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Background: Helicobacter pylori eradication in penicillin-allergic patients is challenging. The effective regimen is lacking in areas with high antibiotic resistance and tetracycline unavailable. Minocycline, cefuroxime, and full-dose metronidazole are promising drugs. Aims:To compare the eradication rate, safety, and compliance among three new bismuth quadruple therapies for first-line H. pylori eradication in penicillin-allergic patients.Methods: This randomized trial was conducted on 450 naive patients with H. pylori infection and penicillin allergy. The 14-day minocycline-metronidazole-containing (minocycline 100 mg twice daily and metronidazole 400 mg four times/day), minocycline-cefuroxime-containing (minocycline 100 mg twice daily and cefuroxime 500 mg twice daily), and cefuroxime-metronidazole-containing (cefuroxime 500 mg twice daily and metronidazole 400 mg four times/day) bismuth quadruple therapies were randomly assigned to the participants. Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed 4-8 weeks after eradication to evaluate outcome. Results:The differences of eradication rates in either intention-to-treat (84.0%, 82.7%, and 23 82.0%, p = .896) or per-protocol (91.7%, 90.9%, and 88.2%, p = .599) analysis among minocycline-metronidazole, minocycline-cefuroxime, and cefuroximemetronidazole-containing bismuth quadruple therapies were statistically insignificant.The incidence of adverse events (35.1%, 22.6%, and 28.9%) and compliance (90.5%, 91.8%, and 91.9%) were similar. Taste distortion, nausea, and anorexia were more common in metronidazole-containing regimens, and dizziness was more common in minocycline-containing regimens. The allergy was rare (~3%). Conclusions:The efficacies of three bismuth quadruple therapies containing minocycline, cefuroxime, and full-dose metronidazole (pairwise) for first-line H. pylori eradication in penicillin-allergic patients were similarly satisfactory with relatively good safety and compliance. The study was registered in the Chinese Clinical Trials Registration (ChiCTR1900023702). How to cite this article: Zhang Y, Suo B, Tian X, et al. New regimens as first-line eradication therapy for Helicobacter pylori infection in patients allergic to penicillin: A randomized

Background The roles of inflammation and hypercoagulation in predicting outcomes of coronavirus disease 2019 (COVID-19) are unclear. Methods Adult patients diagnosed with COVID-19 from 28 January 2020 to 4 March 2020 in Tongji Hospital, Wuhan were recruited. Data on related parameters were collected. Univariate analysis and multivariable binary logistic regression were used to explore predictors of critical illness and mortality. Results In total, 199 and 44 patients were enrolled in the training and testing sets, respectively. Elevated ferritin, tumor necrosis factor-α and D-dimer and decreased albumin concentration were associated with disease severity. Older age, elevated ferritin and elevated interleukin-6 were associated with 28-day mortality. The FAD-85 score, defined as age + 0.01 * ferritin +D-dimer, was used to predict risk of mortality. The sensitivity, specificity and accuracy of FAD-85 were 86.4%, 81.8% and 86.4%, respectively. A nomogram was established using age, ferritin and D-dimer to predict the risk of 28-day mortality. Conclusions Thrombo-inflammatory parameters provide key information on the severity and prognosis of COVID-19 and can be used as references for clinical treatment to correct inflammatory and coagulation abnormalities.

Objectives This study aimed to examine the association between hyperglycemia and the malignant transformation of oral leukoplakia (OLK). Patients and Methods This retrospective case–control study involved 133 patients with the malignant transformation of OLK into oral squamous cell carcinoma (case group) and 266 patients with untransformed OLK (control group). The clinical history and follow‐up data included age, gender, lesion size and location, and fasting plasma glucose. Logistic regression analysis, Kaplan–Meier survival analysis, and univariate and multivariate Cox regression analyses were used to assess the effects of risk factors on the malignant transformation of OLK. Results Hyperglycemia (adjusted hazard ratio [AHR] = 4.7, p = .001), non‐homogenous OLK (AHR = 3.0, p < .001), location of the lesion on the ventral surface of the tongue or floor of the mouth (AHR = 3.6, p < .001), and epithelial dysplasia (AHR = 2.8, p = .005) had significant effects on the malignant transformation of OLK. Conclusion Hyperglycemia, non‐homogenous OLK, location of the lesion on the ventral surface of the tongue or floor of the mouth, and epithelial dysplasia might be associated with malignant transformation of OLK.