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.

Purpose To compare the distribution of 23 kinds of human papillomavirus ( HPV) genotypes in tissues of condyloma acu-minata ( CA) of cervix in 120 women and its clinical significance. Methods Polymerase chain reaction ( PCR) and gene-chips tech-nology were utilized for the detection of 23 kinds of HPV genotypes in tissue specimens from 120 cases of CA in cervix and related ma-terials of all subjects were conducted and analyzed. Results There were 115 positive cases in 120 women with CA in cervix and the rate of total HPV infection was 95. 83% (115/120). The rate of single type was 70. 83% (85/120) and multiple types was 25. 00%(30/120). The predominant type of single infection was HPV11 and the infective rate was 45. 00% (54/120), followed by HPV6 (22. 50%, 27/120). Otherwise, the predominant type of multiple infections was HPV6+11 with the infective rate of 20. 00% (6/30), and HPV11+16 infection accounted for 10. 00% (3/30). Conclusions HPV11, 6, 6+11 and 11+16 are the main genotypes in the pathogenesis of CA in cervix in 120 women. PCR and gene-chip technology can detect single and multiple HPV genotyping in tis-sues of CA in cervix with high sensitivity and specificity. Detection of HPV genotypes could be used to understand the prevalence situa-tion of HPV infection in tissues of CA and tumors of cervix and further to provide references for the research and development of HPV vaccine in women.

Objective To compare the application and clinical significance of the liquid based cytology examination and the DNA quantitative analysis in female cervical lesions.Methods The cervical cell samples were collected from 879 women participating in the comparison by the cervical brush and performed the the liquid-based thin layer section preparation for conducting Papanicolaou staining and DNA staining respectively.The liquid based cytology examination was performed on the Papanicolaou staining section and the fully automatic scanning diagnosis was performed on the DNA staining section.Results The cases of above atypical squa-mous cells of undetermined significance(ASCUS)detected by the liquid based cytology examination and the partial cases of hetero-ploid cell detected by the fully automated DNA ploidy analysis system were recommended to further perform colposcopy and cervi-cal biopsy.28 women were performed the pathological biopsy.With the cytological examination result as the standard,the detection rate of above ASCUS cervical lesions detected by the cellular DNA quantitative analysis was calculated.Conclusion The combined application of the cellular DNA quantitative analysis method and the liquid based cytology examination can obviously increase the positive detection rate of cervical cancer and precancerous lesion,which has important significance for the prevention and treatment of female cervical cancer in our country.

Objective To investigate the distribution of 39 kinds of human papillomavirus(HPV)infection genotypes in female cervical cells and its clinical significance.Methods 39 types of HPV DNA were extracted from 434 samples of female cervical cells. The gene amplification combined with the gene chip technique was adopted to detect 39 kinds of HPV genotype.And the clinical da-ta of the patients were analyzed.Results Among 434 samples of female cervical cell,175 cases were HPV positive,the total HPV infection rate was 40.32%(175/434).Among them,105 cases were the single type HPV infection with the positive detection rate of 24.19%(105/434)and 70 cases were the multiple types HPV infection with the positive detection rate of 16.13%(70/434).Among single type HPV infection,31 cases were the HPV18 infection with the positive detection rate of 17.71%(31/175),which was the main HPV infection type;followed by HPV16 in 12 cases with the positive detection rate of 6.86%(12/175)and HPV52 in 11 cases with the positive detection rate of 6.29%(11/175).Among the multi-type HPV infection,each 2 cases were HPV 6+54,HPV 18+52,HPV 51+68 infection respectively,each accounted for 2.86% of the multi-type HPV infection,which were the main infection types.Conclusion HPV 16,18,52 and HPV 6+54,HPV 18 +52 and HPV 51 +68 are the main HPV infection genotypes of fe-male cervical cells.The gene amplification combined with the gene chips technique is a method suitable for clinically conducting the HPV genotyping diagnosis and the molecular epidemiologic research of HPV infection.Along with the increase of detected HPV genotypes,the HPV infection rate is also increased,its genotypes combinations trend towards diversification.

Objective To compare the genotype distribution of HPV in cervical cells of natural crowd and tissues of cervical in‐traepithelial neoplasia(CINⅢ grade) and cervical carcinomas patients .Methods PCR and gene‐chip technology were utilized for the genotype detection of 23 kinds of HPV in cell specimens from 1 047 women of natural crowd (normal group) and tissue specimens from 173 cases of cervical intraepithelial neoplasia(precancerosis group) and 133 cases of patients with cervical carcinoma (cervical carcinoma group) .Results There were 109 ,159 and 121 cases of HPV positive specimens respectively in normal group ,precancer‐osis group and cervical carcinoma group ,and the HPV infection rates were 10 .41% (109/1 047) ,91 .91% (159/173) and 90 .98%(121/133) ,respectively .Conclusion PCR and gene‐chip technology can be used to detect HPV genotypes in cervical cells and cer‐vical tissues specimens .

Objective To compare the distribution situation of human papillomavirus(HPV)infective genotypes in normal cells and atypical squamous cells of undetermined significance(ASC-US)in uterine cervix and its clinical significance.Methods The pol-ymerase chain reaction(PCR)combined with the gene-chips technology were adopted to detect 23 kinds of HPV genotype from 1 000 cases of normal cells specimens and 229 cases of ASC-US specimens.Results 106 cases of HPV-positive infection were de-tected from 1 000 cases of normal cells with the total HPV infection rate of 10.60%(106/1 000),in which the single genotype in-fection rate was 9.30%(93/1 000)and the multiple genotypes infection rate was 1.30%(13/1 000);116 cases of HPV-positive in-fection were detected from 229 cases of cervial ASC-US specimens with the total HPV positive rate was 50.66% (116/229 ),in which the single genotype infection rate was 34.06%(78/229)and the multiple genotypes infection rate was 16.59%(38/229).The total HPV positive rates,single and multiple genotype infection had statistically significantly differences between the two groups(P<0.05).Conclusion The HPV types 16,18,33,42,43,52,58 are the predominant genotypes in normal cervical cells and ASC-US. PCR combined with the gene-chip technology can be used in the HPV genotype detect in cervical cells,conduces to perform the fur-ther distribution management on ASC-US and has the important significance to prevention and control of cervical cancer.

Objective To study the genotypes of human papillomavirus (HPV)infection in female anus and anal canal condylo-ma acuminata(CA)tissues and their clinical significance.Methods 23 kinds of HPV-DNA were extracted from the paraffin-embed-ded anus and anal canal tissue samples in 140 cases of female CA and detected by using PCR combined with the gene-chips tech-nique.Furthermore the related clinical pathological data of the patients were analyzed.Results Among 140 female anus and anal ca-nal CA tissue samples,103 cases were HPV positive and the total HPV infection rate was 73.57%(103/140).Among them,68 ca-ses were single type HPV infection,the positive detection rate was 48.57%(68/140)and 35 cases were multiple types HPV infec-tion,the positive detection rate was 25.00% (35/140).In single type HPV infection,34 cases were HPV11 and the positive detec-tion rate was 24.29% (34/140),HPV11 was the main infection type,followed by HPV 6 in 27 cases,its positive detection rate was 19.29%(27/140).In the multiple types HPV infection,13 cases were HPV 6 + 11,accounting for 37.14% (13/35 )of multiple types infection,followed by HPV11 +18 in 3 cases and HPV 6+11+16 in 3 cases,each accounting for 8.57%(3/35)of the multi-ple types infection.Conclusion HPV 6,11 ,6+11,11 +18 and 6+11+16 are the main infection genotypes in female anus and anal canal CA.PCR combined with the gene-chips technique is a diagnostic method more suitable for clinical development of HPV geno-typing detection,which has high sensitivity and good specificity and is especially suitable for the molecular epidemiology study of HPV infection.

Objective:Autoimmune mechanisms, including cellular and humoral immune, are likely to participate in the pathogenesis of at least a subgroup of idiopathic dilated cardiomyopathy(IDC), in which cellular immune-mediated one plays a more important role. Cytotoxic T lymphocyte associated antigen-4(CTLA-4) is the major negative regulatory factor of cellular immunity. This study was conducted to investigate the association of CTLA-4 gene promoter -318C/T polymorphism, exon 1 A/G polymorphism and 3′ untranslated region microsatellite polymorphism with susceptibility to IDC in Han Chinese.Methods:Polymerase chain reaction-restriction fragment length polymorphisms(PCR-RFLP) techniques were used to analyze the polymorphisms of CTLA-4 promoter -318, exon 1 A/G and 3′ untranslated region in the unrelated Han ethnic population in Heilongjiang Province(including 72 IDC patients and 100 normal controls). Serum sCTLA-4 was tested by ELISA. The relationship of CTLA-4 genotype and alleles frequencies with sCTLA-4 was evaluated by linear regression analysis.Results:Compared with controls, the frequencies of GG genotype(0.604 2 and 0.739 6, P=0.012) and the G allele(0.360 0 and 0.560 0, P=0.008) were significantly increased in patients with IDC. Increased serum sCTLA-4 was found in the IDC group compared with the controls[(1.87?1.06)?g/L vs (0.54?0.19)?g/L, P