中文摘要：

目的：观察移植超薄表皮片中成熟表皮细胞的分化及分布状态，以及其向表皮干细胞逆分化现象在创面修复过程中的存在。 方法：采用荧光标记和免疫组织化学方法，检测解放军空军总医院2004-11／2005-05经环切术切取的成人的包皮12例，用中性蛋白酶消化获得表皮片，反复冲洗使基底层干细胞脱落。在一部分行苏木精-伊红、免疫组织化学染色的同时，另一部分皮片用DAPI标记后移植于由北京协和动物中心提供的12只裸鼠全层皮肤缺损的创面，于第4和7天取材制作冰冻切片，行免疫组化染色，荧光显微镜观察创面修复过程中表皮细胞角蛋白19、角蛋白14、角蛋白10的分布情况与表达特征。 结果：①苏木精-伊红染色可见未标记移植的表皮片示有正常的层次结构，但标记移植的皮片组织学观察显示细胞层次有松弛、紊乱的迹象。②免疫组化染色及荧光显微镜示未标记移植前的皮片颗粒层以下几乎未见角蛋白19阳性细胞而有少量角蛋白14阳性细胞和大量角蛋白10阳性细胞，而标记移植的皮片有孤立成团同时发蓝-红双荧光的角蛋白19阳性细胞，且角蛋白14阳性细胞明显增多。③这些现象在移植后的第4天最为显著。 结论：在超薄表皮片移植中显示有成熟表皮细胞向表皮干细胞方向的逆分化，起到了维持皮片活力和参与创面修复的作用。

英文摘要：

AIM： To observe the differentiation and distribution of mature epidermis cells in the super-thin epidermal graft, and confirm the existence of dedifferentiation towards epidermis stem cell during the wound repair process. METHODS： The fluorescence labeling and immunohistochemical methods were used to detect the 12 human circumcised foreskins in the General Hospital of Air Force of Chinese PLA between November 2004 and May 2005. The epidermis sections were obtained by being digested with neutral protease and washed repeatedly to exfoliate the stem cells of basal layer. Then they were divided into two groups： one was used for hematoxylineosin （HE） staining and immunohistocbemical staining, the other labeled with DAP1 was grafted to the wound of cutaneous deficiency in 12 nude mice provided by Beijing Union Animal Center. And then the frozen sections were obtained on the 4^th and 7^th day and stained with immunohistochemical methods. The expression characteristics and distribution of epidermis cytokeratin （CK） 19, CK14 and CK10 were observed under the fluorescence microscope. RESULTS： ①The grafted epidermis skins before labeling demonstrated normal hierarchical structure by HE, while the loosened and disordered stratification was found in the labeled skin grafts by histology observation. ②The results of the fluorescence microscope and immunohistocbemical staining showed, mass positive CK10 cells and some positive CK14 cells were found below the granular layer of skin grafts without any positive CK19 cells before labeling. While in the labeled skin grafts, there were some positive CK19 cells, which presented isolated cluster and double fluorescence of blue and red, and positive CK14 cells were remarkably increased. ③The above phenomena were the most significant on day 4 after grafting. CONCLUSION： The mature epidermal cells in the super-thin grafts dedifferentiate towards stem cells, which can maintain the activity of skin grafts and participate in the wound repair process.