced hypoglycemia were systematically searched using Chinese and English databases. Primary patient and clinical information were extracted for analysis.ResultsA total of 34 patients were reported from 31 studies (16 males and 18 females). The patients had a median age of 64 years (range 0.4-91), and 75.8% had renal dysfunction. The median duration of a hypoglycemic episode was six days (range 1-20), and the median minimum glucose was 28.8 mg/dL (range 12-60). Thirty-two patients (97.0%) showed neuroglycopenic symptoms, with consciousness disturbance (30.3%) and seizure (24.2%), sweating (18.2%), confusion (15.2%), asthenia (12.1%) being the most common symptoms. Fifteen patients (44.1%) had elevated serum insulin levels, with a median of 31.8 μU/mL (range 3-115.3). C-peptide increased in 13 patients (38.2%), with a median of 7.7 ng/mL (range 2.2-20). Complete recovery from symptoms occurred in 88.2% of patients without sequelae. The duration of hypoglycemia symptoms was 8 hours to 47 days after the intervention. Interventions included discontinuation of TMP-SMX, intravenous glucose, glucagon, and octreotide.ConclusionHypoglycemia is a rare and serious adverse effect of TMP-SMX. Physicians should be aware of this potential adverse effect, especially in patients with renal insufficiency, increased drug doses, and malnutrition.

Taking the advanced aeroengine compressor blisk as the application object, the development and experimental study on the TC11/TC17 different materials linear friction welding integral blisk was carried out. The microstructure of welded joint was analyzed, the tensile and stress rupture properties of base metal and welded joint were compared, the vibration fatigue test on welded blade test pieces, and the overrunning test and low-cycle fatigue test on welding blisk were developed. The results show that the TC11/TC17 linear friction welding joint consists of five typical zones, they are TC11 base metal zone, TC11 thermal influence zone, weld zone, TC17 thermal influence zone and TC17 base metal zone. The tensile strength of the welded joint is basically equivalent to that of the TC11 base metal， elongation is equivalent to TC17 base metal; endurance strength lower than TC17 base metal, but less higher than TC11 base metal. The median fatigue life of welded blade test pieces with three weld positions is respectively 1.501 × 106, 0.344 × 106, and 0.132 × 106 cycles, the fatigue crack isn’t at welding seam and thermal influence zone. The welding blisk pass the 115% overrunning test and 1000 cycles low-cycle fatigue test, the experiment results meet the requirement.