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High incidence of asymptomatic venous thromboembolism (VTE) has been observed in severe COVID-19 patients, but the characteristics of symptomatic VTE in general COVID-19 patients have not been described.

To comprehensively explore the prevalence and reliable risk prediction for VTE in COVID-19 patients.

This retrospective study enrolled all COVID-19 patients with a subsequent VTE in 16 centers in China from January 1 to March 31, 2020. A total of 2779 patients were confirmed with COVID-19. In comparison to 23,434 non-COVID-19 medical inpatients, the odds ratios (ORs) for developing symptomatic VTE in severe and non-severe hospitalized COVID-19 patients were 5.94 (95% confidence interval [CI] 3.91-10.09) and 2.79 (95% CI 1.43-5.60), respectively. When 104 VTE cases and 208 non-VTE cases were compared, pulmonary embolism cases had a higher rate for in-hospital death (OR 6.74, 95% CI 2.18-20.81). VTE developed at a median of 21days (interquartile range 13.25-31) since onset. Independent factors for VTE were advancing age, cancer, longer interval from symptom onset to admission, lower fibrinogen and higher D-dimer on admission, and D-dimer increment (DI) ≥1.5-fold; of these, DI ≥1.5-fold had the most significant association (OR 14.18, 95% CI 6.25-32.18, p=2.23×10

). A novel model consisting of three simple coagulation variables (fibrinogen and D-dimer levels on admission, and DI ≥1.5-fold) showed good prediction for symptomatic VTE (area under the curve 0.865, 95% CI 0.822-0.907, sensitivity 0.930, specificity 0.710).

There is an excess risk of VTE in hospitalized COVID-19 patients. This novel model can aid early identification of patients who are at high risk for VTE.

There is an excess risk of VTE in hospitalized COVID-19 patients. This novel model can aid early identification of patients who are at high risk for VTE.

The efficacy and safety of reverse hybrid therapy in the treatment of Helicobacter pylori (H.pylori) infection remained unclear.

This systematic review was performed in accordance with the PRISMA 2009 guidelines. A systematic search of the Pubmed, Embase, and Cochrane database was conducted using the combination of "Helicobacter pylori or H.pylori or Hp" and "hybrid". The primary endpoint of this meta-analysis was to evaluate the efficacy of reverse hybrid therapy; the second endpoint was to evaluate the efficacy of reverse hybrid therapy among the strains with antibiotic resistance and the compliance, safety of reverse hybrid therapy.

Four studies with 1530 participants were included. The crude H.pylori eradication rate of reverse hybrid therapy was 95.5% (737/772) and 96.2% (701/729) by ITT and PP analysis, respectively. There is no statistical significance of efficacy between reverse hybrid therapy and control according to ITT (pooled rate 96% vs. 94%, RR=1.02, 95% CI, 0.95-1.05, p=.28) and PP (pooled rate 96% vs. 94%, RR=1.02, 95% CI, 0.99-1.06, p=.23) analysis. The effect of reverse hybrid therapy in strains with isolated clarithromycin resistance (pooled rate 89% vs. 65%, RR=1.13, 95% CI, 0.77-1.66, p=.53), metronidazole resistance (pooled rate 91% vs. 81%, RR=1.00, 95% CI, 0.96-1.05, p=.85), and dual clarithromycin-metronidazole resistance (pooled rate 86% vs. 83%, RR=0.94, 95% CI, 0.69-1.27, p=.69) showed no superior to that of control. The compliance of reverse hybrid therapy is 96%, and side effect is slightly lower to that of control group.

Reverse hybrid therapy shows good efficacy, safety, and compliance in the treatment of H.pylori infection. However, its application for H.pylori treatment in regions with high antibiotic resistance need to be further explored.

Reverse hybrid therapy shows good efficacy, safety, and compliance in the treatment of H. pylori infection. However, its application for H. pylori treatment in regions with high antibiotic resistance need to be further explored.Syntheses of the copper and gold complexes [CuFe(CO)5 2 ][SbF6 ] and [AuFe(CO)5 2 ][HOB3,5-(CF3 )2 C6 H3 3 ] containing the homoleptic carbonyl cations [MFe(CO)5 2 ]+ (M=Cu, Au) are reported. Structural data of the rare, trimetallic Cu2 Fe, Ag2 Fe and Au2 Fe complexes [CuFe(CO)5 2 ][SbF6 ], [AgFe(CO)5 2 ][SbF6 ] and [AuFe(CO)5 2 ][HOB3,5-(CF3 )2 C6 H3 3 ] are also given. The silver and gold cations [MFe(CO)5 2 ]+ (M=Ag, Au) possess a nearly linear Fe-M-Fe' moiety but the Fe-Cu-Fe' in [CuFe(CO)5 2 ][SbF6 ] exhibits a significant bending angle of 147° due to the strong interaction with the [SbF6 ]- anion. The Fe(CO)5 ligands adopt a distorted square-pyramidal geometry in the cations [MFe(CO)5 2 ]+ , with the basal CO groups inclined towards M. The geometry optimization with DFT methods of the cations [MFe(CO)5 2 ]+ (M=Cu, Ag, Au) gives equilibrium structures with linear Fe-M-Fe' fragments and D2 symmetry for the copper and silver cations and D4d symmetry for the gold cation. There is nearly free rotation of the Fe(CO)5 ligands around the Fe-M-Fe' axis. The calculated bond dissociation energies for the loss of both Fe(CO)5 ligands from the cations [MFe(CO)5 2 ]+ show the order M=Au (De =137.2 kcal mol-1 )>Cu (De =109.0 kcal mol-1 )>Ag (De =92.4 kcal mol-1 ). The QTAIM analysis shows bond paths and bond critical points for the M-Fe linkage but not between M and the CO ligands. The EDA-NOCV calculations suggest that the [Fe(CO)5 ]→M+ ←[Fe(CO)5 ] donation is significantly stronger than the [Fe(CO)5 ]←M+ →[Fe(CO)5 ] backdonation. Inspection of the pairwise orbital interactions identifies four contributions for the charge donation of the Fe(CO)5 ligands into the vacant (n)s and (n)p AOs of M+ and five components for the backdonation from the occupied (n-1)d AOs of M+ into vacant ligand orbitals.

Data on the incidence and outcomes of ischemic stroke in patients undergoing coronary artery bypass grafting (CABG) in the current era are limited. selleck chemical The goal of this study was to examine contemporary trends, predictors, and outcomes of ischemic stroke following CABG in a large nationally representative database over a 12-year-period.

The National Inpatient Sample was used to identify all adult (≥18years) patients who underwent CABG between 2004 and 2015. The incidence and predictors of post-CABG ischemic stroke were assessed and in-hospital outcomes of patients with and without post-CABG stroke were compared.

Out of 2569597 CABG operations, ischemic stroke occurred in 47279 (1.8%) patients, with a rising incidence from 2004 (1.2%) to 2015 (2.3%) (P<.001). Patient risk profiles increased over time in both cohorts, with higher Charlson comorbidity scores observed amongst stroke patients. Stroke was independently associated with higher rates of in-hospital mortality (3-fold), longer lengths of hospital stay (~6 more days), and higher total hospitalisation cost (~$80000 more).

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