The scar formation and chronic ulcer development are the iain sequelae faced by surgeons in the treatmemt of wounds. Therefore,the prevention and treatment of these sequelae are the main tasks for clinicians.In this paper,the current research concerning both sequelae is reviewed.The authors emphasize that the use of some high technologiesl, such as stem cell technology, clone technology and tissue engineering may bring the hope in improving the treatment and prevention of these sequelae.

Objective To discuss the clinical effect and safety on rosiglitazone applied to patients with early type 2 diabetic nephropathy.Methods Ninety-six patients with early type 2 diabetic nephropathy were divided into the control group(n=48) and the research group (n =48).The patients of the control group were given mefformin treatment, while of research group were given rosiglitazone, both the courses were three months.The urinary albumin excretion rate (UAER), 24 h urine trace albumin (UAE), serum creatinine clearance (SCr) , fasting plasma glucose (FPG), postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA 1 c), triglycerides (TG), cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) before and after treatment and clinical effect between the two groups were compared.Results The HbA1c, FPG, 2 hPG, UAER, UAE, TC, TG of after treatment of all patients decreased obviously,while the HDL-C level increased remarkably, and compared with control group the differences were significant (HbA1 c: (7.32±0.84)％ vs (7.56±0.98)％, FPG: (8.02± 1.42) mmol/L vs (8.16± 1.54) mmol/L, 2 hPG: (11.54±2.11) mmol/L vs (12.02±1.97) mmol/L,UAER: (67.34±6.45) mg/24 h vs (52.56±5.35) mg/24 h,UAE: (108.64±22.64) mg/d vs (68.84± 11.43) mg/d, TC : (5.44± 0.72) mmol/L vs (4.76± 0.51) mmol/L, TG: (2.04± 0.53) mmol/L) vs (1.73±0.46) mmol/L);t =-4.172,-3.973,-4.026,-4.263,-6.634,-5.737,-5.635, -4.735,-4.633;P＜O.05).While there were no statistical significance about SCr before and after treatment(P ＞0.05).The total clinical effect of the research group was obviously higher than that of the control group (87.5％ (42/48) vs 66.7％ (32/48), x2 =5.363,P =0.035).There were not obvious adverse reaction occurred during treatment for all patients.Conclusion Rosiglitazone can effectively reduce the blood glucose in patients with early type 2 diabetic nephropathy and reduce urinary protein excretion, the effect is more obvious than that of metformin.

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.

Background The loss of perspiration after a massive deep burn hampers the survivor to lead a life of high quality, as they are deprived the function of regulating body temperature through perspiration during sultry months. With maturation of science of burn care, the number of survivors is increased, therefore, it is imperative that this problem should be tackled in order to improve their quality of life. Objective To explore the possibility of transdifferentiating bone marrow mesenchymal stem cells (MSCs) into sweat gland cells (SGCs), and implanting the latter into fresh skin wound to generate functional sweat glands. Methods Human bone marrow MSCs and SGCs were isolated from the same patients. They were identified with specific markers, and then co-cultured. The stem cells which subsequently exhibited the phenotype of sweat gland cells were implanted into scald injured paws of nude mice, and regeneration of functioning sweat glands was confirmed by perspiration test (iodine and starch) and histological examination. A male patient bearing almost iden- tical burn scars on the posterior aspect of both arms was enrolled for clinical trial. The scars were first proved to be anhydrotic with iodine and starch test. With patient's written consent, the clinical trial was carried out. Bone marrow MSCs and sweat gland cells were obtained from the patient. After being heat shocked, the SGCs were co-cultured with MSCs. Three days later, the scars of both arms were excised. MSCs having acquired the phenotype of sweat gland cells after co-culture were evenly spread onto the excision wound on the right arm. They were covered with a piece of acellular allogeneic dermis, which was perforated with numerous micropores. On top of the latter, micrografts of autologous origin were transplanted, and the wound was finally covered with a piece of allogeneic skin graft. The wound on the left side was similarly covered, but without transdifferentiated MSCs. After complete healing of the wounds, perspiration test with iodine and starch was performed, and biopsy was taken from the MSCs transplanted area. The components of the sweat collected from the implantation area were analyzed and compared with that from normal skin elsewhere on the body. The same procedure was performed in a girl patient with a chin-neck contracture. The scar was totally excised, and into one third of the excision wound in vitro transdifferentiated MSCs were implanted similar to the above patient. The examinations were repeated after wound healed. Results In the animal experiment, it was shown that there was regeneration of functional sweat glands in the burned paws of the nude mice. In human patients, all wounds healed nicely. The areas where transdifferented MSCs were implanted showed positive iodine-starch perspiration test. Histological and immunohistochemical examination confirmed that the transformed MSCs bore the specific marker carcinoembryonic antigen (CEA) of sweat gland cells. Biochemical analysis of the excreted sweat contained similar components as that of sweat collected from normal skin. Conclusions MSCs can be transdifferentiated into SGCs in vitro, and they can be implanted into a fresh wound to form functional sweat glands. However, enormous amount of work should be done before the same result would be realized in patients with massive deep burn within a short duration after the injury, so that the patients could regain the function of perspiration after surviving the massive loss of normal skin.

Wound repair is a complex biological process and great progresses have been achieved during the last ten years because of the integration of molecular biology and traumatology. However, some fundamental principles in these fields, which are closely related to developmental biology and comparative biology have not been fully understood. Therefore, more attention should be paid to the incorporation basic knoweldge with technology of developmental biology and comparative biology in the research of wound repair before better understanding and new discoveries are achieved in this field.

The cytokine-receptor- heparin sulfate functional complex combined by cytokines, cytokine receptors, and heparin sulfate chains formed by concatenation of heparin sulfate proteoglycans (HSPG), an important component of extracellular matrix and modified by some relative enzymes, can regulate the density of cytokine receptors and their intracellular signal transduction. This article focused on the regulatory function of this complex. Many morphological abnormalities and diseases occur when the complex is dysfunctional.

Angiopoietin family is a recently discovered type of cellular factors that specifically bind to the TIE-2 receptors located exclusively in endothelial cell membrane. The protein structures of this family members are similar. They can be structurally divided into three domains: an N-terminal region lacking homology to any known structures, an alpha-helical rich coiled-coil segment, and a fibrinogen-like domain. The distribution and biological activity of these factors are different in organism. Angiopoietin-1 as a agonist, mostly locates in close proximity with vascular endothelial cells, keeps the stability of blood vessels, enhances the affinity of vascular endothelial cells with surrounding cells and matrix, decreases the leakage of vessel. Ang-2 is a naturally occurring antagonist of Ang-1, exists in the angiogenic remodeling region and is related to the decrement of the stability of vessel. Ang-3 is widely distributed in multiple mouse tissues, while Ang-4 is expressed only in lung. Although Ang-3 and Ang-4 are structurally diverged from each other, they appear to represent the mouse and human counterparts of the same gene locus. Biological functions of Ang-3 and Ang-4 have not been elucidated yet. Angiopoietin family has potentially clinical applications for incurring illnesses which lead to vessel wound and vascular abnormal development.

The basic concept of gene therapy is to introduce a therapeutic gene into a cell, whose expression can improve to healing of wound. To achieve this goal, the suitable therapeutic gene has been selected and delivered into the reparative cell, which is becoming a focal point works about gene therapy in wound healing. There have been several different therapeutic genes and gene transfer strategies that have been used in models of wound healing. This article discusses several methods that have been used to deliver genes encoding growth factor proteins, stem cells into wounds and the advantages/disadvantages of each approach. We hope a safe vectors system to deliver the effectual transgene in wound healing.

〔Abstract〕 The paper analyzes problems existing in the traditional outpatient diagnosing distribution process of hospitals , redesigns and optimizes the triage process .It designs a unified diagnosing distribution system , introduces the advantages , system composition , queuing rules and treatment priority strategies of the optimized process , and illustrates the application effects of the diagnosing distribution system with the outpatient of obstetrics and gynecology department of a large grade -III level-a hospital as an example .

To explore the activities of signal transduction pathway involved in heat-stressed fibroblast in vitro. Human dermal fibroblasts were cultured in Dulbecco′s modified Eagle′s medium with 5% calf serum at 5%CO 2 in a water-saturated atmosphere. Cultured cells were heated to 45℃ for 10min. Western blotting was used to detect ERK1/2 and JNK expression, and the expression of caspase-3 protein was observed by immunoflurescence technique. The results showed that the MAPKs signal transduction pathway was activated in heat-stressed fibroblasts. The expression of JNK reached the peak at 60min, then maintained up to 180min. The expression of ERKs peaked at 30min, then lowered. The expression of caspase-3 was weak at 30min after heat-stress, and became evidently strong at 60min. The signal pathway of ERKs and JNK played important roles in the changes in biologic characteristics of fibroblasts after heat-stress.