Objective To evaluate the feasibility of upper limb lymph node conservation in axillary lymph node dissection(ALND)for early breast cancer patients.Methods This study involved 52 patients.Before ALND,they were,injected 5 ml of methylene blue subcutaneouly in ipsilateral upper limb for upper limb lymphatic mapping.Level II lymph nodes and upper limb lymph nodes were respectively separated from axillary lymph nodes during operation.Level II lymph nodes were given intraoperative imprint cytology and frozen section.All lymph nodes were given routine pathological examination after operation.Results Of the 52 patients,50 cases showed blue stained lymphatic vessels or lymph nodes in the axillary region.The rate of blue dye under naked eyes was 96.2%(50/52).The postoperative pathological examination showed there were 31 cases of axillary lymph nodes metastasis in patients with blue stained lymph nodes.There was 1 case with metastasis to level II lymph nodes only(2.0%)and 30 cases with metastasis to level I lymph nodes(60.0%).There were 10 cases with metastasis to both level II and level I lymph nodes(22.0%).There were 3 cases with metastasis to both level II and upper limb lymph nodes.3 patients with metastasis to upper limb lymph nodes all had metastasis to level II lymph nodes.For cases with metastasis to level I lymph nodes only,pathological examination showed there was no metastasis to the blue stained lymph nodes removed from the axillary region.For the ll cases with metastasis to level II lymph nodes,8 cases were successfully detected by intraoperative imprint cytology,9 cases were detected by frozen section and 10 were detected by the combination of imprint cytology and frozen section.Comparing the combining method(intraoperative imprint cytology and frozen section)and postoperative routine pathological examination,the concordant rate was 98.0%(49/50).Conclusions Subcutaneous methylene blue injection in ipsilateral upper limb call effectively map lymph nodes of upper limb in the axillary region.The upper limb lymph-node-conserving surgery in ALND can be performed if the patients don't have level II lymph node metastasis identified by intraop erative rapid pathological examination.

AIM: To determine the combined effect of transmuscle laser revascularization (TMR) and endothelial progenitor cells(EPCs) treatment on ischemic hindlimb of nude rats.METHODS: Mononuclear cells (MNCs) isolated from human umbilical cord-blood (HUCB) by density gradient centrifugation were expanded in vitro. Immunocytochemistry and flow cytometry studies were performed. EPCs were labeled with 1, 1'- dioctadecyl-1 to 3, 3, 3', 3'- tetramethyl-indocarbocyanine perchlorate (DiI) before injected into the laser induced channels or ischemic region. Acute ischemic limb was created in 4 groups of nude rats by ligating right external iliac artery. All animals were divided randomly into the following four groups: TMR+EPCs group: local transplantation of EPCs into laser channels; TMR group: transmuscular channels were created without EPCs; EPCs group: EPCs were injected into ischemic hindlimb; control group: ischemic model without TMR or EPCs. All rats underwent femoral artery ultrasonic blood flow measurements of the ischemic and nonischemic limbs to obtained a flow ratio [femoral artery flow index (FAFI): right femoral artery flow /left femoral artery flow] at baseline (after ligating artery immediately) and 28 days postoperation, and then the samples of ischemic limb muscle underwent histochemical and immunohistologic analysis. RESULTS: The attached cells expressed endothelial cell (ECs) markers (KDR, CD34, CD31, AC133 and von Willebrand factor) and exhibited function similar to that of ECs judged by Ac-LDL incorporation. Flow cytometric analysis disclosed that AT cells were positive for CD34 (62%?7%) and AC133 (57.2%?9.8%) at day 7 of culture. 28 days after therapy, FAFI was significantly higher in the TMR +EPCs (0.66?0.09, P0.05). FAFI in the control group was unchanged and no difference was found between TMR group and control group. TMR+EPCs (5.66?0.77), TMR (4.96?0.31) as well as EPCs (4.68?0.44) treatment resulted in an increased number of capillaries in the treated regional area compared with control group (2.60?0.31, P

Objective: The genetic characteristics of the human adenovirus type 53 (HAdV-53) strains isolated from Taiyuan city of Shanxi Province were studied to obtain the baseline data of their molecular characteristics. Methods: Conjunctival swabs (n=79) were collected from epidemic keratoconjunctivitis (EKC) patients in Shanxi eye Hospital in 2016, and five HAdV-53 strains were obtained after virus isolation and identification based on the three major capsid genes sequences including Penton base, Hexon and Fiber gene. And the corresponding sequences of global epidemic HAdV-53 strains and the strains with the same genetic origin as HAdV-53 were also downloaded from GenBank database, and then the three gene database were established, respectively. With the database, phylogenetic tree was constructed, and the genetic and molecular evolutionary characteristics were analyzed with bioinformatics software. Results: Five HAdV-53 strains in Shanxi Province in 2016 showed high consistency with the HAdV-53 strains prevalent in other countries in 1996-2014 (>99.8%). All HAdV-53 strains were in the same evolutionary branch with their recombinant source genotypes (HAdV-37 and HAdV-8) in Penton base and Fiber gene, respectively, and maintained a high degree of consistency in gene sequences. In Hexon gene, HAdV-53 strains were more closed to its recombinant source genotype HAdV-22, the nucleotide and amino acid sequences between two types were highly homologous, while HAdV-53 and HAdV-22 belonged to different evolutionary branches, and the evolution rate of HAdV-53 based on Hexon gene was 3.51×10^-5 substitution/site/year. Conclusion HAdV-53 has become an important new ocular infectious pathogen of Taiyuan. HAdV-53 strain are relatively conservative and stable based on Penton base, Hexon, and Fiber gene.