评价Profile铒激光治疗痤疮瘢痕的疗效。方法:Profile铒激光治疗痤疮瘢痕128例,其中凹陷性瘢痕106例,增生性瘢痕22例。结果:Profile铒激光治疗痤疮瘢痕的总有效率为93%,凹陷性瘢痕总有效率93.3%,增生性瘢痕总有效率92.2%。术后出现暂时性色素沉着6例(4.7%),均于3个月内基本消退。结论:Profile铒激光治疗痤疮瘢痕疗效好(凹陷性瘢痕优于增生性瘢痕),副作用小。

To assess the therapeutic efficacy of Profile Er: YAG laser in the treatment of acne scar. Methods: One hundred and twenty eight patients of acne scar were treated with Profile Er:YAG laser, including 106 patients with depressed scar and 22 patients with hyperplastic scar. Results: The total effective rate was 93%. The effective rates of depressed scar and hyperplastic scar were 93.3% and 92.2%. Six patients had temporary pigmentation after treatment, which disappeared in three months. Conclusion: Profile Er:YAG laser is effective in the treatment of acne scar with few side effects.

背景：瘢痕是创伤修复的产物，严重的瘢痕增生常常导致机体的畸形及功能障碍。血管生成伴随着瘢痕形成的整个过程，与瘢痕的形成密切相关。细胞因子也参与了与瘢痕的形成的过程。 目的：关于血管生成相关细胞因子与瘢痕增生进行阐述，了解血管生成相关细胞因子通过影响瘢痕形成过程中血管的生成与成熟，影响瘢痕的增生及萎缩成熟，最终为临床防治瘢痕提供新的理论依据及方法。 方法：应用计算机检索中文数据库CNKI，应用“瘢痕，血管生成，细胞因子”等为检索词进行检索；应用计算机检索英文数据库PubMed及Medline，应用“scar，angiogenesis，cytokine”等为检索词进行检索。筛选关于瘢痕增生与血管生成，瘢痕增生与细胞因子，血管生成与细胞因子的相关文献，最后筛选纳入54条文献。 结果与结论：瘢痕的形成是机体各种复杂因素综合作用的结果，受多种因素的影响。瘢痕的形成过程中存在血管生成和成熟。各种血管生成相关因子必然会通过影响血管生成成熟，从而影响瘢痕的增生和萎缩。在临床应用中通过干预相关血管生成因子的表达或阻断其作用，影响瘢痕组织中的血管生成与成熟，从而达到防治瘢痕的目的，为瘢痕治疗与预防提供新的思路及方法。

BACKGROUND:Scar is the product of wound healing. Severe scar hyperplasia often leads to the deformity and dysfunction. The scar generates along with angiogenesis. Angiogenesis is closely related to the formation of scar. Cytokines are involved in the scar formation. OBJECTIVE:To summarize the relationship between the cytokines of angiogenesis and scar hyperplasia and to understand the cytokines of angiogenesis effect on scar hyperplasia and atrophy by influencing the angiogenesis and vascular maturity during scar formation, thereby providing a new theoretical basis and measures for clinical prevention and treatment of scar. METHODS:A computer-based online search of PubMed, Medline and CNKI databases was performed for acquiring relevant articles in English and Chinese, respectively, by using the key words of “scar, angiogenesis, cytokines”. Fifty-four articles were included which related to angiogensis in scar hyperplasia, cytokines in scar hyperplasia and cytokines of angio

目的：检测增生性瘢痕经皮水分丢失（TEWL）；探讨表皮屏障功能障碍程度与增生性瘢痕临床特征的关系。方法：以23例患者30处增生性瘢痕为观察对象，进行瘢痕的温哥华评分和瘙痒程度分级；蒸发测定仪Dermalab检测瘢痕及其邻近正常皮肤经皮水分丢失（TEWL）；数据进行统计学分析。结果：（1）增生性瘢痕TEWL（13.52±4.58）g·h-1·m-2明显高于邻近正常皮肤（6.43±3.29）g·h-1·m-2（t=5.89 P＜0.01）。（2）增生性瘢痕TEWL净丧失量与瘢痕的温哥华评分呈正相关（r=0.85 P＜0.01）。（3）重度瘙痒组增生性瘢痕TEWL净丧失量明显高于轻、中度瘙痒瘢痕组。结论：增生性瘢痕表皮屏障功能存在障碍，其障碍程度与临床特征相关；增生性瘢痕TEWL的净丧失量可能成为一个瘢痕评估的客观指标。

Objective:To evaluate the skin barrier function in hypertrophic scar(HS)by measuring transepidermal water loss(TEWL)and study the relationship between the severity of epidermal barrier dysfunction and clinic characteristics in HS. Method:Thirty HSs in 23 patients were assessed through Vancouver Scar Assessment Table and scar itch severity assessment. The level of TEWLs in HS and adjacent normal skin were measured with computerized evaporimetry using the DermaLabR. The difference in TEWLs between HS and adjacent normal skin was as the severity of epidermal barrier dysfunction in HS. Statistic analysis was performed. Result:(1)The level of TEWLs in HS was higher than that in adjacent normal skin.(2)A significant positive relation was reported between the difference in TEWLs and the score in Vancouver Scar Assessment in HS. (3) The difference in TEWLs in severe degree pruritus group in HS was higher than that in mild and moderate pruritus groups. Conclusion:The skin barrier func

目的探讨瘢痕子宫(前次剖宫产史)对再次妊娠的分娩方式和结局的影响。方法回顾性分析2012-01至2014-03于北京军区总医院妇产科初诊建档、定期产检,并于该院分娩的瘢痕子宫妊娠病例322例(瘢痕组),随机抽取同期非瘢痕子宫妊娠病例328例(非瘢痕组),比较两组的分娩方式和妊娠结局。结果瘢痕组和非瘢痕组孕妇年龄、分娩孕周、孕次、产次、分娩前体重指数比较,差异均无统计学意义。瘢痕组剖宫产261例,占81.1%;非瘢痕组剖宫产173例,占52.7%;两组差异有统计学意义(χ2=58.70,P0.01)。瘢痕组的前置胎盘、胎盘粘连(植入)的发生率为13.7%、9.0%,均高于非瘢痕组的0.9%、0.6%(χ2分别为39.38、25.22,P均0.01);而瘢痕组和非瘢痕组的胎盘早剥发生率比较,差异无统计学意义(χ2=2.76,P0.05)。瘢痕组子宫破裂(1.6%)、产后出血(10.9%)、产褥发热(11.5%)等发生率均高于非瘢痕组(分别是0、2.7%和5.5%),差异有统计学意义(χ2分别为5.13、17.00、7.56,P均0.01)。结论瘢痕子宫妊娠的并发症发生率高于非瘢痕子宫妊娠,其前置胎盘、胎盘粘连(植入)、产后出血的风险性明显升高。瘢痕子宫孕妇再次妊娠的分娩方式仍以剖宫产为主。

Objective To study the influence of the uterine scar pregnancy on the ways of delivery and outcome.Methods A retrospective survey was conducted of the patients who had been admitted to the obestetrics department of this hospital, all of whom had been under rules of regular inspection and had given birth to baby in the same hospital.The total sample included 322 cases of u-terine scar pregnancy as the observation group, and 328 patients without uterine scar pregnancy as the control group by random.Com-parison was made between the two groups in the ways of delivery and outcome of pregnancy.Results The comparisons of average age, average week of delivery, mean gravidity, mean parity between the two groups did not show statistically significant differences.261 ca-ses (81.1%) underwent cesaran section in the observation group, 173 cases (52.7%) did so in the control group, with statistically significant difference between the two groups.The incidence rates of placenta praevia and

目的 探讨瘢痕疙瘩的临床分类方法,为瘢痕疙瘩的治疗提供思路.方法 总结2004年11月至2012年10月收治的600例瘢痕疙瘩患者的资料,填写患者信息表,照片记录瘢痕疙瘩的形态,分析其治疗方法,提出瘢痕疙瘩的临床分类方法.结果 根据瘢痕疙瘩发生的部位、数量,将瘢痕疙瘩患者分为单部位单发、多部位单发、单部位多发及多部位多发4大类;根据面积和厚度,将瘢痕疙瘩单发病变分为小面积薄型、小面积厚型、大面积薄型及大面积厚型4个亚类;根据病变数量,将瘢痕疙瘩多发病变分为孤立多发和弥散多发2个亚类.不同的类型适合选择不同的方法进行治疗.结论 瘢痕疙瘩的这一临床分类方法,可以为瘢痕疙瘩的治疗提供思路,有较好的应用价值.

Objective To explore the clinical classification method of keloids and providing a thread for the treatment of keloids.Methods To summarize the 600 cases of keloid patients we accepted and diagnosed from November 2004 to October 2012,and filling in keloid patients information sheet,recording the keloids form by photographs,analyzing the treatment,putting forward the classification method of keloids in clinic.Results According to the position and quantity that keloids grow,the keloid patients are divided into four major categories:one in single site,one in each site,more than one in single site and more than one in each site; According to the area and thickness of keloids,the keloid single lesion is divided into four subclasses:type of small area and thin,type of small area and thick,type of large areas and thin,type of large areas and thick; According to the number of lesions,keloid multiple lesions is divided into two subgenera:isolated multiple and dispersion multiple,different kinds