Conclusion:Perioperative mortality and morbidity is high in HIV patients undergoing abdominal aortic surgery. Hypoalbuminemia and low CD4 lymphocyte counts are associated with poor clinical outcomes.Summary: The authors assessed outcome in HIV patients undergoing aortic reconstruction for occlusive or aneurysmal disease. This retrospective study covered an 11-year period, with patients identified through hospital and clinic records. The authors identified 48 HIV-positive patients (mean age 53 Ϯ 13 years) who underwent an abdominal aortic procedure during the study period. There were 20 operations for aneurysm and 28 for occlusive disease. There were no intraoperative deaths. Sixteen patients (33%) had postoperative complications, and 7 patients (15%) died in the hospital. Follow-up was for a mean of 41 months. Survival rates for aneurysm patients at 60 months were 43.2% Ϯ 5.3% and for occlusive disease patients, 46.3% Ϯ 7.4% (P ϭ NS). Multivariable analysis indicated low CD4 lymphocyte counts (Ͻ200/L, P Ͻ 0.05) and hypoalbuminemia (Ͻ3.5g/dL, P Ͻ 0.05) were risk factors for perioperative complication. The incidence of late graft infection was 10%. All patients with graft infection died, either from complications of the graft infection or its treatment.Comment: Everyone likes to publish good results. It is, however, sometimes the responsible thing to publish horrible results. Clearly the results of aortic surgery in patients with HIV infection are significantly inferior to what one would expect in patients without HIV infection. The message: aortic reconstruction in patients with HIV infection should be undertaken only for compelling indications.

Diffuse panbronchiolitis (DPB) is a chronic diffuse airway inflammatory disease, which is strongly associated with the class I human leukocyte antigen (HLA) alleles. Here, we report a pair of sisters who have been suffering from chronic cough, expectoration and wheezing for many years. They were previously misdiagnosed as chronic bronchitis and bronchial asthma, and were recently diagnosed as diffuse panbronchiolitis. The 36-year-old elder sister suffered from diffuse panbronchiolitis complicated with pulmonary tuberculosis. The 30-year-old younger sister suffered from diffuse panbronchiolitis complicated with bronchial asthma and bronchiectasis. We have performed HLA genotyping research on the two sisters, their parents and younger brother. The results showed that all family members were positive for HLA-A24 and HLA-B13. The younger sister and mother were positive for HLA-A2. The younger brother and father were positive for HLA-A11. We suspect that the two sisters’ disease susceptibility may be caused by their parents’ consanguineous marriage. In this study, we reported the clinical characteristics of the two sisters with diffuse panbronchiolitis and shared the associated HLA genotyping results of this family cluster, hoping to provide reference for the etiology, diagnosis and treatment of this disease.

Objective. To explore the clinical characteristics of patients with different severity in the early outbreak of COVID-19, hoping to provide reference for clinical diagnosis and treatment. Methods. We retrospectively analyzed the clinical data of 95 COVID-19 patients in Wuhan Red Cross Hospital of China from January 17 to February 13, 2020. All patients were investigated with epidemiological questionnaires. Outcomes were followed up until April 1, 2020. Results. There were 53 males and 42 females, aged 22–84 years (mean 57.3 years). Clinical classification included 54 cases of common type, 27 cases of severe type, and 14 cases of critical type. Six patients had been exposed to the local Huanan seafood market. There were 38 clusters of COVID-19, including 27 family clusters and 11 work unit clusters. Common symptoms included fever (86 (90.5%) of 95), cough (73 (76.8%)), and fatigue (50 (52.6%)). Laboratory findings showed that the most common abnormalities were lymphopenia (75 (78.9%)), elevated D-dimer (60 (63.2%)), and elevated C-reactive protein (56 (58.9%)) on admission. All patients had abnormal chest computed tomography, showing patchy shadows or ground-glass opacities. Severe and critical cases were older, more likely to have shortness of breath, more likely to have underlying comorbidities, and more likely to have abnormal laboratory findings than common cases. The prognosis of patients with different degrees of severity was significantly different. All common and severe patients (100%) were cured and discharged from the hospital, while 10 (71.4%) of 14 critical patients died. Conclusions. COVID-19 has fast transmission speed and high pathogenicity. We must assess the severity of the disease and take corresponding treatment measures as early as possible.