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Objective: To investigate and analyze the cognition of menopause in women over 40 years old. Methods: Using the stratified sampling method, 224 females, age ranging from 40 to 60, from our university staff (Xi’an Medical University) and the surrounding communities were selected, and both online and offline questionnaires were distributed. Results: (1) 224 questionnaires were recovered, with 204 valid questionnaires, among which 100 questionnaires were from our university staff (aged 42–60 years old) and 104 questionnaires from the surrounding communities (aged 40–60 years old); (2) the cognition of menopause among the surveyed population was found to be related to occupation and education level; the cognition of menopause among university staff (76%) was significantly higher than that of the surrounding communities (45.19%); (3) most people were able to accept menopausal hormone therapy; the degree of acceptance among the university staff (80%) was found to be higher than that among the surrounding communities (60.58%). Conclusion: According to the recovered data, women over the age of 40 have less than ideal cognition of menopause, and although the cognitive level of the university staff on menopause was found to be significantly higher than that of the surrounding communities, their cognitive level still requires improvement.

ContextPatients with adult growth hormone deficiency (AGHD) are at increased risk of metabolic syndrome. Metabolic profiles in AGHD patients have been insufficiently evaluated.ObjectiveThis work aims to explore serum metabolite profiles by metabolomics analysis and assess potential metabolites associated with recombinant human growth hormone (rhGH) treatment.MethodsThirty-one AGHD patients and 31 healthy controls were enrolled. Untargeted ultra-performance liquid chromatography–coupled mass spectroscopy was conducted in all patients and controls at baseline and during 12 months of rhGH treatment in 11 AGHD patients. Data were processed by principal component analysis, variable importance in projection scoring, orthogonal partial least squares–discriminant analysis, and MetaboAnalyst 5.0. We further explored the associations between metabolites and clinical parameters.ResultsMetabolomics indicated a distinct metabolic pattern between AGHD patients and healthy controls. The perturbed pathways mainly include the biosynthesis of unsaturated fatty acids, sphingolipid metabolism, glycerophospholipid metabolism, fatty acid elongation, degradation, and biosynthesis. rhGH treatment increased the levels of specific glycerophospholipids compounds and reduced fatty acid ester compounds. Significant correlations existed between the 40 identified metabolites and insulin-like growth factor-1 SD score (IGF-1 SDS), body composition, and glucose and lipid metabolism plasma markers. During rhGH treatment, there was a statistically significant negative correlation between deoxycholic acid glycine conjugate and waist-to-hip ratio, while a statistically significant positive correlation existed between decanoylcarnitine and serum low-density lipoprotein levels.ConclusionAGHD patients have unique metabolomic profiles. rhGH treatment alters the serum levels of several fatty acid compounds/amino acids, which may contribute to the improvement of metabolic status in AGHD patients.

Asthma and allergic rhinitis (AR) are widely considered to be the most common chronic inflammatory disorders. This study was performed to investigate the clinical features, disease severity, and upper airway inflammation among patients with asthma, AR, and asthma comorbid AR. Blood and nasal lavage fluid samples were collected from patients with isolated asthma (n = 23), isolated AR (n = 22), and asthma comorbid AR (n = 22). Demographic data, symptom evaluation, and spirometry were obtained from all subjects. The levels of interleukin (IL)-4, IL-5, IL-13, IL-17, IL-25, IL-33, and S100 proteins were measured in the nasal lavage fluid. Compared with isolated asthma, patients with asthma comorbid AR showed a lower quality of life according to the asthma quality-of-life questionnaire (AQLQ) score (6.11 ± 0.47 vs. 6.45 ± 0.35, P = 0.007). Additionally, no significant difference in the levels of IL-4 (P = 0.116), IL-25 (P = 0.235), and S100A12 (P = 0.392) was observed in nasal lavage fluid among three groups. However, miniscule levels of IL-5, IL-17, IL-13, IL-33, S100A8, and S100A9 were detected in nasal lavage fluid in all three groups. Patients with asthma comorbid AR showed an increased level of systemic cytokine in plasma than that of patients with isolated AR or asthma alone. The finding from our study may help clinicians to better understand the airway inflammation among asthma patients with or without AR.

Background This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases at the start of the pandemic in China. Methods In this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included. Demographic data, symptoms, laboratory values, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Results 58 patients were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12·9 ± 4·4 vs 8·3 ± 4·7; P = 0·0011), duration of viral shedding (15·7 ± 6·7 vs 11·8 ± 5·0; P = 0·0183), and hospital stay (20·7 ± 1·2 vs 14·4 ± 4·3; P = 0·0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1·28, 95%CI 1·06–1·54, per 0·1 × 109/L reduced; P = 0·007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0·14, 95%CI 0·02–0·80; P = 0·0275). Conclusions The low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. However, this study was carried out right after the start of the pandemic with small sample size. Further prospective studies are warranted to confirm these findings. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029839. Registered 15 February 2020 - Retrospectively registered.

With the continuous generation of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pressure of epidemic prevention and control continues to increase in China. Omicron with stronger infectiousness, immune escape ability and repeated infection ability spread to many countries and regions around the world in a short period of time. China has also successively reported cases of imported Omicron infections. This study aims to understand the epidemiological characteristics of Omicron variant via analyzing the epidemiological characteristics of imported patients with Omicron in Hunan Province, and to provide reference for preventing and controlling the imported epidemics.The clinical data of imported patients with coronavirus disease 2019 admitted to Hunan Province from December 16 to December 31, 2021 were retrospectively collected. The epidemiological information, general information, clinical classification, clinical symptoms, vaccination status, and lung CT were analyzed. Nasopharyngeal swabs and blood samples were collected. Virus nucleic acid was detected by magnetic beads method using SARS-CoV-2 detection kit. Ct values ofSeventeen patients with Omicron variant infection were treated in Hunan, including 15 confirmed patients (5 common type and 10 mild type) and 2 asymptomatic infection patients. The 17 patients were all Chinese, they were generally young, and 16 were male. There were 9 patients with diseases. Of them 3 patients had respiratory diseases. All 17 patients had completed the whole process of vaccination, but only one person received a booster shot of SARS-CoV-2 vaccine. The clinical manifestations of the patients were mild, mainly including dry/painful/itchy throat, cough, and fatigue. The total protein and creatine in the asymptomatic infection and confirmed cases infected with Omicron variant were all within the normal range, but other biochemical indicators were abnormal. There were the significant differences in C-reactive protein and fibrinogen between asymptomatic infection and confirmed patients (bothThe patients with Omicron variant tend to be young people and have milder clinical symptoms, but the viral load is high and the infectiveness is strong. Therefore, the timely identification and effective isolation and control for asymptomatic infections and confirmed patients with mild symptoms are extremely important. In terms of epidemic prevention and control, the government still needs to strengthen the risk control of overseas input, adhere to normalized epidemic prevention and control measures, to effectively control the source of infection, cut off the route of transmission, and protect vulnerable people.

Introduction: This study described a Chinese case of X-linked acrogigantism (X-LAG) and summarized the characteristics and treatment of all reported cases. Methods: Clinical materials and biological samples from a 5-year and 2-month-old female due to “growth acceleration for 4 years” were collected. Array comparative genomic hybrid (aCGH) and further verification were performed. All X-LAG cases from the PubMed and Web of Science databases were collected and summarized with available data. Results: The patient presented accelerating growth since 1 year, and her height reached 134.6 cm (+5.24 standard deviation score [SDS]) when she was 5-year and 2-month old. She also had coarsening facial features, snoring, and acral enlargement. Growth hormone (GH) was not suppressed by the glucose-GH inhibition test, and insulin-like growth factor 1 (IGF-1) and prolactin (PRL) levels were elevated. Pituitary MRI revealed a pituitary enlargement with a maximum diameter of 22.3 mm. Octreotide imaging indicated the presence of a pituitary adenoma. The tumor shrank slightly after 3 courses of somatostatin analog but without clinical or biochemical remissions, of which the GH nadir value was 9.4 ng/mL, and IGF-1 was elevated to 749 ng/mL. Therefore, she underwent transsphenoidal surgery. Immunohistochemistry showed GH-positive and PRL-positive cells in the pituitary adenoma. Xq26.3 microduplication of the patient’s germline DNA was identified by aCGH. Of all 35 reported cases, females accounted for 71.43%. There were 93.10% and 53.83% patients with hyperprolactinemia and hyperinsulinemia, respectively. Pathology showed that 75.00% of cases were adenomas. Ninety percent of cases had germline variants. The clinical and biochemical remission rates were 78.26% and 82.61%, respectively. However, the rate of complication occurrence during therapy reached 80%. Conclusion: It is important to recognize the possibility of X-LAG when a child under 2-year old presents overgrowth. Early diagnosis and treatment are of great importance for better treatment efficacy and clinical outcome.

Background Recently, side effects from Dopamine Receptor Agonist Drugs (DAs) in treating pituitary prolactinoma have raised widespread concern. This study explores the incidence and influencing factors of DAs-related side effects in Chinese prolactinoma patients. Methods A cross-sectional study was conducted. 51 prolactinoma patients treated with DAs, 12 prolactinoma or pituitary microadenoma patients without DAs treatment, and 33 healthy controls were included. The Barratt impulsivity scale-11, Patient Health Questionnaire 9, and the ICD screening questionnaire were all used to evaluate the psychological and physical side effects of DAs. Clinical data of all subjects were collected from their electronic medical records. Results The incidence of ICDs in the treated group, the untreated group, and control group was 9.8% (5/51), 16.7% (2/12), and 9.1% (3/33), respectively. In the treated group in particular, there were 1 patient (2%, 1/51), 2 patients (3.9%, 2/51), and 2 patients (3.9%, 2/51) with positive screening for punding, compulsive shopping, and hypersexuality, respectively. In terms of depression, the incidence of "minimal", "mild" and "moderate" depression in the treated group was 62.8% (32/51), 25.5% (13/51), and 5.9% (3/51), respectively. The incidence of physical symptoms was 51.0% (26/51) in the treated group and gastrointestinal symptoms were the most common symptoms (33.3%, 17/51). In addition, we found that the various parameters of DAs treatment had no association with the occurrence of physical symptoms or ICDs (all P > 0.05). Conclusions Chinese prolactinoma patients treated with DAs had a lower incidence of ICDs (9.8%), while gastrointestinal symptoms were common. In this way, more attention should be paid to side effects, especially physical symptoms, in Chinese prolactinoma patients with DAs therapy during follow-up regardless of dose.

To determine the association between fish intake and dietary polyunsaturated fatty acids (PUFA) and incidence of lung cancer. We systematically reviewed and meta-analyzed all available studies to quantify the associations of fish and PUFA consumption with risk of lung cancer. Relative risk (RR) with 95% confidence interval (CI) was calculated. 13 population-based prospective cohort studies involving 1,785,000 participants and two randomized control trials were included. Our study demonstrated that dietary PUFA significant reduced risk of lung cancer for men (RR 0.99, 95%CI 0.98 to 1.00) and the U.S. population (RR 0.99, 95%CI 0.98 to 1.00). Dose-response analysis indicated that a 5 g/day increment of dietary PUFA was associated with 5% lower risk of lung cancer (RR 0.95, 95%CI 0.91 to 0.99). In addition, PUFA supplementation is significant improved overall survival in patients with lung cancer (RR 1.98, 95%CI 1.09 to 3.59). Our study showed an inverse association between dietary PUFA and risk of lung cancer in males and among the U.S. population. Although smoking cessation is the single biggest factor associated with lung cancer risk reduction, this study adds to a growing body of evidence that diet may have a role in modestly reducing lung cancer risk.

PurposeCornelia de Lange syndrome (CdLS) is a rare congenital developmental disorder, and cases caused by variants in SMC3 are infrequent. This article describes a case of CdLS related to a pathogenic variant in SMC3 and performs a literature review.MethodsWe collected clinical data and biological samples from a 12-year-old boy with “short stature for 11 years”. Gene variants in the proband were detected by whole-exome sequencing, and the variants in his parents were verified by Sanger sequencing. All SMC3-related CdLS patients from the PubMed and Web of Science databases were collected and summarized using the available data.ResultsA pathogenic variant in SMC3 in the proband, c.1942A>G, was identified. Neither of his parents carried the same variant. Twenty-eight patients were diagnosed with CdLS with variants in SMC3, including the cases in this study and those reported in the literature, where half of the variant types were missense, followed by 32% (9/28) with a deletion and 11% (3/28) with a duplication. All patients showed symptoms of verbal development delay and intellectual disability to different degrees, and 90% patients had long eyelashes while 89% patients had arched eyebrows.ConclusionThis study summarized different gene variants in SMC3 and the frequencies of the various clinical manifestations according to the reported literature. For CdLS caused by SMC3 variants, short stature and facial dysmorphic features are the two most important clinical clues. Definite diagnosis of this rare disease may be challenging clinically; thus, it is significant to use molecular diagnosis.

Consumption of additional H2O2 is necessary in classical Fenton catalysis. Herein, we report a novel and special nanocatalyst consisting of CoMoS2 nanosphere-embedded, reduced graphene oxide (rGO) nanosheets (CMS-rGO NSs). This nanocatalyst was discovered to have an impressive reactivity for in situ generation and synchronistical activation of H2O2 in different active centers, yielding fast and efficient degradation of the pollutants. The reaction rate is ∼21 times higher than that of conventional Fenton catalysts. The characterization shows that countless flower-like CoMoS2 nanospheres are uniformly embedded in the rGO nanosheets through Mo S C bonding bridges in CMS-rGO NSs, which leads to activation of the π electrons and their transfer from rGO to the metal centers (π → M). The formed Mo O Co further leads to a distribution of orientations of the electrons around the metal centers due to the different electronegativity of Mo and Co. During the reaction, the dissolved O2 is efficiently reduced to HO2 /O2 − around the electron-rich Mo center, and HO2 /O2 − is further reduced to H2O2 around the Co center. The generated H2O2 is finally reduced to OH for degrading dyes in the electron-rich metal (Mo or Co) centers of CMS-rGO NSs. The dye pollutants also act as electron donors, and they are directly degraded in the electron-poor π-center of CMS-rGO NSs, which promote the electron transfer cycle and achieve electron gain-loss balance. This discovery provides a new strategy for H2O2 generation-activation and pollutant degradation through constructing electron transfer bridges over the surface of catalysts.

SummaryBackgroundStarting from early December 2019, cases of human infection with a novel coronavirus were identified in Wuhan, Hubei Province, China. It spreads rapidly to other cities and numerous countries. This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases.MethodsIn this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included from Ningbo First Hospital and Jingzhou Central Hospital. Demographic data, symptoms, laboratory values, comorbidities, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Logistic regression analysis was performed to assess risk factors in predicting the patients with SARS-CoV-2 pneumonia who would convert to severe cases.Findings120 patients (36 from Ningbo First Hospital and 84 from Jingzhou Central Hospital) were included in this study, among which 62 were excluded and 58 were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12.9±4.4 vs 8.3±4.7; p=0.0011), duration of viral shedding (15.7±6.7 vs 11.8±5.0; p=0.0183), and hospital stay (20.7±1.2 vs 14.4±4.3; p=0.0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1.28, 95%CI 1.06–1.54, per 0.1×109/L reduced; p=0.007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0.14, 95%CI 0.02–0.80; p=0.0275).InterpretationThe low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. This finding may help clinicians more accurately predict prognosis, and triage priorities to improve clinical outcomes.Research in contextEvidence before this studySevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) is a novel coronavirus that have emerged in early December 2019, and has caused a novel coronavirus disease (COVID-19). It has been deemed as a public health emergency of global concern by The World Health Organization (WHO). We searched PubMed for articles published up to March 11, 2020, using the search terms (“novel coronavirus” OR “SARS-CoV-2” OR “COVID-19”) with no language or time restrictions. Previous work has described clinical characteristics of critically ill and non-critically ill patients with COVID-19. However, no published works have focused on clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases.Added value of this studyIn this retrospective and multicenter cohort study, we reported demographics characteristics, baseline symptoms, laboratory findings, corticosteroid usage and hospital course of patients with non-severe COVID-19 and severe COVID-19. Comparing with non-severe patients, severe patients with COVID-19 was found to have a longer: time to clinical recovery (12.9±4.4 vs 8.3±4.7; p=0.0011), duration of viral shedding (15.7±6.7 vs 11.8±5.0; p=0.0183), and hospital stay (20.7±1.2 vs 14.4±4.3; p=0.0211). By multivariate logistic regression, we found increasing odds of converting to severe cases associated with lower lymphocyte count (odds ratio 1.28, 95%CI 1.06–1.54, per 0.1×109/L reduced; p=0.007). Using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0.14, 95%CI 0.02–0.80; p=0.0275).Implications of all the available evidenceLow lymphocyte count in peripheral blood was an independent risk factor for patients who converted to severe cases. In addition, using of systematic corticosteroids in mild to moderate patients with SARS-CoV-2 pneumonia was associated with a reduced risk of converting to severe cases. These findings may help clinicians predict prognosis more accurately, and triage priorities to improve clinical outcomes. Further prospective studies are warranted to confirm these findings.

Consumption of additional H

Influence of anammox process on autotrophic denitrification was investigated in this study, during simultaneous ammonium, nitrate and sulfide treatment. Elemental sulfur production and nitrogen removal by sulfide-dependent denitrifier (S-den) and mixed culture (S-den-anammox) were compared. Accumulation of nitrite (100%) and elemental sulfur (46.3%) was achieved at pH 7.0 and 30 °C with S2O32−/NO3− ratio of 1:1 by autotrophic denitrifier. Enhanced elemental sulfur production (56.5%–99.5%) by autotrophic denitrifier was obtained after coupling with anammox process. Total nitrogen removal increased to 80.5% in mixed culture reactor, which was 72.0% in anammox reactor. N2O emission in anammox reactor was not affected (