High-Performance Reconfigurable Pipeline Implementation for FPGA-Based SmartNIC.

As the key module of programmable switches or the SmartNIC card, the packet processing pipeline undertakes the task of packet forwarding and processing. However, the current pipeline for the FPGA-based SmartNIC is inflexible, and the related reconfigurable commercial device designs are closed-source. To solve this problem, this paper proposes a high-performance reconfigurable pipeline design, which has fully reconfigurable match-action units, supporting various network functions by its flexible reconfiguration. The fields of the match key and the size of the match table can be reconfigured without recompiling the HDL code or modifying the hardware. The processing rules and action instructions for the pipeline can be dynamically installed by the configuration module at runtime. We implement our design on the Xilinx Alveo U200 board with a Virtex UltraScale+ XCU200-2FSGD2104E FPGA and show that the designed pipeline supports fast reconfiguration to implement new network functions and that the throughput of the designed pipeline reaches 100 Gbps with low latency.

Human health risks of heavy metal(loid)s mediated through crop ingestion in a coal mining area in Eastern China.

The heavy metal(loid)s (HMs) in soils can be accumulated by crops grown, which is accompanied by crop ingestion into the human body and then causes harm to human health. Hence, the health risks posed by HMs in three crops for different populations were assessed using Health risk assessment (HRA) model coupled with Monte Carlo simulation. Results revealed that Zn had the highest concentration among three crops; while Ni was the main polluting element in maize and soybean, and As in rice. Non-carcinogenic risk for all populations through rice ingestion was at an "unacceptable" level, and teenagers suffered higher risk than adults and children. All populations through ingestion of three crops might suffer Carcinogenic risk, with the similar order of Total carcinogenic risk (TCR): TCRAdults > TCRTeenagers > TCRChildren. As and Ni were identified as priority control HMs in this study area due to their high contribution rates to health risks. According to the HRA results, the human health risk was associated with crop varieties, HM species, and age groups. Our findings suggest that only limiting the Maximum allowable intake rate is not sufficient to prevent health risks caused by crop HMs, thus more risk precautions are needed.

SASEGAN-TCN: Speech enhancement algorithm based on self-attention generative adversarial network and temporal convolutional network.

Traditional unsupervised speech enhancement models often have problems such as non-aggregation of input feature information, which will introduce additional noise during training, thereby reducing the quality of the speech signal. In order to solve the above problems, this paper analyzed the impact of problems such as non-aggregation of input speech feature information on its performance. Moreover, this article introduced a temporal convolutional neural network and proposed a SASEGAN-TCN speech enhancement model, which captured local features information and aggregated global feature information to improve model effect and training stability. The simulation experiment results showed that the model can achieve 2.1636 and 92.78% in perceptual evaluation of speech quality (PESQ) score and short-time objective intelligibility (STOI) on the Valentini dataset, and can accordingly reach 1.8077 and 83.54% on the THCHS30 dataset. In addition, this article used the enhanced speech data for the acoustic model to verify the recognition accuracy. The speech recognition error rate was reduced by 17.4%, which was a significant improvement compared to the baseline model experimental results.

Improving prediction of soil heavy metal(loid) concentration by developing a combined Co-kriging and geographically and temporally weighted regression (GTWR) model.

The study of heavy metal(loid) (HM) contamination in soil using extensive data obtained from published literature is an economical and convenient method. However, the uneven distribution of these data in time and space limits their direct applicability. Therefore, based on the concentration data obtained from the published literature (2000-2020), we investigated the relationship between soil HM accumulation and various anthropogenic activities, developed a hybrid model to predict soil HM concentrations, and then evaluated their ecological risks. The results demonstrated that various anthropogenic activities were the main cause of soil HM accumulation using Geographically and temporally weighted regression (GTWR) model. The hybrid Co-kriging + GTWR model, which incorporates two of the most influential auxiliary variables, can improve the accuracy and reliability of predicting HM concentrations. The predicted concentrations of eight HMs all exceeded the background values for soil environment in China. The results of the ecological risk assessment revealed that five HMs accounted for more than 90% of the area at the "High risk" level (RQ ≥ 1), with the descending order of Ni (100%) = Cu (100%) > As (98.73%) > Zn (95.50%) > Pb (94.90%). This study provides a novel approach to environmental pollution research using the published data.

Impact of economic development on soil trace metal(loid)s pollution: A case study of China.

Recently, intensive anthropogenic activities, while promoting economic growth, have also exacerbated soil trace metal(loid) (TM) pollution. To explore the impact of economic development on soil TM pollution, a time-weighted method was introduced to calculate the average concentrations of eight TMs in Chinese topsoil from 2001 to 2020, and panel data on TMs and economic factors of 31 provinces were used for regression analysis. The results revealed that the average concentrations of soil TMs all exceeded their respective soil background values. Meanwhile, the spatial distribution of soil TMs was characterized by obvious regional heterogeneity, with economically developed areas being heavily polluted and having high ecological risks. In addition, the results derived from panel data models showed that the relationship between soil TM pollution and economic development in China presented a continuous growth curve, but with an N-shaped pattern in eastern China, a U-shaped pattern in central China, and a positive linearity in western China. Four control variables were also introduced to evaluate their impact on TM pollution, and the results indicated that the proportion of secondary industry and the road area per capita were the major influencing factors. Ultimately, the inflection point estimation results suggested that the soil TM pollution level will increase in eastern China, central China and western China with ongoing economic growth. Our findings contribute to the current understanding of the relationship between soil TM pollution and anthropogenic activities, and provide a scientific basis for adjusting and planning industrial development and layout according to the characteristics of soil TM pollution.

QGWFQS: A Queue-Group-Based Weight Fair Queueing Scheduler on FPGA.

Weight Fair Queuing is an ideal scheduling algorithm to guarantee the bandwidth of different queues according to their configured Weights when the switching nodes of the network are congested. Many of the switching nodes based on FPGA in the current network support four physical ports or hundreds of virtual ports. Massive logic and storage resources would be consumed if each port implemented a WFQ scheduler. This paper proposes a Queue-Group-Based WFQ Scheduler (QGWFQS), which can support WFQ scheduling across multiple ports through the reuse of tag calculation and encoding circuits. We also propose a novel finish tag calculation algorithm to accommodate the variation in the link rate of each port. The remainder of integer division is also taken into account, which makes the bandwidth allocation fairer. Experimental results show that the proposed scheduler supports up to 512 ports, with 32 queues allocated on each individual port. The scheduler has the capability to operate at 200 MHz and the total scheduling capacity reaches 200 Mpps.

Escitalopram versus other antidepressive agents for major depressive disorder: a systematic review and meta-analysis.

BACKGROUND: Escitalopram is selective serotonin reuptake inhibitors (SSRIs) and one of the most commonly prescribed newer antidepressants (ADs) worldwide. We aimed to explore the efficacy, acceptability and tolerability of escitalopram in comparison with other ADs in the acute-phase treatment of major depressive disorder (MDD). METHODS: Medline/PubMed, EMBASE, the Cochrane Library, CINAHL, and Clinical Trials.gov were searched from inception to July 10, 2023. Trial databases of drug-approving agencies were hand-searched for published, unpublished and ongoing controlled trials. All randomized controlled trials comparing escitalopram against any other antidepressant for patients with MDD. Responders and remitters to treatment were calculated on an intention-to-treat basis. For dichotomous data, risk ratios (RRs) were calculated with 95% confidence intervals (CI). Continuous data were analyzed using standardized mean differences (with 95% CI) using the random effects model. RESULTS: A total of 30 studies were included in this meta­analysis, among which sixteen trials compared escitalopram with another SSRI and 14 compared escitalopram with a newer AD. Escitalopram was shown to be significantly more effective than citalopram in achieving acute response (RR 0.67, 95% CI 0.50-0.87). Escitalopram was also more effective than citalopram in terms of remission (RR 0.53, 95% CI 0.30-0.93). CONCLUSIONS: Escitalopram was superior to other ADs for the acute phase treatment of MDD in terms of efficacy, acceptability and tolerability. However, no significant difference was found between escitalopram and other ADs in early response or follow-up response to treatment of MDD.

Uptake, accumulation, and degradation of dibutyl phthalate by three wetland plants.

The uptake and degradation mechanisms of dibutyl phthalate (DBP) by three wetland plants, namely Lythrum salicaria, Thalia dealbata, and Canna indica, were studied using hydroponics. The results revealed that exposure to DBP at 0.5 mg/L had no significant effect on the growth of L. salicaria and C. indica but inhibited the growth of T. dealbata. After 28 days, DBP concentrations in the roots of L. salicaria, T. dealbata, and C. indica were 8.74, 5.67, and 5.46 mg/kg, respectively, compared to 2.03-3.95 mg/kg in stems and leaves. Mono-n-butyl phthalate concentrations in L. salicaria tissues were significantly higher than those in the other two plants at 23.1, 15.0, and 13.6 mg/kg in roots, stems, and leaves, respectively. The roots of L. salicaria also had the highest concentration of phthalic acid, reaching 2.45 mg/kg. Carboxylesterase, polyphenol oxidase, and superoxide dismutase may be the primary enzymes involved in DBP degradation in wetland plants. The activities of these three enzymes exhibited significant changes in plant tissues. The findings suggest L. salicaria as a potent plant for phytoremediation and use in constructed wetlands for the treatment of DBP-contaminated wastewater.

Human activities contributing to the accumulation of high-risk trace metal(loid)s in soils of China's five major urban agglomerations.

Rapid urbanization has accelerated the accumulation of trace metal(loid)s (TMs) in soils, but the relationship between this accumulation and human activities remains largely unknown. Therefore, based on 775 published literatures (2001-2020), this study aimed to identify the influence of human activities on TM accumulation. Results showed that all soil TM concentrations were higher than their corresponding Chinese soil background values. The pollution risk assessment indicated that the soil TMs in the study area were at moderate levels, and the value of Pollution load index was 2.10. According to the assessment of health risks, the non-carcinogenic risks for adults were at the "Negligible risk" level; while the carcinogenic risk was not negligible for all populations, with children being more susceptible than adults. Meanwhile, six high-risk TMs were identified based on the grading of Contaminating factors (CF ≥ 3) and contribution to health risk (≥ 75%), including four high pollution risk TMs (Cd, Hg, Cu, and Pb) and two high health risk TMs (Cr and As) . In addition, in accordance with the results of the Random forest model, the accumulation of soil high-risk TMs was closely related to influencing factors associated with human activities. The accumulation of Hg and Cr among five major urban agglomerations had the same influencing factors (the number of industrial companies and the amount of industrial wastewater discharge for Hg; the amount of pesticide application and highway mileage for Cr). However, there were significant differences in the factors influencing the accumulation of the other four high-risk TMs (including Cd, As, Cu and Pb), due to the different characteristics of each urban agglomeration. Our results provide new insights into the relationship between human activities and soil TM accumulation.

New insights into health risk assessment on soil trace metal(loid)s: Model improvement and parameter optimization.

Trace metal(loid)s (TMs) in soils may pose potential health risks to humans. Due to model uncertainty and variability of exposure parameters, the traditional health risk assessment (HRA) model may lead to inaccurate risk assessment results. Therefore, this study developed an improved HRA model to assess health risks by combining two-dimensional Monte Carlo simulation (2-D MCS) with a Logistic Chaotic sequence based on published data from 2000 to 2021. The results showed children and adult females were the high-risks populations for Non-carcinogenic risk and Carcinogenic risk, respectively. Meanwhile, children's Ingestion rate (IngR < 160.233 mg/day) and adult females' Skin adherence factor (0.026 mg/(cm2•d) < AF < 0.263 mg/(cm2•d)) were used as recommended exposure to make the health risk within acceptable range. Additionally, when performing risk assessment using actual exposure parameters, priority control TMs were identified, with As being the priority control TM for Southwest China and Inner Mongolia, whereas Cr and Pb for Tibet and Yunnan, respectively. Compared to health risk assessment, improved models increased risk assessment accuracy and provided recommended exposure parameter for high-risk populations. This study will provide new insights for soil-related health risk assessment.

Biodegradable polymer everolimus-eluting stents versus contemporary drug-eluting stents: a systematic review and meta­analysis.

In spite of similar efficacy and safety in pilot studies, compared with the contemporary durable polymer drug-eluting stent (DP-DES), the bioabsorbable polymer drug-eluting stent (BP-DES) may be more superior in promoting blood vessel healing. We sought to compare the safety and efficacy of everolimus-eluting BP-DES (BP-EES) with contemporary DP-DES through a meta-analysis. We performed this meta-analysis to provide further evidence of the safety and efficacy of BP-EES. Medline, Embase and the Cochrane library databases were searched for randomized controlled trials comparing clinical efficacy and safety of BP-EES versus contemporary DP-DES. Fifteen RCTs with a total of 15,572 patients were selected. The rate of MACE was 9.4% in patients receiving BP-EES and 7.3% receiving DP-EES (RR 1.13, 95% CI 0.99-1.29, p = 0.05; I2 = 46%). TLF and MI were also similar in both groups. Based on the available data, this review demonstrates that BP-EES displays a clinically comparable efficacy and safety profile to that of contemporary DP-DES at years of follow-up in patients undergoing PCI.

Spatio-temporal characteristics of soil Cd pollution and its influencing factors: A Geographically and temporally weighted regression (GTWR) method.

Soil Cd pollution is the result of the combined influence of various human activities over a long period of time, and then quantifying the influence is essential for the prevention and control. Based on published literature data during 2000-2020, this study investigated the pollution characteristics and influencing factors of soil Cd in the Yangtze River Delta. The results were as follows: (1) The average Cd concentration was higher than the Chinese soil criteria value (0.30 mg/kg), and the proportion of Cd concentration exceeding its background value was 87.43%. (2) The assessment results using Contamination factor (CF) and Geo-accumulation index (Igeo) indicated that the soil Cd pollution risk could not negligible in the study area. (3) The pollution center shifted significantly owing to the combined effect of human activities. (4) The main influencing factors of Cd pollution obtained by Geographically and temporally weighted regression (GTWR) model were GDP per capita, Consumption of chemical fertilizer, Output value of primary industry, and Output value of secondary industry, but there were significant differences in the dominant factors for different provinces. Our findings contribute to the current understanding of the relationship between Cd pollution and human activities, and provide a scientific basis for pollution control.

Intracervical Foley catheter plus intravaginal misoprostol compared to intravaginal misoprostol-only for cervical ripening: A systematic review and meta-analysis.

To compare the combination of intracervical Foley catheter and intravaginal misoprostol administration versus intravaginal misoprostol administration-only for cervical ripening. The Medline, EMBASE, ClinicalTrials.gov, PROSPERO, Scopus, and Cochrane Collaboration databases were searched systematically. Randomized controlled trials that included patients with a singleton viable fetus who underwent induction of labor that required cervical ripening with an unfavorable cervix (Bishop ≤ 6) were eligible for inclusion. Primary outcomes was time to delivery and rate of cesarean delivery. Thirteen trials with 2978 subjects met the inclusion criteria. There was no difference in the incidence of cesarean delivery between the two groups (RR, 0.90; 95 % CI, 0.72-1.14; I2 = 69 %). The combination group resulted in comparable time to delivery (MD -2.50 h; 95 % CI 0.38, -5.38; I2 = 97 %), shorter time to vaginal delivery (MD -3.49 h; 95 % CI -4.89, -2.09; I2 = 81 %), lower risk of neonatal intensive care unit (NICU) admission (RR 0.72, 95 % CI 0.58-0.90, I2 = 0 %), meconium-stained fluid (RR 0.48, 95 % CI 0.31-0.73, I2 = 28 %), and tachysystole with fetal heart trace changes (RR 0.49, 95 % CI 0.27-0.86, I2 = 43 %), compared with intravaginal misoprostol-only group. There was no statistical difference in rates of terbutaline use, endometritis or chorioamnionitis between the two groups. The combination of intravaginal misoprostol with intracervical Foley catheter for cervical ripening is not associated with shorter time to delivery. However, the combination group shows significant difference in shorter time to vaginal delivery, NICU admission, meconium-stained fluid, and tachysystole with fetal heart trace changes.

In vitro Antitumor Properties of Fucoidan-Coated, Doxorubicin-Loaded, Mesoporous Polydopamine Nanoparticles.

Chemotherapy is a common method for tumor treatment. However, the non-specific distribution of chemotherapeutic drugs causes the death of normal cells. Nanocarriers, particularly mesoporous carriers, can be modified to achieve targeted and controlled drug release. In this study, mesoporous polydopamine (MPDA) was used as a carrier for the antitumor drug doxorubicin (DOX). To enhance the release efficiency of DOX in the tumor microenvironment, which contains high concentrations of glutathione (GSH), we used N,N-bis(acryloyl)cysteamine as a cross-linking agent to encapsulate the surface of MPDA with fucoidan (FU), producing MPDA-DOX@FU-SS. MPDA-DOX@FU-SS was characterized via transmission electron microscopy, thermogravimetric analysis, and X-ray photoelectron spectroscopy (XPS), and its antitumor efficacy in vitro was investigated. The optimal conditions for the preparation of MPDA were identified as pH 12 and 20 °C, and the optimal MPDA-to-FU ratio was 2:1. The DOX release rate reached 47.77% in an in vitro solution containing 10 mM GSH at pH 5.2. When combined with photothermal therapy, MPDA-DOX@FU-SS significantly inhibited the growth of HCT-116 cells. In conclusion, MPDA-DOX@FU-SS may serve as a novel, highly effective tumor suppressor that can achieve targeted drug release in the tumor microenvironment.

Evaluation of Radio Frequency-Assisted Enzymatic Extraction of Non-Anthocyanin Polyphenols from Akebia trifoliata Flowers and Their Biological Activities Using UPLC-PDA-TOF-ESI-MS and Chemometrics.

A new radio frequency heating-assisted enzymatic extraction (RF-E) method is applied for the determination of phenolic compounds in Akebia trifoliata flowers, compared with hot water, acidified ethanol (EtOH), and enzymatic-assisted (EA) extractions. Non-anthocyanin polyphenol profiles, antibacterial, angiotensin-converting enzyme (ACE) inhibitory, anti-inflammatory activities, and structures of extracts are evaluated. Results show no significant differences in the extraction of total flavonoid content (15.85-16.63 mg QEs/g) and ACE inhibitory activity (51.30-52.86%) between RF-E and EA extracts. RF-E extract shows the highest anti-inflammatory activities. FTIR and UV spectra reveal that acidified EtOH treatment has a significant effect on the structure of the extract due to its highest flavonoid content (20.33 mg QEs/g), thus it has the highest antibacterial activity against Staphylococcus aureus and Escherichia coli. Sixteen non-anthocyanin polyphenols are identified by UPLC-PDA-TOF-ESI-MS and RF pre-treatment did not cause significant compound degradation. The chemometric analysis shows that enzymatic hydrolysis significantly increased biological activities, and the presence of non-anthocyanin polyphenols correlates well with ACE inhibitory and anti-inflammatory activities. Accordingly, A trifoliata flowers have potential as reagents for the food and pharmaceutical industries due to their abundant polyphenols that could be extracted efficiently using RF-E.

Adalimumab for induction of remission in patients with Crohn's disease: a systematic review and meta-analysis.

PURPOSE: A large number of people with Crohn's disease (CD) fail to recover from conventional therapy or biological therapy. Some studies showed that adalimumab (ADA) may be an effective alternative therapy for these patients. The aim of this study was to evaluate the efficacy and safety of ADA in inducing CD remission. METHODS: We performed search of Pubmed/MEDLINE, Embase, CENTRAL, the Cochrane IBD Group Specialized Register, and several other databases. Randomized controlled trials (RCTs) comparing any dose of ADA with controls (placebo or active) in participants with active CD were included. The primary outcome was the failure to achieve clinical response/remission at 4 weeks. Several subgroup and sensitivity analyses were performed. Review Manager Software v5.3 was used. RESULTS: Four RCTs were included (n = 919), in which 553 participants received ADA and 366 participants received placebo. A meta-analysis of four studies showed that at 4 weeks, there were more people in the ADA group with clinical response/remission or symptom improvement compared with the placebo group. The rates of side effects, serious side effects, and study withdrawals due to side effects were lower in ADA participants than placebo ones. CONCLUSION: This meta-analysis shows that ADA is superior to placebo in induction of clinical response/remission of CD patients, but no firm conclusions can be drawn on the safety of ADA in CD due to the low number of events.

Quark Cheese Processed by Dense-Phase Carbon Dioxide: Shelf-Life Evaluation and Physiochemical, Rheological, Microstructural and Volatile Properties Assessment.

Dense-phase carbon dioxide (DPCD), a novel non-thermal processing technology, has attracted extensive attention due to its excellent performance in food sterilization and enzyme inactivation without quality deterioration. In this work, we aimed to extend the shelf life of quark cheese with DPCD and explore the effect of DPCD treatment as well as storage time on the quality of quark cheese. The sterilization parameters were optimized by means of orthogonal experiments, and the physiochemical, rheological, microstructural and volatile properties of cheese were investigated. The optimal DPCD treatment (20 MPa, 45 min, 55 °C) successfully extended the shelf life of quark cheese due to its inhibition effect on yeast and was able to slow down the proteolysis and alterations in pH and color of cheese. Cheese processed using DPCD after 14-day storage even displayed similar rheological properties to the control at day 0, from which bound water significantly migrated during storage. Moreover, DPCD contributed to the retention of the volatile profile of cheese during storage. This study demonstrated that DPCD is a promising pasteurization technology for quark cheese to improve its quality stability during storage.

Response of the common reed (Phragmites australis) to nutrient enrichment depends on the growth stage and degree of enrichment: A mesocosm experiment.

Human-induced nutrient enrichment is a major stressor in aquatic ecosystems that has resulted in the alteration of ecosystem structures and functions. However, to date, relatively few studies have explored the temporal dynamics of reed biomass and morphological and biochemical traits under different nutrient levels, as well as the phenological pattern. Based on a mesocosm experiment, we monitored the aboveground and underground biomass of reed at the different plant growth stages, along with plant height, ramet and leaf number, leaf length and width, and carbohydrate and nutrient contents in different organs. We found that the significantly different ratio of aboveground to underground biomass was only observed at the late flowering stage between the slight enrichment (S-E) and heavy enrichment (H-E) groups. The start of the fast-growth phase of the aboveground part and underground part was delayed in the higher nutrient enrichment groups. The length of the fast-growth phase of the aboveground part was the same in the medium enrichment (M-E) and H-E groups and longer than that in the S-E group. For the underground part, the longest fast-growth phase was found in the S-E group (105 days), followed by the H-E and M-E groups (46 and 41 days, respectively). As the nutrient level increased, both increased and decreased values were observed for the 29 monitored morphological and biochemical traits, and the magnitude changed with the different growth stages. Moreover, different degrees of nutrient enrichment could differentially enhance or weaken the relationships among the groups between total biomass and the integrated morphological trait, between structural carbohydrate (SC) and total nitrogen (TN) contents, between total organic carbon (TOC) and TN, between total phosphorus (TP) contents, between TOC and SC contents. Our findings highlight a crucial contribution of ambient nutrient supply to temporal variation in plant biomass and phenological, morphological and biochemical traits.

Risk assessment and driving factors of trace metal(loid)s in soils of China.

Recently, with the rapid development of China's economy, the pollution of trace metal(loid)s (TMs) in soils has become increasingly severe and attracted widespread attention. Based on 1,402 published papers from 2000 to 2021, this study aimed to analyze the pollution intensity, ecological risk and driving factors for eight TMs (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) in Chinese soils. Results showed that the average concentrations of eight TMs in Chinese soils all exceeded background values, and the pollution of Cd and Hg was the most serious. Based on Principal component analysis of pollution intensity and ecological risk, the priority control TMs were identified for the heavily polluted provinces. The results of Geo-detector model suggested that Urban development factors contributed most to the TM accumulation in Chinese soils. Further, spatial analysis using bivariate Moran's I indicated that industrial activities contributed most to soil TM accumulation in the middle and lower reaches of the Yangtze River, while soil TM pollution in the southwest and northwest provinces was mainly caused by mining and metal smelting. This study investigated the relationship between soil TM pollution and anthropogenic activities, thus providing a scientific basis for controlling soil TM pollution at a large-scale level.

Effects of Renin-Angiotensin System Inhibitors on Mortality and Disease Severity of COVID-19 Patients: A Meta-analysis of Randomized Controlled Trials.

BACKGROUND: There is controversy over the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on the prognosis in patients with coronavirus disease 2019 (COVID-19), therefore, we aim to further explore the effect of renin-angiotensin-aldosterone system inhibitors on COVID-19-associated disease severity and mortality. METHODS: We systematically searched PubMed, Embase, Cochrane Library databases, medRxiv, and bioRxiv from inception to 6 September 2021. The primary outcome was all-cause mortality. Secondary outcome was severe disease which was defined as admission to the intensive care unit, the use of noninvasive or invasive mechanical ventilation, or death. RESULTS: A total of 7 randomized controlled trials involving 1,321 COVID-19 patients were included. Fixed-effects meta-analysis demonstrated that the use of ACEI/ARB was not associated with higher risk of mortality (risk ratio [RR] = 0.84, 95% confidence interval [CI] 0.57-1.22, P = 0.10, I2 = 43%) and disease severity (RR = 0.86, 95% CI 0.71-1.05, P = 0.11, I2 = 47%). However, the subgroup analysis showed that compared with no ACEI/ARB use, the use of ARB was associated with a significant reduction of mortality (RR = 0.23, CI 0.09-0.60, P = 0.55, I2 = 0%) and disease severity (RR = 0.38, CI 0.19-0.77, P = 0.007). CONCLUSIONS: In conclusion, based on the available data, ACEI/ARB is not associated with the risk of mortality and disease severity in COVID-19 patients. And ACEI/ARB medications, especially ARB, should not be discontinued for patients with COVID-19.