ABSTRACT
<p><b>BACKGROUND</b>Coarctation of the aorta (CoA) with aortic arch hypoplasia (AAH) is a relatively common congenital heart disease in clinical practice. Nonetheless, the corrective surgical technique for infants and children is a clinical problem that remains controversial. In this study, we sought to evaluate the surgical effects of aortic arch (AA) reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch for infants and young children with CoA and AAH.</p><p><b>METHODS</b>Between January 2009 and December 2015, a total of 22 infants and young children with CoA and AAH who underwent coarctation resection and aortoplasty with autologous pulmonary artery patch were enrolled in this study. The median age of patients was 4.5 (Q1, Q3: 2.0, 14.0) months and the median body weight was 5.75 (Q1, Q3: 4.10, 9.38) kg. All patients were diagnosed with CoA and AAH, and concomitant cardiac anomalies were corrected in one stage. Perioperative and postoperative data were collected and analyzed using the paired sample t-test.</p><p><b>RESULTS</b>No perioperative deaths occurred. No residual obstruction was detected by echocardiography. The postoperative pressure difference across the repaired segment of CoA was 14.05 ± 4.26 mmHg (1 mmHg = 0.133 kPa), which was smaller than the preoperative pressure difference (48.30 ± 15.73 mmHg; t = -10.119, P < 0.001). The median follow-up time was 29.0 (Q1, Q3: 15.5, 57.3) months. There was no death during the follow-up period, and all patients experienced obvious clinical improvement. Only one child underwent subsequent aortic balloon angioplasty due to restenosis. Computed tomography angiography showed that the AA morphology was smooth, with no aortic aneurysm or angulation deformity.</p><p><b>CONCLUSION</b>AA reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch could effectively correct CoA with AAH, and the rate of reintervention for restenosis is low.</p>
ABSTRACT
Objective To investigate the HIV drug resistance among HIV/AIDS patients who had received highly active antiretroviral treatment (HAATR) in Liangshan prefecture and related factors.Methods This investigation was conducted from August to October 2010.Data on epidemiology,treatment,CD4 + T cell,viral load and drug resistance tests were collected.Results 233 (73.50％) had a viral load of ＜ 1000 copy/ml,with the median CD4+T cell count as 329 cell/μl.26 samples appeared to be drug resistant,with the rate as 8.20％.Among 84 patients with antiviral therapy failure,the overall drug resistance rate was 30.95％(26/84).While 24 (28.57％) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs.Among nucleoside reverse transcriptase inhibitors (NRTI),7 (8.33％) were resistant.1 (1.19％) had protease inhibitor (PI)resistance mutations identified.Factors that significantly associated with drug resistance would include:being injecting drug users (A OR =3.37,95 ％ CI:1.06-10.66,P =0.0390),having had chronic diarrhea ＞1 month (AOR=8.38,95％ CI:1.87-37.69,P=0.0055),having had CD4+T cell＜200(AOR=3.48,95％CI:1.29-9.39,P=0.0139),being residents from Butuo area (AOR=17.68,95％ CI:4.97-62.86,P＜0.0001 ).When comparing with other areas,data from Butuo showed that people who carried Yi ethnicity (AOR=17.35,95％ CI:2.01-149.73,P=0.0095) and were literate (having had primary or higher levels of education) (AOR=0.18,95％ CI:0.08-0.42,P＜0.0001 ),being married or having cohabited relations (AOR=8.17,95％ CI:2.35-28.39,P=0.001 ) were found to be less adherent (AOR=0.05,95％ CI:0.02-0.13,P＜0.0001) to the treatment.Conclusion Successful antiviral outcomes were seen among those AIDS patients under treatment,in Liangshan prefecture.Resistance rates were significantly different in regions.For IDUs,enforcement on subjects including prevention on drug resistance,adherence to HAART and treatment for drug addiction should be strengthened and programs being integrated.