Objective To explore the clinical effect and safety of methimazole combined with 131I in treatment of hyperthyroidism.Methods Patients (83 cases) with hyperthyroidism accepted in Xi'an Jiaotong University Affiliated San Er Ling Yi Hospital from June 2012 to June 2015 were selected and divided into observation group with 42 cases and control group with 41 cases.Patients in observation group were given methimazole combined with 131I,and patients in control group were given PTU combined with 131I.Then the clinical effect,thyroid gland serological indexes,adverse reations,and reoccurrence rates of two groups were observed and compared.Results The total clinical efficacy of observation group was 95.24％,which was obviously higher than 70.73％ of control group with statistically significance (P ＜ 0.05).TSH was getting higher after treatment of two groups,and T3,T4,FT3,FT4,TRAb,and TPOAb were getting lower after treatment of two groups.And TSH in the observation group was significantly higher than that in the control group,T3,T4,FT3,and FT4 were significantly lower than those in the control group (P ＜ 0.05).The adverse reaction rate of observation group (14.29％) was obviously lower than that of control group (46.34％) with statistically significance (P ＜ 0.05).The reoccurrence rate of observation group (4.76％) was obviously lower than that of control group (26.83％) with statistically significance(P ＜ 0.05).Conclusion Methimazole combined with 131I has good effect and safety in treatment of hyperthyroidism,which is worth of clinical application.

Objective To study the characteristics and clinical significance of the coronary plaques in patients with benign prostatic hyperplasia (BPH).Methods A total of 91 patients undergoing coronary artery angiography (CAG) were selected and divided into two groups according to with or without BPH,56 cases in BPH group,46 cases in control group.The qualitative and quantitative characteristics of 102 lesions area were analyzed by intravascular ultrosound (IVUS),including external elastic membrane-cross-sectional area (EEM-CSA),minimal lumen area (MLA),plaques area (PA),plaques burden (PB),reference external elastic membrane-cross-sectional area (REEM-CSA),reference minimal lumen area (RMAL),reference plaques area (RPA) and reference plaques burden (RPB).Results IVUS showed a higher rate of area stenosis than did the CAG [(58.2± 7.1)％ vs.(55.9 ± 5.2)％,P＜0.01].BPH group had more soft plaques,eccentric plaques,positive remodeling and less calcified than did the control group (P＜0.05).The MLA and RMAL of BPH group were smaller than those of control group:MAL [(5.61±0.96) mm2 vs.(6.06±0.75) mm2,P＜0.05],RMAL[(9.26±1.05) mm2 vs.(10.02±1.10) mm2,P＜0.05]； while the EEM-CSA,PA,PB,RPA,RPB were larger than those of control group:EEM-CSA[(14.51±1.10)mm2 vs.(13.37±1.02)mm2],PA[(8.90±1.24) mm2 vs.(7.31±1.04) mm2],PB[(61.26±6.53)％ vs.(54.53±5.69)％],RPA[(4.26±1.15) mm2 vs.(3.73±1.33) mm2],RPB [(31.30±8.37) ％ vs.(26.81±8.75) ％,P＜0.05].Conclusions IVUS has a higher value on evaluation of mild to moderate coronary artery stenosis.Evidence of myocardial ischemia in patients with BPH needs further excludeing coronary heart disease.

Objective Meta-analysis was used to summarize the current status of medication adherence in patients with type 2 diabetes mellitus and to clarify the characteristics of people with low medication adherence.Methods Relevant literatures were searched in Pubmed,Cochrane Library,Web of Science,Embase,CINAHL,CBM,China National Knowledge Infrastructure,Wanfang Data,and VIP.Two researchers conducted literature screening,data extraction and quality evaluation.Stata 16.0 software was used for subgroup analysis,sensitivity analysis,offset analysis.Results A total of 42 papers were included,and the overall medication adherence of middle-aged and elderly type 2 diabetes patients ranged from 18.37%-96.53%.The medication adherence was higher among those with high education level(63%),married(61%),not living alone(50%),monthly income>3000 RMB/month(64%),having medical insurance(49%),good psychological status(61%),no chronic co-morbidities(66%),having knowledge about the disease(53%),taking≤3 types of medication(58%),convenient access to medical care(58%),and good doctor-patient relationship(50%).Conclusion The medication adherence of patients with type 2 diabetes mellitus varies greatly among different subgroups.In the future,the specific influencing factors should be further explored to formulate targeted policies and intervention measures to improve patients'medication adherence and improve their health and quality of life.

Background::To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods::This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results::A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled; 66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64] vs. 42.4% [14/33]; difference of conversion rate 27.9%; 95% confidence interval [CI], 7.7%-48.1%; P = 0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 days vs. 12.0 days; hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060, P = 0.006), symptom of fever (median 3.0 days vs. 12.0 days; HR: 18.990, 95% CI: 5.350-67.410, P < 0.001), as well as hospitalization (median 12.5 days vs. 20.0 days; P < 0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 days vs. 14.5 days; P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression. Conclusions::SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.Trial registration::Chinese Clinical Trial Registry, NCT04260594, www.clinicaltrials.gov/ct2/show/NCT04260594?term= NCT04260594&draw=2&rank=1

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R² = 0.033; P = 0.018), followed by acute kidney injury (AKI; R² = 0.032; P = 0.011) and plasma MIP-1β level (R² = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
Acute Kidney Injury/complications* ; Bacteria/classification* ; Chemokine CCL4/blood* ; Community-Acquired Infections/microbiology* ; Humans ; Lung ; Microbiota/genetics* ; Pneumonia, Bacterial/diagnosis* ; Prognosis ; RNA, Ribosomal, 16S/genetics*