Objective To analyze the clinical features and evolution ot segmental vitiligo in children.Methods A standardized questionnaire was used to clinically investigate segmental vitiligo in 170 children aged ＜ or =12 years and 174 adults with an age of onset ＞ 18 years.Data analysis was done by the software SPSS16.0.Results The female to male ratio was 108:62 in the 170 child patients,significantly different from that in the adult patients (x2 =14.44,P ＜ 0.05).Localized vitiligo occurred as the initial presentation in 82.9％ (141/170) ofthe children and 76.4％ (133/174) of the adults,and progressed into segmental vitiligo in half a year in 76.5％ of the 141 children and 63.9％ of the 133 adults.Vitiligo entered the quiescent stage after half-a-year progression in 71.6％ of the children and 67.3％ of the adults with localized vitiligo as the initial presentation,and after one-month progression in 62.1％ of the children and 41.5％ of the adults with segmental vitiligo as the first presentation (x2 =8.39,P ＜ 0.01).Head and face were affected at the onset of segmental vitiligo in 44.1％ of the childhood cases and 56.9％ of the adult cases.Single nerve segments were involved at the onset in 94.7％ of the child patients and 86.8％ of the adult patients (x2 =0.04,P ＞ 0.05).The proportions of patients with white hairs,autoimmune diseases,and family history were significantly lower in the child patients than in the adult patients (x2 =15.88,5.62,6.66 respectively,all P ＜ 0.05).Conclusions Childhood-onset segmental vitiligo shows a predilection for males,usually presents as localized vitiligo at the onset,and becomes quiescent after half-a-year progression in more than 70％ of patients.

Objective To remedy the general defects of external fixator such as poor stability,complexed operation,strong stress shielding and bad extension function. Methods A total of 102 patients with limb shaft fracture were treated with the self-made external fixation and the curative effect observed. There were 84 males and 18 females aged at 5-78 years. Of all, 76 cases had tibial and fibular fractures, 10 femoral shaft fractures (children), 4 intertrochanteric or subtrochanteric fractures, 7 ulnar or radial fractures and 5 humeral shaft fractures. Results All patients got good results through a all-course observation, among which 76 cases with tibial and fibular fractures were followed up for 3 months to one year. Furthermore, the mean substantial bone healing time was only 3.5 months. The joint functions of the knee and the ankle recovered synchronously, with an overall excellence rate of 93.4%. No displacement of the fractured part or further fracture occurred. Conclusions The structure and function of the self-made external fixation accord with the demanding of current external fixator in orthopaedics.

Objective To evaluate the relationship between transplantation of allogeneic peripheral blood stem cells (allo-PBSCs) and low incidence of leukemic relapse. Methods Thirty-seven adult patients with acute myeloid leukemia in first remission ( n =16) and chronic myeloid leukemia in chronic phase ( n =21) underwent allo-PBSCT from June 1997 to December 1999. A median number of CD34 + cells, CD3 + cells, CD4 + cells and CD8 + cells infused was 7.3 ?10 6/kg, 364?10 6/kg, 210?10 6/kg and 137?10 6/kg, respectively. Busulfan and cyclophosphamide were used as conditioning regimen (BU-CY2). All patients received cyclosporine and methotrexate for GVHD prophylaxis. Results Engraftment of neutrophil and platelet was achieved at a median of day +13(9～28) and day +12(7～19) respectively. Acute GVHD (aGVHD) occurred in 18 of 37 patients ( 48.6% ) with grade II～IV aGVHD ( 24.3% ). Chronic GVHD (cGVHD) developed in 22 (extensive 8, limited 14) out of 32 evaluable patients ( 68.8% ). 28 patients were still alive in complete remission at a median follow-up of 950 days (range 600～ 1 500 days). The main causes of death were aGVHD in two patients, CMV-IP in four patients, cGVHD in two patients, and relapse only in one patient. The probability of disease free survival at 3 years was 75.7% . Conclusion In our series, leukemia recurrence was seen only in one patient ( 2.7% ), suggesting that a high incidence of cGVHD may have an enhanced graft-versus-leukemia effect and hence reduce the incidence of relapse after transplantation.

Objective To characterize the progression of segmental vitiligo.Methods Clinical data were collected using questionnaires from 387 patients with segmental vitiligo at the Department of Dermatology,Third People's Hospital of Hangzhou,between October 2011 and October 2012.The progression of segmental vitiligo was analyzed.Results Among the 387 patients,329 initially sufferred from focal vitiligo that evolved into segmental vitiligo later,58 began with segmental vitiligo.Vitiligo progressed most rapidly in the initial three months,and tended to be stable after three years in 220 (66.9％) of the 329 patients experiencing the evolution from focal to segmental vitiligo.By contrast,vitiligo developed most rapidly in the first month,and tended to be quiescent after one year in 40 (69.0％) of the 58 patients presenting with segmental vitiligo only.The condition still remained active in 27.6％ (107/387) of these patients after several years of progression.Totally,333 (86.0％) patients showed the involvement of single ganglion at the onset of vitiligo,including 173 (52.0％) patients with the involvement of trigeminal ganglion.Autologous melanocyte transplantation was conducted for 62 patients whose condition had been quiescent for more than one year,and 56 (90.3％) patients achieved more than 80％ repigmentation.Conclusions Segmental vitiligo,which tends to remain quiescent after three-year progression,seems to have a more rapid onset than focal vitiligo.Autologous melanocyte transplantation appears to be an effective treatment for segmental vitiligo in stable stage.

Objective To determine the optimal volume of plasma that should be used to perfuse through the portal vein (PV) to washout preservation fluid in retrograde reperfusion during liver transplantation.Methods The clinical data of S0 patients who underwent orthotopic liver transplantation (OLT) using retrograde reperfusion via the inferior vena cava (IVC) in our hospital from January 2011 to October 2013 were retrospectively analyzed.The patients were divided into two groups based on the volume of plasma infused via the PV to flush out the preservation fluid.Group 1:27 patients who received 400 ml,and Group 2:23 patients who received 1 200 ml.The preoperative and intraoperative data of the two groups were compared and analyzed.The serum concentrations of K+,Na+,Ca2+,mean arterial pressure (MAP) and pH were continuously monitored in the transplant recipients at different time points during liver transplantation.In addition,for patients in Group 2,the serum K +,Na + and Ca2 + concentrations in the samples of effluent fluid from the liver grafts were collected via the anastomotic stoma of the infrahepatic IVC and measured after infusion of 200 ml,400 ml,600 ml,800 ml,1 000 ml,or 1 200 ml of plasma.Results There were no significant differences in the preoperative and intraoperative data between the two groups.The plasma concentration of K + in Group 1 was significantly higher than that of Group 2 at 1 min after PV revascularization (T3) [(4.31 ± 0.54) mmol/L vs (3.96 ± 0.58) mmol/L,P ＜ 0.05],while the pH was significantly lower in Group 1 than that of in Group 2 (7.26 ± 0.02 vs 7.30 ± 0.04,P ＜ 0.05).The plasma Na + and Ca2 +concentrations,as well as the MAP,were not significantly different between the two groups at this time point.In group 2,no significant changes were observed in Ca2+ concentration in IVC blood following perfusion of 200 ml plasma.The insignificant changes in Na + after perfusion of 400 ml of plasma and for K + after 800 ml of plasma (P ＞ 0.05).Conclusions The electrolyte concentrations,blood pressure and arterial blood pH were fairly normal after resuming flow with PV revascularization after a perfusion volume of 800 ml of plasma.This volume was the most appropriate perfusion volume,balancing its effectiveness with economy to wash out any UW solution during OLT using retrograde reperfusion.

Somatostatin,a cyclopeptide hormone,is generally distributed in vivo.Some studies have indicated that somatostatin can reduce proinflammatory cytokine in hepatic stellate cells and extracellular matrix,and inhibit their proliferation and contraction,promote their apoptosis.It can also regulate the function of Kupffer cells,influence the homing of hepatic stem cells.Somatostain has therapeutic effect on liver fibrosis,especially on the liver fibrosis caused by schistosoma mansoni.

Objective　To investigate the activation of human T cells with superantigen SEA. Methods　T cells proliferation, IL-2 production, DNA synthesis, cell phenotype and apoptosis induced by the SEA in the first or restimulation were detected. Results　 It was shown that 100 ng/mL was the optimal activation concentration, IL-2 production arrived at top level in the third day, SEA activated CD4+ and CD8+T with the same degree, T cells start apoptosis in response to SEA restimulation within 24 hours and apoptosis disappeared through addition of rhIL-2. Conclusions　 There were correlation between activation and SEA concentration or stimulation period； SEA activated both CD4+ and CD8+T cells without change the cell phenotype.

Objective To define a suitable and adequate sample volume for the detection of bacterial contamination in cord blood (CB) via BacT/ALERT system. Methods A total of 1 376 cord blood units were routinely screened for aerobic and anaerobic microorganisms by culturing the erythrocyte fraction(EF) or plasma fraction(PF) with 20 ml and 10 ml sample volume. The microbial contamination was detected by BacT/ALERT 3D system, and the results of this method were compared with the improved Martin/thiogly collate broth(22 ℃) and thioglycollate broth(35 ℃).Results The rates of positive BacT/ALERT results were 1.16%(10 ml) and 1.24%(20 ml) for PF, and 3.20%(20 ml) for EF. The positive rate of Martin/thiogly collate broth(22 ℃/35 ℃) was 1.00% for EF. Conclusion Using BacT/ALERT system for microbial detection in cord blood bank can enhance the security of umbilical cord blood transplantation.

Objective To explore the influence of parenterai nutrition(PN) on nutritional status and immune function in breast cancer patients undergoing postoperative chemotherapy.Methods 94 patients with breast cancer postoperative patients were randomly divided into the treatment group(47 cases) and the control group(47 cases).All the patients were given chemotherapy with VBP.The treatment group was given glutamine fortified PN,and the control group was given normal nutrition support,respectively.The nutritional status and immune function before and after chemotherapy,and main toxicities were observed.Results Compared with those before chemotherapy,there were no significant decrease on the level of ALB,PA and HB in treatment group(all P ＞ 0.05),while those indicators in control group was significantly decreased (all P ＜ 0.05).After chemotherapy,CD4,CD8,CD4/CD8 and IgA,IgG,IgM levels of the two groups were lower than those before chemotherapy (all P ＜ 0.05),and the levels of immune indicators of the treatment group were significantly higher than those of the control group(all P ＜ 0.05).The main toxicities in two groups were nausea and vomiting,diarrhea and mild bone marrow suppression,and the body weight in control group decreased (0.91 ± 0.53)kg,while it increased (0.45 ± 0.21)kg in treatment group (t =5.53,P ＜0.05).Conclusion PN treatment for breast cancer patients during chemotherapy can improve nutrition status and immune function,enhance the tolerance of chemotherapy,so as to improve curative effect and prognosis.

As the base for the healthy development of civil medical equipment industry,the independent developing ability has attracted extensive attention.Firstly,medical equipment enterprises were divided into 5 modes according to their independent developing ability.Then the fuzzy evaluation method was utilized to evaluate them so as to correctly know the independent developing ability of medical equipment industry in our country.The evaluation shows that the brand value of the civil medical equipment is generally low.