Dual antiplatelet agents and Rivaroxaban for massive intracoronary thrombus in STEMI

Management of intracoronary thrombus in patients presenting more than 12 hours after the onset of ST elevation myocardial infarction is challenging. We present such a case which had massive thrombus in left anterior descending artery. It was managed successfully with dual antiplatelet agents and factor Xa inhibitor rivaroxaban administered orally.     

The Univariate and Bivariate Impact of HIV/AIDS on the Quality of Life： A Cross Sectional Study in the Hubei Province-Central China

This study is aimed to evaluate the quality of life （QOL） for individuals living with human immunodeficiency virus （HIV）/acquired immunodeficiency syndrome （AIDS） in Hubei province-central China by using WHOQOL-BREF instrument （Chinese version）. One hundred and thirty six respondents （HIV/AIDS individuals） attending out-patient department of Chinese Center for Disease Control and Prevention （Chinese CDC） were administered a structured questionnaire developed by investigators. QOL was evaluated by using WHOQOL-BREF instrument （Chinese version）. The results showed that the mean score of overall QOL on a scale of 0-100 was 25.8. The mean scores in 4 domains of QOL on a scale of 0-100 were 82.9 （social domain）, 27.5 （psychological domain）, 17.7 （physical domain） and 11.65 （environmental domain）. The significant difference of QOL was noted in the score of physical domain between asymptomatic （14.6） and early symptomatic individuals （12） （P=0.014）, and between patients with early symptoms （12） and those with AIDS （10.43） （P〈0.001）. QOL in psychological domain was significantly lower in early symptomatic （12.1） （P〈0.05） and AIDS patients （12.4） （P〈0.006） than in asymptomatic individuals （14.2）. The difference in QOL scores in the psychological domain was significant with respect to the income of patients （P〈0.048） and educational status （P〈0.037）. Significantly better QOL scores in the physical domain （P〈0.040） and environmental domain （P〈0.017） were noted with respect to the occupation of the patients. Patients with family support had better QOL scores in environmental domain. In our research, QOL for HIV/AIDS individuals was associated with education, occupation, income, family support and clinical categories of the patients. It was concluded that WHOQOL-BREF Chinese version was successfully used in the evaluation of QOL of HIV/AIDS individuals in Chinese population and proved to be a reliable and useful tool.     

Evaluation of Atrial Septal Defect Using Real-time Three-dimensional Echocardiography： Comparison with Surgical Findings

The present study evaluated the application of three dimensional echocardigraphy （3DE） in the diagnosis of atrial septal defect （ASD） and the measurement of its size by 3DE and compared the size with surgical findings. Two-dimensional and real-time three dimensional echocardiography （RT3DE） was performed in 26 patients with atrial septal defect, and the echocardiographic data were compared with the surgical findings. Significant correlation was found between defect diameter by RT3DE and that measured during surgery （r=0.77, P〈0.001）. The defect area changed significantly during cardiac cycle. Percentage change in defect size during cardiac cycle ranged from 6%-70%. Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings. Therefore, RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.     

Epidemiology of Human Immuno-deficiency Virus and Quality of Life for People Living with HIV/AIDS in China

HIV/AIDS is increasing in prevalence in China and spread of infection from highly risk populations to the general populations was recognized. Despite the fact, there are still only few scientific reviews on quality of life （QOL） for people living with HIV/AIDS （PLWHAs）. However, many PLWHAs are struggling with social and psychological influences such as substances abuse, cultural beliefs, depression, stigma, poverty, which can affect their QOL. Public unawareness about infection and disease, willingness to seek medical care and motivation to follow therapy are indirectly influencing health outcome. In 2003 Chinese government has established the so-called the ＂Four Frees and One Care＂ policy. The policy was officially implemented from 2004 in some areas, yet to date it is not implemented nationwide. This paper discussed the epidemiology of HIV, underlying psychosocial factors affecting PLWHAs and their impact on QOL. We put forward some recommendations for stakeholders, advocacy groups, non-government organizations and Chinese government.