Tryptophan is the essential amino acid in the growth of cell.Indoleamine 2,3-dioxygenase is the rate-limiting enzyme in the catabolism of tryptophan along the kynurenine pathway.Indoleamine 2,3-dioxygenase enzyme mainly promotes tryptophan consumption of local micro-environment,causing tryptophan lack,thus inhibiting proliferation and activation of T cell.Tryptophan-derived catabolites suppress allogeneic T-cell proliferation (kynurenine,3-hydroxykynurenine,and 3-hydroxyanthranilate).Indoleamine 2,3-dioxygenase dendritic cells may interact with regulatory T cells forming an immunomodulatory network to promote immune tolerance induction.Though the immune regulation mechanism of the indoleamine 2,3-dioxygenase-initiated L-tryptophan in transplantation remains unclear,Numerous researches indicate that its role of tolerance induction in transplantation will be significant.

Papillary thyroid cancer (PTC) is the most common malignant neoplasm originating from the thyroid gland and has an excellent prognosis.But cervical lymph node metastases are common and the most common sites of metastases are the central lymph nodes of the neck (level Ⅵ).While therapeutic central lymph node dissection for involved lymph nodes is needed in our nation and others,the controversial topic is whether routine prophylactic central lymph node dissection in patients without evidence of lymph node metastasis should be performed in patients with PTC.The author reviewed the research development of prophylactic central lymph node dissection for papillary thyroid cancer in the article.

Ki-67 is a common proliferation marker,especially used to reflect the proliferation activity of malignancy cells.Recently this marker has been widely studied among early breast cancer patients,However,to date,whether include Ki67 in the list of required routine biological markers there is still a hot argument.This review mainly explores and summarizes the prognostic and predictive role of this marker in breast cancer,the clinical value of the combination of Ki-67 and other makers,and the problems lie in the application of Ki-67 in clinical practice.

Tryptophan 2,3-dioxygenase (TDO)is the rate-limiting enzyme in the catabolism of Trp along the kynurenine pathway.Trp is mainly catabilized by the TDO in the liver,which could not only regulate the concentration of the Trp and suppress the T cells proliferation,but also participate in antibacterial action and inflammatory response.The metabolin kynurenines as an endogenous ligand of the AhR receptor,the TDO enzymes,Kyn and AhR form the TDO-Kyn-AhR pathway have effects of regulatory the growth of tumor.With the research of the mechanism of immune regulation goes futher,it is expected to be a promising prospect in cancer therapy and the immune tolerance of transplantation.We reviewed in the article,which summarized the TDO mediated catabolism of Trp and immunomodulatory effect.

Alopeeia areata (AA) has been well recognized with familial tendencies, but the genetic basis of this clinical observation remains unknown. The cytokine interleukin-1 receptor antagonist (ILlra) is a potent anti-inflammatory protein that can prevent immune-mediated inflammatory response in the skin. We characterized a polymorphism within the gene for this cytokine ILlra in this study and tested the gene as a possible marker in patients with alopecia areata. We have determined allele frequencies of the polymorphic cytokine genes in a control population and a group of 72 patients with alopecia areata. The frequency of allele 2 of interleukin-1 receptor antagonist in patients with AA was significantly higher than that of control group. It suggests that interleukin-1 receptor antagonist gene may be a candidate gene or severity factor for alopecia areata.

In order to observe the therapeutic effect of azithromycin combined with IFN-γ on mouse toxoplasmosis and its impact on the cellular immune function of mouse, a total of 100 BALB/c mice were selected and divided into 5 groups, namely an infection control group (Group A) , azithromycin treatment group (Group B) , azithromycin combined with IFN-γ treatment group (Group C) , IFN-γ treatment group (Group D) and blank control group (Group E). The mice in Group A, B, C, D were infected by Toxoplasma tachyzoites through intraperitoneal injection and those in Group B, C, D were treated with relative drugs 24 h later for S days. The survival time of mice in each group and the levels of CD4 ~+ and CD8~+ T cells in blood were observed. The results showed that azithromycin combined with IFN-γ could improve the therapeutic effect of mouse toxoplasmosis and the cellular immune function of mice.

Objective To determine chlamydia pneumoniae(Cpn) DNA and inclusion bodies in peripheral blood mononuclear cell(PBMC) of coronary heart disease.Methods The PBMC were isolated by low permeate hemolysis method.The presence of Cpn-DNA and inclusion bodies were determined by nest-PCR and directed immunofluorescence(DIF) in 150 cases with CHD and 55 non CHD(control group,CG).Results Cpn DNA positive rates were 32.7%(49/150) in CHD and 1.8%(1/55) in CG,simultaneity inclusion bodies were detected 13.3%(20/150) in CHD and 1.8%(1/55) in CG.The positivity rates of Cpn-DNA and inclusion bodies in CHD groups were significantly higher than those in control group.Conclusion Chlamydia pneumoniae DNA and inclusion bodies are present in PBMC among the significant proportion of CHD patients.PBMC sample can be collected easily and trustworthily.

Aim To investigate the function of fenofi-brate on PAN ( puromycin aminonucleoside )-induced podocyte injury. Methods SD female rats of 18-week-old were randomly assigned into 3 groups ( n =6 ) . Mice in PAN group and fenofibrate treated group received a single intravenous injection of PAN ( 65 mg ·kg-1 ) , while those in control group received equal volume of saline. Mice in fenofibrate treated group re-ceived 40 mg · kg-1 · d-1 of fenofibrate ( intragastric administration ) on day 1 after PAN injection , while those in PAN group and control group received equal volume of vehicle. 24 hours urine samples from all group were collected on day 0(1 day before PAN injec-tion), day 6, day 10. The 24 hours urine protein was detected by Bradford assay. All the rats were sacrificed 10 days after the induction of podocyte injury, and glo-merulus sample were collected. The expression of podocyte injury marker and transcription level in apop-tosis, podocyte cytoskeleton protein, slit diaphragm protein were evaluated by Western blot and real-time PCR. Results Compared with the control group, 10 days after injection of PAN, 24 hours urine protein was obviously increased, and the expression and transcrip-tion level of podocyte injury marker desmin, apoptosis, podocyte cytoskeleton protein, slit diaphragm protein were upregulated greatly, however, those were signifi-cantly lower in fenofibrate treated group as compared with those in PAN group. Conclusions PPAR-α ago-nist fenofibrate can ameliorate PAN-induced glomerulus podocyte injury, and the mechanism involved may be associated with inhibition of the mitochondria apopto-sis, TGF-β/Smad pathway and p38 pathway.

Objective To study the effect of antivirus therapy of HBV reinfection and YMDD mutation after liver transplantation. Methods Fifteen of 317 patients with HBV-related end-stage liver diseases received lamivudine ( LAM ) monothereapy, others received combination low-dose hepatitis B immune globulin( HBIG) and LAM (or adefovir dipivoxil, ADV) therapy, as prophylaxis against HBV reinfection after OLT. Hepatitis serum markers, HBsAg, HBeAg, HBcAb-IgM, and HBcAg were detected every 2 weeks by immunohistochemistry. Serum HBV DNA was examined by PCR every 2 weeks. HBsAg and HBcAg in the liver specimens were examined by immunohistochemistry. YMDD mutation was detected by PCR in those patients with recurrence of positive HBV DNA posttransplantation. Results In LAM monotherapy group, 4 developed HBV reinfection out of 15 patients with pretreatment positve HBV DNA. Sixteen of 302 patients with combination HBIG and LAM therapy suffered from posttransplant HBV reinfection, the difference between the two groups was significant (26.7% vs. 5. 30% ,P

Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation(SKPT) with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine(PE).Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage.The clinical data,operative techbuque,and the prevention of non-technical complications were summarized.Results This procedure was successfully applied in the 5 patients.Three patients recovered excellently;but 2 died perioperatively,one died of sepsis due to pancreatic leakage,and one of FK506 toxicity.On postoperative day 3,in the 3 survivors,blood creatinine and urea nitrogen levels returned to normal;insulin administration was discontinued on 7d postoperatively,and the endogenous and exogenous secretory functions of the graft were normal.Conclusions SKPT with PE is a resonable procedure,because of its potential physiologic,metabolic,and immunologic advantages.PE drainage may become the prefer technique of pancreas transplantation.Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.