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The patient,a 11-year-old boy,presented with a 4-year history of erythema and vesicles on the face and arms as well as a 4-month history of tumor and ulcer on the extremities,accompanied by progressive fatigue and intermittent fever.The patient had a body temperature of 37.7℃.No lymph node involvement was observed.Cutaneous examination revealed minimally indurated pink-red patches on the face and nose and dusky red firm nodules and tumors of varying sizes on the extremities.The nodules ranged from 2.0 cm to 18 cm in diameter,some had necrosis and black crusts on the surface.Ulcers were observed in some of the larger nodules;many of the ulcers extended into the muscle layer.White purulent discharge was seen on the surface of many of the nodules.The lesions were sharply demarcated,firm,tender, and surrounded by small satelite nodules.Histologically,there were large quantities of irregularly shaped, middle-sized tumor cells with clear cytoplasm,large twisted nuclei and prominent chromatin,infiltrating from the epidermis to subcutaneous tissue.The tumor cells infiltrating the follicles and eccrine sweat glands were either distributed perivascularly in a nest shape,or dispersed.There were broken nuclei and reactive histio- cytic infiltration in the dermis and subcutaneous tissue.Immunohistologically,the tumor cells were positive for cytoplasmic CD3 around the nuclei,for CD56,CD45RO and T cell intracellular antigen-l,and partly for CD30,CD8 and Ki67.Epstein-Barr virus-encoded nuclear RNA was positive with in situ hybridization. TCR?-2 gene rearrangement was positive in these tumor cells.A diagnosis of hydroa vacciniforme-like primary cutaneous NK/T-cell lymphoma was made.Therefore,this is a case report of hydroa vaccini- forme-like primary cutaneous NK/T-cell lymphoma with primary involvement in the skin;the condition was slowly progressive over 51 months.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is a kind of emergency treatment for cardiopulmonary arrest, and chest compression is the most important and necessary part of CPR. The American Heart Association published the new Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in 2010 and demanded for better performance of chest compression practice, especially in compression depth and rate. The current study was to explore the relationship of quality indexes of chest compression and to identify the key points in chest compression training and practice.METHODS: Totally 219 healthcare workers accepted chest compression training by using Laerdal ACLS advanced life support resuscitation model. The quality indexes of chest compression, including compression hands placement, compression rate, compression depth, and chest wall recoil as well as self-reported fatigue time were monitored by the Laerdal Computer Skills and Reporting System.RESULTS: The quality of chest compression was related to the gender of the compressor. The indexes in males, including self-reported fatigue time, the accuracy of compression depth and the compression rate, the accuracy of compression rate, were higher than those in females. However, the accuracy of chest recoil was higher in females than in males. The quality indexes of chest compression were correlated with each other. The self-reported fatigue time was related to all the indexes except the compression rate.CONCLUSION: It is necessary to offer CPR training courses regularly. In clinical practice, it might be better to change the practitioner before fatigue, especially for females or weak practitioners. In training projects, more attention should be paid to the control of compression rate, in order to delay the fatigue, guarantee enough compression depth and improve the quality of chest compression.