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.

Humans ; Otitis Media ; microbiology ; Tuberculosis

Adenocarcinoma, Clear Cell ; pathology ; Adult ; Female ; Humans ; Thyroid Neoplasms ; pathology

Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)complicating anterior cervical surgery.Methods1052patients were performed anterior cervical surgery between October1997and October2002.Of 1052cases,926cases were of cervical spondylotic myelopathy(CSM),and126of ossification of posterior longitudinal ligament (OPLL).11patients suffered from cerebrospinal fluid leakage during operation.There were8males and3females aging from46to72years(average,58years).In the group of CSM,there were2cases of CSFL(0.22%)occurred in resection of osteophyte of the posterior vertebral edge,who were serious CSM of C 4,5 and C 5,6 with severe anterior compression by osseous mass to spinal cord showed on MRI.In the group of OPLL,there were9cases of CSFL(7.14%)occurred in resection of the ossified posterior longitudinal ligament accompanied with severe spinal canal stenosis and anterior compression to spinal cord on radiological imagings,4of them were con-tinuous OPLL from C 2 to C 6 combined with herniation of cervical disc,3segmental,and2mixed.Results The defect area of spinal dura were(0.6～2.0)cm?(1.0～1.5)cm.The cerebrospinal fluid was blocked with fascia and absorbable gelatin sponge during the operation.If CSFL was persistent more than3days after oper-ation,expectant treatment was performed.After the operation,no CSFL occurred in8of 11patients,and the other3cases with postoperative CSFL were cured5,14and17days by dressing change,blocking the wound with gelatin sponge,and suturing of the wound respectively.All patients were followed up for 10to62months(mean,26months).No cerebrospinal fluid cyst and infection occurred.There were no significant negative effects of CSFL on the recovery of neuromuscular function.Conclusion CSFL following cervical anterior surgery can be cured by blocking up leakage of spinal dura during operation,however,conventional conservative treatment including of dressing change,antibiotics administration,horizontal position with low pillow are necessary after operation.

Bone Diseases ; Diagnosis, Differential ; Femur Head Necrosis ; Humans ; Medicine, Chinese Traditional ; methods ; Osteoporosis

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.

Accidents, Occupational ; Adult ; Female ; Hexanes ; poisoning ; Humans ; Male ; Occupational Diseases ; chemically induced ; diagnosis ; Shoes

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.