Context The evidence of long-term polyethylene glycol recombinant human GH (PEG-rhGH) in pediatric GH deficiency (GHD) is limited. Objective This study aimed to examine the effectiveness and safety of long-term PEG-rhGH in children with GHD in the real world, as well as to examine the effects of dose on patient outcomes. Design A prospective, observational, posttrial study (NCT03290235). Setting, participants and intervention Children with GHD were enrolled from 81 centers in China in 4 individual clinical trials and received weekly 0.2 mg/kg/wk (high-dose) or 0.1 to <0.2 mg/kg/wk (low-dose) PEG-rhGH for 30 months. Main outcomes measures Height SD score (Ht SDS) at 12, 24, and 36 months. Results A total of 1170 children were enrolled in this posttrial study, with 642 patients in the high-dose subgroup and 528 in the low-dose subgroup. The Ht SDS improved significantly after treatment in the total population (P < 0.0001), with a mean change of 0.53 ± 0.30, 0.89 ± 0.48, 1.35 ± 0.63, 1.63 ± 0.75 at 6 months, 12 months, 24 months, and 36 months, respectively. In addition, the changes in Ht SDS from baseline were significantly improved in the high-dose subgroup compared with the low-dose subgroup at 6, 12, 24, and 36 months after treatment (all P < 0.05). A total of 12 (1.03%) patients developed serious adverse events. There was no serious adverse event related to the treatment, and no AEs leading to treatment discontinuation or death occurred. Conclusions PEG-rhGH showed long-term effectiveness and safety in treating children with GHD. Both dose subgroups showed promising outcomes, whereas PEG-rhGH 0.2 mg/kg/wk might show additional benefit.

Although nitriding treatment usually improves the hardness and wear resistance of stainless steel, it also reduces its corrosion resistance. The effects of different nitriding temperatures and time and main alloying elements in stainless steel on the properties of the martensitic precipitation hardening of stainless steel were studied by first-principles calculations and experiments in this study. The results showed that the corrosion resistance of the martensitic stainless steel 0Cr17Ni4Cu4Nb was much lower than that of 1Cr15Ni2Mo2Cu before and after nitriding. According to the density functional theory calculation results, the molybdenum-containing stainless steel had higher stability and corrosion resistance and a lower Fermi level, electron conduction concentration and electrochemical activity than the niobium-containing stainless steel before and after nitriding. In addition, at the same temperature, the surface hardness of the 1Cr15Ni2Mo2Cu steel increased linearly with the prolongation of nitriding time, but its corrosion resistance decreased. Under the same nitriding time (24 h), the nitriding temperature increased from 300 to 450 °C, and the surface hardness and nitriding layer depth of the nitriding steel increased gradually, while the corrosion resistance decreased gradually. These results were attributed to the Cr-poor phenomenon caused by the formation of CrN. The 1Cr15Ni2Mo2Cu martensitic stainless steel obtained a high surface hardness after nitriding at 300 °C for 24 h, and the corrosion resistance did not decrease.