Humans ; Reconstructive Surgical Procedures ; adverse effects ; Surgery, Plastic

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.

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.

Objective To investigate the inductive role of traumatic microenvironment in dedifferentiation of epidermal cells and explore the potential role of Wnt signaling pathway in this biological process. Methods The sheets of human foreskin were digested overnight after removal of adipose tissue, and then the epidermis was separated from the dermis. The separated epidermis sheets were repeatedly adhered to type Ⅳ collagen and flushed to remove the epidermal stem cells. The obtained epidermis sheets were transplanted onto the full-thickness skin wounds on the back of BALB/c nude mice, five days after which the cell lineage was evaluated by immunohistochemistry and the expressions of Wnts and downstream components in the grafted epidermal sheets examined by RT-PCR and Western blot. Results The cells in the basal layer of full-thickness epidermal sheets were positive for CK19 and β1 integrin and negative for CK10. While the cells in uhrathin epidermal sheets treated with type Ⅳ collagen were fully positive for CK10. Five days after transplantation of the ultrathin epidermal sheets, cells negative for CK10 but positive for CK19 and β1 integrin emerged at the wound-neighboring side of the skin grafts. At the same time, the expressions of Wnt-10b, Wnt-4 and Wnt-7a mRNA were increased by about 3.1-fold, 2.2-fold and 1.4-fold independently after transplantation. Furthermore, the expressions of β-catenin and β-catenin target genes (cyclin D1 and c-myc) were elevated by about 3-fold, 1.5-fold and 2-fold respectively in the grafted epidermal sheets (P < 0.01). Conclusion Traumatic microenvironment can induce epidermal cell dedifferentiation, when the Wnt/β -catenin signaling pathway may play an important role.

OBJECTIVE To explore the changes in foot fungus mobility and its drug resistance for further etiology investigation and clinical treatment. METHODS Sabourand′s agar culture medium was used to culture fungi, ID identification strip was employed to identify the fungi and drug sensitive test was performed by disk diffusion test. RESULTS The incidence of Trichophyton rubrum infection was the highest (79.1%). The isolated fungi were relatively sensitive to amphotericin B (AMB, 98.9%) and itraconazole (ITC, 98.0%), and resistant to 5-fluorocytosine (5-FC, 22.1%). CONCLUSIONS Detection technique of fungal infection should be improved and anti-fungal medicine should be used reasonably according to the results of drug sensitive test so that the fungal infection, especially fungi-resistant infection could be reduced.

OBJECTIVE To monitor the characteristics of distribution and drug resistance of Acinetobacter baumannii in our hospital. METHODS A. baumannii isolates were collected in our hospital from Jan 2004 to Dec 2005. Antimicrobial susceptibility testing was performed by disk-diffusion method,according to the standards of NCCLS 2004. RESULTS Totally 177 strains of A. baumannii were distributed clinically in the respiratory unit as the most ones (47 strains, 26.6%), and in ICU as the next (38 strains, 21.5%); the older the age, the higher the appearing rate; the highest appearing rate was from the sputum, up to 78.1%; more than 60% of isolates were resistant to all antimicrobial agents tested except imipenem, meropenem and cefoperazone/sulbactam. However,10 pan-resistant strains were found. CONCLUSIONS With the increasing isolation rate of A. baumannii, its drug resistance increases simultaneously.

OBJECTIVE To analyze pathogenic bacterium distribution and antibiotic resistance of our hospital,and provide scientific basis for clinical rational using of antibiotics.METHODS The patients′ clean catch(midstream)(urine) was collected from Jan 2004 to Dec 2005 and cultivated.Antibiotic sensitivity test and adopted by Kirby-Bauer method.RESULTS The pathogenic bacteria mainly consisted of Gram-negatives,among which Escherichia coli was the most frequent,the others in turn were Pseudomonas aeruginosa,Enterobacter cloacae and(Proteus) mirabilis;Enterococcus were the most common among Gram-positives;fungal infection obviously(increased).The bacteria showed different antibiotic resistance rate and multi-drug resistance.CONCLUSIONS It′s very important for making the clinical use of antibiotic more reasonable and controlling drug resistant strains(transmission).

OBJECTIVE To study the constituent ratio of the pathogenic fungi of blood culture in recent 24 months and their resistance in our hospital.METHODS Blood culture of patients in our hospital was performed by BacT/AlerT120 and the isolated pathogenic fungi were identified by API identified tests(API Inc,France).In(addition) antibiotics sensitivity test was by K-B.RESULTS Of the specimens in 4135 cases,there were 110 strains((2.7%)) with Candida albicans(29%).C.tropicalis(21%) and C.portugal(9%).The(specimens) come from(hepatobilliary)(25%),neurosurgery(24%) and emergency(10%) departments.CONCLUSIONS It is important and necessary to monitor the circumstance of fungal(infection) and resistance of the pathogenic fungi due to its(morbidity) increased.

OBJECTIVE To investigate the distribution and resistance of non-fermenting bacteria isolated from(patients) in 2005 and offer a basis for the treatment of bacterial infection.METHODS The isolated bacteria were(identified) with API identified test(API Inc,France) and Kirby-Bauer(K-B) test used for the antibiotics(susceptivity) test.The data were analyzed by using WHONET-5 software.RESULTS Totally 604 strains of non-fermenting bacteria were isolated from the 2908 pathogenic strains.The most common bacteria were Pseudomonas aeruginosa(52.32%),followed by Stenotrophomonas maltophilia(14.07%) and Acinetobacter baumannii((13.74%)).76.32% of non-fermenting bacteria were isolated from the sputum.These bacteria had various(resistances) to all detected antibiotics.CONCLUSIONS Non-fermenting bacteria have high isolation rate and(multi-drug) resistance,so antibiotics should be used correctly under the guidance of antibiotic susceptibility testing.