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 methylation status and mRNA expression of the estrogen receptors(ERs) gene promoter in acute leukemic patients and detect the protein expression in leukemia cell lines with or without treatment of 5'-aza-Dc.And to find out the possibility of promoters methylation profile of estrogen receptor gene as an early diagnosis biomarker in leukemia.METHODS With RT-PCR and MSP,evaluating ERs mRNA expression and status of methylation in 40 acute leukemia patients without treatment.With Western-blot,detecting protein expression in leukemic cell lines with or without treatment of 5-azaDc.RESULTS The protein expression was significantly enhanced in all of leukemic cell lines with 5'-Aza-Dc.ER?-A was inactivated and specifically methylated(97.5%;39/40) in most of the acute leukemic patients.CONCLUSIONS The promoter ER?-A is inactivated and specifically methylated(97.5%;39/40) in most of the acute leukemic patients.This study may provide a new direction method to study the pathogenic mechanism of leukemia,and indicates that ER?-A methylation could be a potential reference marker for leukemia diagnosis.

OBJECTIVE To investigate the epidemiology of fungemia and provide evidence for clinical therapy.METHODS A retrospective survey was done with the 69 cases of fungemia in our hospital from Jan 2004 to Dec 2008.RESULTS More than 65% of the patients suffered from two and more underlying diseases.Over a half of infections were developed following placement of catheters.And all of the patients had a history of antimicrobial agents use before blood culture.53(76.8%) cases were associated with Candida spp.Only 18 strains were C.albicans.The mortality rate of fungemia was 44.9%.Different Candida species had different resistance rates to antifungal agents.CONCLUSIONS Fungemia patients often have serious underlying diseases.Most fungemia cases are candidemia caused by non-C.albicans.Some fungal pathogens are resistant to fluconazole and itraconazole.

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 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.

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.