抗肥厚性瘢痕外用中药涂膜剂的研制

瘢痕的表层细胞十分单薄,仅数层表皮细胞,其下具有丰富的毛细血管网和肥厚的胶原纤维层,因而通过外敷和外涂膜剂,可有效地使药物进入瘢痕组织内.外用剂型也可持续缓慢释放药物,以达到缓释长效地局部高浓度作用瘢痕组织细胞和胶原纤维.     

孕8^＋月 瘢痕子宫破裂误诊为急性胃肠炎1例

子宫破裂（rupture of uterus）是指在分娩期或妊娠晚期子宫体部或子宫下段发生破裂,是产科极为严重的并发症,若未及时诊治可导致胎儿和产妇死亡。子宫破裂多发生于分娩期,为逐渐发展期,多数分为先兆子宫破裂和子宫破裂两个阶段。     

Clinical Analysis of 45 Cases of Caesarean Scar Pregnancy

Objective To summarize the clinical characteristics of caesarean scar pregnancy and to investigate its treatment.
Methods Clinical case records of 45 cases of caesarean scar pregnancy from June 2003 to September 2007 were reviewed. The characteristics and management of cases were analyzed.
Results The women＇s average age was 32.8 ± 5.1 years. All cases had amenorrhoea, and 27 cases had vaginal bleeding from spotting to morderate. Seven cases were misdiagnosed as normal early intrauterine pregnancy or inevitable miscarriage before dilation and curettage（D ＆ C）. In case of massive bleeding, caesarean scar pregnancy was diagnosed after D ＆ C. Bleeding was controlled and uterus was conserved in 6 cases, and 1 case underwent hysterectomy because of uncontrollable bleeding. The remaining 38 cases had ultrasound scan, which indicated scar pregnancy before primary treatment, Eight cases were primarily treated with dilation and curettage, in which only 2 cases had slight bleeding in the operation and no further treatment, Nineteen cases were primarily treated with dilation and curettage after uterine artery embolization, in which 17 cases needed no further treatment and had no complications. The success rate was 89.4% （17/19）. Eleven cases were primarily treated with trichosanthin 1.2 mg intramuscular. No one encountered massive bleeding, but 7 cases of these 11 cases needed extra treatment.
Conclusion Caesarean scar pregnancy must be cautious of especially in cases of inevitable miscarriage. Dilation and curettage followed uterine artery embolization can be used as the primary treatment for caesarean scar pregnancy.     

Plastic surgery

Anatomic study of intramuscular nerve and blood vessel in forearm muscles： an anatomical study; The relationship between RUNX3 gene mutation and keloid; Constructing of smooth muscle layers of tissue engineered blood vessel in a hioreactor;tal research of correlation between anatomy structure of rabbit ear and creating hypertrophic sear animal model; A new model of skin avulsion injuries in rats……     

多普勒超声诊断6例子宫瘢痕部位妊娠

目的探讨多普勒超声对瘢痕子宫妊娠的诊断。方法对6例瘢痕子宫妊娠患者,采用治疗前、后声像图的特征分析及多普勒实时探测。结果3例超声提示宫体下段前壁处不均质低回声团,余3例超声提示子宫下段前壁切口处探及胚芽及原始心管搏动声像图均表现为子宫体下段不均质稍低回声区,CDFI显示异常丰富血流信号,RI为0.30-0.68。结论多普勒超声能无创简便地诊断瘢痕子宫妊娠并判断治疗效果。     

瘢痕子宫中期妊娠引产胎盘部分植入2例

1病例报告 例1：女，37岁。孕4次，剖宫产2次，人流1次，1990年足月妊娠剖宫产1女，1992年再次足月妊娠剖宫产1男，均健康。第2次剖宫产同时行结扎术，几年前因结扎失败早孕人流1次。既往身体健康，无严重内科疾病史及其他手术史。于2003年3月12日以“瘢痕子宫，宫内孕15周，死胎入院”。患者自述3d前在乡卫生院B超提示“胎儿双顶径3．0cm，胎心搏动好”。当日给药物流产药口服，药名及剂量不详。服药后3d无腹痛及阴道流血等症状，来我站。     

皮肤磨削术修复浅表性瘢痕

目的探讨皮肤磨削术对修复浅表性瘢痕的临床疗效。方法使用高速电动皮肤磨削机，借助不同型号的磨头对不同部位皮肤浅表性瘢痕进行磨削，术后半年观察皮肤浅表性瘢痕的改变。结果自2002年5月至2007年5月，利用皮肤磨削术治疗浅表性瘢痕共168例，痊愈120例，显效28例，有效20例。结论皮肤磨削术修复浅表性瘢痕是一种简便有效的方法，可使皮肤浅表性瘢痕表面平滑、色素外观改善，效果较为满意。     

皮肤软组织扩张术治疗颈胸部瘢痕挛缩

颈胸部烧烫伤在临床上较为常见。因为皮肤薄、暴露多等原因，颈胸部烧烫伤创面多较深，伤后常形成瘢痕，直接影响外貌、颈部功能。严重者影响进食、语言和呼吸功能，病人无法平卧。在青少年或幼儿，颈部畸形尚可影响正常发育。2002年以来我们应用皮肤扩张器治疗颈胸部烧烫伤31例，取得了良好效果，现报告如下。     

穿透性胎盘1例

1病例资料 患者，女，36岁，G4P1，第一胎系于1991年行剖宫产术，之后曾有2次人流术，2004年7月2日因孕35^＋2周，阴道少量流血伴腹胀2h入院。LMP：2003年10月28日，EDC：2004年8月5日。入院时查体：宫高29cm，腹围95cm，胎心正常，可扪及不规则宫缩。B超示：孕38周±7d，胎盘未见异常。入院诊断：①G4P1，孕35^＋2周，LOA，先兆早产；②瘢痕子宫，入院以后予硫酸舒喘灵、硫酸镁抑制宫缩、保胎对症处理后有所好转。