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 ; Reconstructive Surgical Procedures ; adverse effects ; Surgery, Plastic

A questionnaire survey on awareness of child health management was conducted in 238 family members ( 236 were parents) of children aged 0 - 36 months; among whom 92 of children aged 0 to 6 months,85 of children aged 7 to 12 months,33 of children aged 13 to 18 months,16 of children aged 19 to 24 months and 12 of children aged 24 to 36 months.52.1％ of the surveyees had college education level.The awareness about medical examination in last half year in female subjects was higher than males ( P ＜ 0.05).There were no differences in other health management knowledge.The results showed that the average times of medical examination was 2.8 ± 1.9 in last half year; the age for supplement of meat in food was 7.4 ± 2.4 mouths; supplement of meat,animal liver and eggs was more than 7 time a week.The subjects with college education or above paid more attention to the children's growth,risk for rickets and anemia than other peoples.Pure breast feeding accounted for only 37.0％ (88/238).The study indicates that strengthening the knowledge and awareness is necessary to improve the children health management.

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.

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.

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.

To identify the stem cell islands in regenerated epidermis, the same biopsies used in our previous experiments were used in this study. CD87 immunohistochemicy and PAS staining were used. The scant CD87 positive cells could be found in basal membrane. Also, the positive staining of PAS could be seen in the basal membrane in both normal and regenerated epidermis. No CD87 positive cells were found in the spinous and granular layers. The results indicate that the error in metrology could be excluded from both CD87 immunohistochemicy and PAS staining, and that the stem cell islands may come from the cell reversion in regenerated epidermis.

To gain insight into the mechanisms of an age related difference in ability of wound healing, the characteristics of stem cell differentiation in skins from fetus, child and adult were investiga ted. Integrin ? 1 and keratin 19 (K19) were used as the biochemical markers for stem cells and transit amplifying cells. Biopsies were taken from fetus (22～24week gestational age), children (4～12year) and adults (35～53year). Immunohistochemistry was used. As for the immunostainings of fetal tissue sections, integrin ? 1 and K19 expressions were observed in all epidermal basal cells. In children skin, the ratio of integrin ? 1 and K19 positive cells in the epidermal basal layer was 60%～80%. In adults, the ratio in the epidermal layer decreased. These results indicate that fetal skin epidermis contains a large number of stem cells and transit amplifying cells, and the proportion of stem cells and transit amplifying cells decreases with age after birth, which maybe a reason of the age associated difference in ability of wound healing.

To investigate the effects of basic fibroblast growth factor (bFGF) on intracellular free Ca 2+ of heating injury, and observe the relationship between mitogen activated protein kinases(MAPKs)signal pathways and Ca 2+ mobilization. Cultured human fibroblasts were heated at 45?C for 10min, then divided into four groups :①basic fibroblast growth factor (10ng/ml) treatment; ②preincubated cells with PD98059 (10?mol/L) for 30 min followed by bFGF (10ng/ml); ③preincubated cells with SB203580 (10?mol/L) for 30min followed by bFGF (10ng/ml); ④preincubated cells with PD98059 (10?mol/L) and SB203580 (10?mol/L) for 30min followed by bFGF (10ng/ml). The cells were incubated with fluorescence Ca 2+ dye fluo 3/AM at 37 C for 30min, then measured by using laser scanning confocal microscope. The results showed fluorescent intensity of fibroblast heating injury was weak, the concentration of intracellular free Ca 2+ increased after stimulation with bFGF treatment. PD98059 and SB203580 could induce calcium oscillation. A rapid decrease of fluorescent intensity was observed after cells were preincubated with PD98059 and SB203580 at the same time. bFGF induced an increase of cytoplasmic and intracellular free Ca 2+ concentrations. It is suggested that MAPKs signaling pathway has a feedback regulation for free Ca 2+ mobilization.