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Coking wastewater is a typical organic refractory wastewater characterized by high chemical oxygen demand (COD), NH4+-N, and total organic carbon (TOC). Herein, coking wastewater was treated using a heterogeneous electro-Fenton (EF) system comprising a novel iron-loaded needle coke composite cathode (Fe-NCCC) and a dimensionally stable anode. The response surface methodology was used to optimize the reaction conditions. The predicted and actual COD removal rates were 92.13 and 89.96% under optimum conditions of an applied voltage of 4.92 V, an electrode spacing of 2.29 cm, and an initial pH of 3.01. The optimized removal rate of NH4+-N and TOC was 84.12 and 73.44%, respectively. The color of coking wastewater decreased from 250-fold to colorless, and the BOD5/COD increased from 0.126 to 0.34. Gas chromatography–mass spectrometry and Fourier transform infrared spectroscopy show that macromolecular heterocyclic organic compounds decomposed into straight-chain small molecules and even completely mineralized. The energy consumption of the EF process was 23.5 RMB Yuan per cubic meter of coking wastewater. The EF system comprising the Fe-NCCC can effectively remove pollutants from coking wastewater, has low electricity consumption, and can simultaneously reduce various pollution indicators with potential applications in the treatment of high-concentration and difficult-to-degrade organic wastewater. HIGHLIGHTS A novel needle coke composite cathode was fabricated to treat coking wastewater.; The maximum COD removal was ∼90% using an electro-Fenton process.; The COD, -N, and TOC removal rates were optimized using the Box–Behnken design.; Macromolecular organic matter in coking wastewater was degraded after treatment.;

BackgroundCommunity clustering is one of the main features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, few studies have been conducted on the clinical characteristics and clinical outcome of clustered cases and sporadic cases with COVID-19.MethodsWe recruited 41 community clusters confirmed with SARS-CoV-2 infection compared with 49 sporadic cases in Zhejiang Province from 19 January 2020 to 9 June 2020. Clinical data were collected to evaluate the clinical outcome and characteristics of community clusters.ResultsCompared to sporadic cases, clustered cases had significantly lower Acute Physiology and Chronic Health Evaluation II (APACHE II) score {5.0 [interquartile range (IQR), 2.0–7.5] vs. 7.0 [IQR, 4.0–12.5]; P = 0.005}, less members in intensive care unit (ICU) (6 [14.6%] vs. 18 [36.7%]; P = 0.018), and shorter time of viral shedding in fecal samples (18.5 [IQR, 17.0–28.3] vs. 32.0 [IQR, 24.3–35.5]; P = 0.002). Univariable logistic regression revealed that older age (odds ratios 1.078, 95% confidence intervals 1.007–1.154, per year increase; p = 0.032), high APACHE II score (3.171, 1.147–8.76; P = 0.026), elevated interleukin-2 levels (3.078, 1.145–8.279; P = 0.026) were associated with ICU admission of clustered cases.ConclusionsCompared to sporadic cases, clustered cases exhibited milder disease severity and a better clinical outcome, which may be closely related to the management of early detection, early diagnosis, early treatment and early isolation of COVID-19.

Autoimmune polyglandular syndrome (APS) is a rare disease that is characterized by autoimmune reactions to multiple endocrine and non-endocrine organs, which can be divided into four main types. The principal manifestations of APS-3 are autoimmune thyroid disease and other autoimmune diseases, such as type 1 diabetes, atrophic gastritis, pernicious anemia, vitiligo, alopecia, and myasthenia gravis, but not Addison’s disease or hypoparathyroidism. Here we report a case demonstrating the rare coexistence of growth hormone deficiency and hyperthyroidism with sexual dysgenesis, secondary amenorrhea, cardiomegaly, splenomegaly, hypoproteinemia, pleural effusion, seroperitoneum, pericardial effusion, anasarca, osteoporosis, vitamin D deficiency, iron-deficiency anemia, poor blood coagulation, leucocytopenia, peripheral neuropathy, hyperuricemia, ichthyosis, tinea cruris, and onychomycosis.