The Effects of Laser Therapy in Treating Hypertrophic Scars and Keloids after Median Sternotomy:A Scoping Review

Background:Hypertrophic scars and keloids,common complications following median sternotomy for cardiac surgery,significantly impact patient quality of life due to their aesthetic and symptomatic burden.Recent advancements in laser therapy have made it a prominent option for managing these complex scars,yet a com-prehensive understanding of its efficacy is lacking.The aim of this scoping review is to explore the effects of laser therapy in managing hypertrophic scars and keloids after median sternotomy.Methods:This scoping review ana-lyzed studies up to February 2024 from databases including PubMed,EMBASE,CINAHL,Scopus,Web of Science,and the Cochrane Library.We included any study that assessed laser therapy’s effects on hypertrophic scars and keloids following median sternotomy.Studies were selected based on predefined inclusion criteria with-out publication year,design,or origin restrictions.Results:Six studies met the inclusion criteria,involving a total offive RCTs and one review.These studies primarily tested 585 and 595-nm pulsed dye laser(PDL)treatments,focusing on scar appearance,patient symptoms,and treatment satisfaction.Most studies reported significant improvements in scar height reduction and patient symptom relief after treatment,with mixed results for scar erythema and elasticity.Adverse events were generally mild and transient.Conclusions:Laser therapy offers a beneficial approach for improving the appearance and symptoms of hypertrophic scars and keloids post-median sternotomy.However,further research is necessary to optimize treatment parameters and explore the long-term psychosocial impacts of this therapy.This review highlights the need for more comprehensive studies to establish standardized treatment protocols and evaluate their effectiveness.

Clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy

Backgrounds Clinical trials have demonstrated that cardiac resynchronization therapy （CRT） is effective in patients with ＂non-is- chemic cardiomyopathy＂. However, patients with dilated-phase hypertrophic cardiomyopathy （DHCM） have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy （IDCM）, or ischemic cardiomyopathy （ICM）. Methods A total of 312 consecutive patients （DHCM： n = 16; IDCM： n = 231; ICM： n = 65） undergoing CRT in Fuwai hospital were studied respectively. Response to CRT was defmed as reduction in left ventricular end-systolic volume （LVESV） _〉 15% at 6-month follow-up. Results Compared with DHCM, IDCM was associated with a lower total mortality （HR： 0.35, 95% CI： 0.13-0.90）, cardiac mortality （HR： 0.29; 95% CI： 0.11-0.77）, and total mortality or heart failure （HF） hospitalizations （HR： 0.34, 95% CI： 0.17-0.69）, independent of known confounders. Compared with DHCM, the total mortality, cardiac mortality and total mortality or HF hospitalizations favored ICM but were not statistically significant （HR： 0.59, 95% CI： 0.22-1.61; HR： 0.59, 95% CI： 0.21-1.63; HR： 0.54, 95% CI： 0.26-1.15; respectively）. Response rate to CRT was lower in the DHCM group than the other two groups although the differences didn＇t reach statistical significance. Conclusions Compared with IDCM, DHCM was associated with a worse outcome after CRT. The clinical outcome of DHCM patients receiving CRT was similar to or even worse than that of ICM patients. These indicate that DHCM behaves very differently after CRT.

Effect of ALA-PDT on the expressions of MMP-9, MMP-13 and TIMP-1 of hypertrophic scar model in rabbit ears

Objective: To investigate the effect of 5-aminolevulinic(ALA)-photodynamic therapy(PDT) on the expressions of MMP-9, MMP-13 and TIMP-1 of hypertrophic scar model in rabbit ears, and analyze the possible therapeutic mechanisms of ALA-PDT treatment to hypertrophic scars of rabbit ears. Methods: The experimental animals were randomly divided into normal control, negative control, high concentration of ALA-PDT, low concentration of ALA-PDT and PDT groups. The latter three groups received ALA-PDT treatment or PDT treatment once a week for 3 weeks. The specimens of the rabbits were collected respectively 1, 2 and 3 months after treatment to be used for RT-PCR and Western-blot test. Results: 1, 2 and 3 months after PDT treatment, the expressions of MMP-9 and MMP-13(including mRNA and protein) in hypertrophic scar tissues of three treatment groups were significantly higher than those of the negative control group(P<0.01), and the expression of TIMP-1 mRNA and protein of three treatment groups were significantly lower than that of the negative control group(P<0.01). There were also significant differences between high-concentration ALA-PDT treatment group and the low one(P<0.05). Conclusion: ALA-PDT is effective in treating hypertrophic scars of rabbit ears, and its possible therapeutic mechanisms are that ALA-PDT treatment generates oxidation activation effect to activate the activity of MMPs and induces the photoaging of fibroblasts of hypertrophic scar tissues of rabbit ears to inhibit the activity of TIMPs, which causes the up-regulation of MMPs and the down-regulation of TIMPs. Because of this, the degradation of collagen and ECM is accelerated and the formation of scars is suppressed.

Advancements in adipose-derived stem cell therapy for skin fibrosis

Pathological scarring and scleroderma,which are the most common conditions of skin fibrosis,pathologically manifest as fibroblast proliferation and extracellular matrix(ECM)hyperplasia.Fibroblast proliferation and ECM hyperplasia lead to fibrotic tissue remodeling,causing an exaggerated and prolonged wound-healing response.The pathogenesis of these diseases has not been fully clarified and is unfortunately accompanied by exceptionally high medical needs and poor treatment effects.Currently,a promising and relatively low-cost treatment has emerged-adipose-derived stem cell(ASC)therapy as a branch of stem cell therapy,including ASCs and their derivatives-purified ASC,stromal vascular fraction,ASC-conditioned medium,ASC exosomes,etc.,which are rich in sources and easy to obtain.ASCs have been widely used in therapeutic settings for patients,primarily for the defection of soft tissues,such as breast enhancement and facial contouring.In the field of skin regeneration,ASC therapy has become a hot research topic because it is beneficial for reversing skin fibrosis.The ability of ASCs to control profibrotic factors as well as anti-inflammatory and immunomodulatory actions will be discussed in this review,as well as their new applications in the treatment of skin fibrosis.Although the long-term effect of ASC therapy is still unclear,ASCs have emerged as one of the most promising systemic antifibrotic therapies under development.

病理性瘢痕的注射治疗进展

皮肤伤口的愈合是一个相对复杂的生物学过程,此过程涉及成纤维细胞与巨噬细胞等多种细胞在不同愈合阶段的共同协调,包括细胞迁移和增殖、血管再生、细胞外基质沉积和重塑。修复过程中任何阶段的异常愈合都可能导致病理性瘢痕的发生,临床上根据病理性瘢痕的持续时间、瘢痕组织内胶原蛋白的排列以及是否侵犯周围正常皮肤,可将其分为增生性瘢痕与瘢痕疙瘩。目前的治疗手段包括病灶内注射疗法、手术切除以及放射治疗。注射疗法因其廉价与易操作性作为临床上主要的治疗手段,且随着药理学及细胞因子的深入研究,以及多种辅助注射手段与工具的开发,注射疗法的优势与可行性进一步得到了提高。本文围绕伤口愈合过程中病理性瘢痕最新的注射治疗相关进展等进行综述。

遗传性心律失常的基因治疗进展

遗传性心律失常是因单基因或多基因突变影响心肌离子通道或心肌结构进而影响心肌电生理特征的一类疾病,是导致心律失常乃至心源性猝死的一类重要原因。目前的主要治疗方案包括通过抗心律失常类药物、除颤器植入及手术等改善症状及降低猝死风险,但均无法阻止疾病进展,且患者需要长期承受疾病相关症状、治疗相关不良反应以及潜在猝死风险威胁。基因治疗则可通过编辑突变基因等多种方式达到稳定、长期的治疗效果,但多数治疗手段仍停留于实验室探索阶段。本文将对目前遗传性心律失常的基因治疗方法及研究进展进行综述。

Pressure therapy upregulates matrix metalloproteinase expression and downregulates collagen expression in hypertrophic scar tissue

Background Pressure therapy improves hypertrophic scar healing, but the mechanisms for this process are not well understood. We sought to investigate the differential expression of matrix metalloproteinases （Mmps） and collagen in post- traumatic hypertrophic scar tissue with mechanical pressure and delineate the molecular mechanisms of pressure therapy for hypertrophic scars. Methods Fibroblast lines of normal skin and scar tissue were established and a mechanical pressure system was devised to simulate pressure therapy. Reverse transcription-polymerase chain reaction （RT-PCR） and Western blotting assays were used to compare differences in the mRNA and protein expression of Mmps and collagen in scar fibroblasts before and after pressure therapy. Results The expression differed between the hypertrophic scar cell line and the normal cell line. RT-PCR assays showed that Collagen I, highly expressed in the hypertrophic scar cell line, decreased significantly after pressure therapy. Mmp2, Mmp9, and Mmp12 expression in the hypertrophic scar tissue increased significantly after pressure therapy （P 〈0.05）. Western blotting assays further revealed that Mmp9 and Mmp12 expression increased significantly in the hypertrophic scar tissue after pressure therapy （P 〈0.05） but not Mmp2 expression （P 〉0.05）. Conclusion Mechanical pressure induces degradation of Collagen I in hypertrophic scar tissue by affecting the expression of Mmp9 and Mmp12.

梗阻性肥厚型心肌病治疗新进展

在梗阻性肥厚型心肌病(HOCM)的治疗中,传统药物治疗虽能改善患者症状,但未能针对其发病机制延缓自然病程,存在局限性。外科室间隔心肌切除术疗效确切,却因创伤大、风险高而限制了其在临床上的广泛应用。同样,酒精室间隔消融术作为一种微创治疗手段,术后导致的房室传导阻滞等并发症也不容忽视。随着医学技术的不断进步,HOCM的治疗策略也在不断发展。本文旨在概述HOCM治疗领域的新进展。

肥厚性梗阻型心肌病治疗的研究进展

肥厚性心肌病是一种常染色体显性遗传病,分为梗阻型和非梗阻型两类。其中肥厚性梗阻型心肌病是导致青年人和运动员猝死的常见原因,也是心脏猝死的重要原因。目前肥厚性梗阻型心肌病的治疗主要包括药物治疗、外科室间隔切除术、介入治疗和心脏再同步治疗。本文对肥厚性梗阻型心肌病综合治疗的研究进展进行了综述,以期为肥厚性梗阻型心肌病治疗方案的选择提供理论依据和参考。

梗阻性肥厚型心肌病的介入和外科手术治疗及进展

肥厚型心肌病是一种最为常见的心血管遗传性疾病,主要病因是编码肌小节蛋白或肌小节相关结构蛋白的基因变异,目前肥厚型心肌病已成为青少年猝死的头号病因,分为梗阻性肥厚型心肌病和非梗阻性肥厚型心肌病,梗阻性肥厚型心肌病相对非梗阻性肥厚型心肌病死亡率更高,诊治更加困难。现从梗阻性肥厚型心肌病的治疗角度出发,对以往及近期有关的治疗手段尤其是介入和手术治疗方面的进展做一综述。

中药黑膏联合压力疗法治疗增生性瘢痕的疗效观察

目的 观察中药黑膏联合压力疗法治疗增生性瘢痕的临床效果。方法 选取2016年7月—2019年6月期间山西省烧伤救治中心康复科门诊及烧伤科住院的36例烧伤后增生性瘢痕患者,选取同一患者体表的烧伤深度、创面愈合时间及方式均相同的两处瘢痕分别以治疗方法不同分为压力组和中药黑膏组。压力组给予压力疗法治疗,中药黑膏组给予中药黑膏联合压力疗法治疗。治疗6个疗程后,观察比较两组患者临床疗效、不良反应情况,治疗前后温哥华瘢痕量表评分(Vancouver Scar Scale,VSS)、视觉模拟评分(Visual Analogue Scale,VAS)。结果 治疗后中药黑膏组临床总有效率87.50%(28/32)明显高于压力组68.75%(22/32),差异有统计学意义(P<0.05)。治疗后两组患者VSS瘢痕色泽、瘢痕硬度、瘢痕厚度评分均较治疗前降低,差异有统计学意义(P<0.05);且中药黑膏组VSS瘢痕色泽、瘢痕硬度、瘢痕厚度评分均较压力组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者VAS瘙痒、疼痛评分均较治疗前降低,差异有统计学意义(P<0.05);且中药黑膏组VAS瘙痒、疼痛评分均较压力组明显降低,差异有统计学意义(P<0.05)。治疗期间,2例患者因中药黑膏使用后出现湿疹未完成治疗,其余均无不良反应情况发生。结论 中药黑膏联合压力疗法治疗能有效改善烧伤后增生性瘢痕患者瘢痕色泽、瘢痕硬度、瘢痕厚度,降低瘙痒、疼痛程度。

Integrative analysis of transcriptome,DNA methylome,and chromatin accessibility reveals candidate therapeutic targets in hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy(HCM)is the most common inherited heart disease and is characterized by primary left ventricular hypertrophy usually caused by mutations in sarcomere genes.The mechanism underlying cardiac remodeling in HCM remains incompletely understood.An investigation of HCM through integrative analysis at multi-omics levels will be helpful for treating HCM.DNA methylation and chromatin accessibility,as well as gene expression,were assessed by nucleosome occupancy and methylome sequencing(NOMe-seq)and RNA-seq,respectively,using the cardiac tissues of HCM patients.Compared with those of the controls,the transcriptome,DNA methylome,and chromatin accessibility of the HCM myocardium showed multifaceted differences.At the transcriptome level,HCM hearts returned to the fetal gene program through decreased sarcomeric and metabolic gene expression and increased extracellular matrix gene expression.In the DNA methylome,hypermethylated and hypomethylated differentially methylated regions were identified in HCM.At the chromatin accessibility level,HCM hearts showed changes in different genome elements.Several transcription factors,including SP1 and EGR1,exhibited a fetal-like pattern of binding motifs in nucleosome-depleted regions in HCM.In particular,the inhibition of SP1 or EGR1 in an HCM mouse model harboring sarcomere mutations markedly alleviated the HCM phenotype of the mutant mice and reversed fetal gene reprogramming.Overall,this study not only provides a high-precision multi-omics map of HCM heart tissue but also sheds light on the therapeutic strategy by intervening in the fetal gene reprogramming in HCM.

Fabry Disease: Update, Focusing on Heart Disease by Multimodal Imaging

Fabry disease (FD) is a rare X-linked lysosomal accumulation disorder caused by a deficiency in the enzyme alpha-galactosidase A (Gal A), resulting in excessive storage of glycosphingolipids, particularly globotriaosylceramide (Gb3). This leads to cellular dysfunction in various organs, with cardiovascular compromise being the major cause of morbidity and mortality. This study aimed to provide a comprehensive overview of FD focusing on its genetic, epidemiological, clinical, diagnostic, and therapeutic aspects. This study explored the genetic mutations associated with FD, its epidemiology, clinical phenotypes, cardiac manifestations, diagnostic approaches, and current treatment options. Background: FD is caused by mutations in GLA on the X chromosome, with over 1000 identified variants. Neonatal screening and specific studies have shown an increased incidence of FD. The clinical presentation varies between classic and late phenotypes, with cardiac involvement being a major concern, particularly in late-onset FD. Purpose: This study aimed to summarize the current knowledge on FD, emphasizing cardiac involvement, diagnostic modalities, and treatment options. Methods: A literature review of relevant studies on FD, including genetics, epidemiology, clinical presentation, diagnostic methods, and treatment options, was conducted. Results: Cardiac manifestations of FD included left ventricular hypertrophy (LVH), heart failure, arrhythmias, and sudden death. Diagnostic approaches such as electrocardiography, echocardiography, and cardiac magnetic resonance imaging play crucial roles in the early detection and monitoring of cardiac involvement. Enzyme replacement therapy (ERT) and emerging treatments have shown promise in managing FD, although challenges remain. Conclusions: FD remains a challenging condition in cardiology, with under-diagnosis being a concern. Early detection and specific therapy are essential to improve patient outcomes. Echocardiography and cardiac MRI are valuable tools for diagnosis and follow-up. Despite the advances in treatment, accessibility remains an issue. More research is needed to deepen our understanding of FD and to improve therapeutic strategies.

支具面罩治疗面部增生性瘢痕疗效的短期研究

目的:探讨支具面罩治疗面部增生性瘢痕的疗效。方法:招募面部增生性瘢痕患者63例(286处瘢痕),分为支具面罩组28例(152处瘢痕)、布类面罩组26例(100处瘢痕)和对照组9例(34处瘢痕)。支具面罩组和布类面罩组患者均接受8周的压力治疗,对照组无压力治疗干预。治疗前后分别使用色谱仪进行瘢痕色泽评估(亮度、红色和黄色),使用超声测量仪进行瘢痕厚度评估,同时,进行温哥华瘢痕量表评估(VSS);治疗8周后进行患者满意度评估。结果:①组内前后比较:对照组瘢痕红色和黄色增高,厚度和VSS评分增加,瘢痕亮度降低(P<0.05);支具面罩组和布类面罩组瘢痕亮度和黄色增高,厚度和VSS评分增加,瘢痕红色降低(P<0.05)。②3组间比较,瘢痕亮度(L)、红色(a)、厚度、VSS评分的差值间比较均存在差异(P<0.05),瘢痕黄色(b)的差值间比较无差异。差值比较,支具面罩组和布类面罩组均与对照组存在差异(P<0.01),但支具面罩组和布类面罩组间无差异(P>0.05)。③使用满意度比较:支具面罩组与布类面罩组的总体满意度分别为75%和69.2%;支具面罩组的舒适度和外形满意度较布类面罩组高,但价格满意度较布类面罩组差。结论:本短期疗效研究显示,支具面罩和布类面罩均可改善面部增生性瘢痕亮度和红色的色泽,抑制瘢痕增生的厚度;患者使用支具面罩和布类面罩后的总体满意度较高。

达比加群辅助手术治疗肥厚型心肌病合并心房颤动的应用效果

目的观察达比加群辅助手术治疗肥厚型心肌病(HCM)合并心房颤动(AF)的临床效果。方法选取121例HCM合并AF患者,按照随机数字表法分为对照组和观察组。两组均行射频消融术治疗,对照组60例,采用常规抗凝辅助手术治疗,观察组61例,采用达比加群辅助手术治疗,比较两组治疗前后的血小板活性、凝血功能变化情况,随访期间的心血管不良事件及不良反应发生情况。结果治疗后,观察组的β-TG、颗粒膜蛋白CD62P、CD63均低于对照组,活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)均高于对照组,差异有统计学意义(P<0.05)。随访期间,观察组心血管不良事件发生率、不良反应发生率均低于对照组(P<0.05)。结论达比加群辅助射频消融术治疗能有效抑制HCM合并AF患者的血小板活性并改善凝血功能,对降低心血管不良事件及药物的不良反应均有积极意义。

Localized surface plasmon resonance improves transdermal photodynamic therapy of hypertrophic scars

Photodynamic therapy(PDT)is an emerging therapeutic strategy for hypertrophic scars(HS),which is heavily dependent on reactive oxygen species(ROS)generation.However,the unsatisfactory delivery and excitation of 5-aminolevulinic acid(ALA,a commercial photosensitizer in dermatology)result in an insufficient ROS generation,and thus limit the clinical application of PDT treating HS(HS-PDT).Consequently,sophisticated transdermal co-delivery nanoethosomes(named A/A-ES)with ALA and Au nanotriangles(AuNTs)in cores are prepared via an in-situ seed-mediated growth method,and then applied to improve HS-PDT through localized surface plasmon resonance(LSPR)-enhanced ROS generation.A/A-ES display a satisfactory performance in co-delivery in HS tissue with sufficient protoporphyrin IX production and LSPR effect in cytoplasm,which is beneficial for ALA excitation as well as ROS generation.In vitrolvivo studies reveal that A/A-ES significantly improve HS-PDT in promoting to fibroblast apoptosis and collagen remodeling through LSPR-enhanced ROS generation.Therefore,this study provides a feasible strategy that integrates transdermal delivery and LSPR to enable the beneficial effects of HS-PDT through boosting the delivery and excitation of ALA.

Efficacy comparison between conservative therapy and septal ablation in patients with hypertrophic obstructive cardiomyopathy

Objective To compare the effects of septal ablation(SA)versus conservative medication(CM)on the hemodynamic,clinical status and survival in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods This retrospective study included 350 consecutive patients with HOCM(mean age(51.3±13.5)years old)hospitalized in Anzhen Hospital between

3.0T MRI与SPECT-CT诊断骨质疏松性椎体压缩骨折的比较分析

背景:骨质疏松性椎体压缩性骨折的诊断已有较多研究,然而目前对不同时期骨折诊断方法的研究较少。目的:比较分析高强度MRI与SPECT-CT在诊断骨质疏松性椎体压缩骨折中的应用价值。方法:回顾性分析35例骨质疏松性椎体压缩骨折患者的临床资料,涉及责任椎体56个,其中男14例,女21例,平均年龄72.6岁。其中22例病程在3周内,属于急性期骨折;10例病程在4-12周内,属于亚急性骨折;3例病程在6个月以上,属于骨折愈合期。所有患者同时接受高强度MRI及SPECT-CT检查,并行经皮椎体成形或经皮椎体后凸成形治疗,使用Fisher精确检验方法比较两种诊断方法对椎体骨折的显示情况。结果与结论:(1)在56个责任椎体中:32个椎体属于急性期骨折,24个椎体属于非急性期骨折。在所有骨折椎体中,MRI诊断49个节段,SPECT-CT诊断52个节段,SPECT-CT检查的敏感度高于MRI检查,特异度低于MRI检查,两者诊断骨折有较高的一致性;(2)32个急性期椎体骨折中:两种检查各诊断29个节段,SPECT-CT检查的敏感度高于MRI检查,特异度低于MRI检查,两者诊断骨折有较高的一致性;(3)24个非急性椎体骨折中:MRI诊断20个节段;SPECT-CT诊断23个节段,SPECT-CT检查的敏感度高于MRI检查,特异度低于MRI检查,两者诊断骨折有较高的一致性;(4)MRI与SPECT-CT检查对不同时期骨折责任椎体的确定具有很高的一致性,但SPECT-CT检查较MRI检查的敏感性更高,是诊断椎体骨折的一种有效检查方法。

微小RNA222靶向调控基质金属蛋白酶1促进增生性瘢痕组织成纤维细胞生长

目的:观察微小RNA(miR-)222在增生性瘢痕(HS)组织中的表达,并研究其调控成纤维细胞生长的机制。方法:采用实时定量RT-PCR检测36例患者HS和正常组织中miR-222的表达;MTT法、流式细胞术和蛋白质印迹法分别检测成纤维细胞的增殖能力、生长周期、凋亡和相关蛋白表达。双荧光素酶报告分析确定miR-222的靶基因。结果:与正常皮肤组织相比,HS组织中miR-222表达显著上调(P<0.05)。上调miR-222的表达可显著提高成纤维细胞的增殖能力,增加增殖细胞核抗原(PCNA)、Ⅰ型和Ⅲ型胶原α1的mRNA和蛋白表达,上调S期细胞比例和细胞周期相关蛋白的表达,下调成纤维细胞的凋亡率和凋亡相关蛋白的表达。MMP1是miR-222的靶基因,miR-222通过绑定MMP1-3'UTR区负向调控MMP1在成纤维细胞的表达。MMP1可逆转miR-222的部分促纤维化作用。结论:miR-222通过负调控其靶基因MMP1的表达来实现其调控成纤维细胞的生长和凋亡。miR-222/MMP1信号通路可能成为HS诊断和治疗的生物学标志物和靶点。

超声波导入瘢痕康治疗增生性瘢痕的临床研究

目的研究超声波导入药物瘢痕康对增生性瘢痕的治疗效果,以寻求一种操作简便、有效的瘢痕治疗方法。方法采用同体动态对照,将50例增生性瘢痕患者的瘢痕分为平均的两个部分,分别用超声波导入瘢痕康(导入治疗组)和单用瘢痕康(对照组)治疗3个月。治疗结束后分别测定瘢痕厚度改变和瘢痕组织中羟脯氨酸的含量。结果超声波导入瘢痕康治疗组瘢痕厚度改变明显高于单用瘢痕康组(t=2.925,P<0.01),治疗后导入组胶原含量为(33±10)mg/g湿组织,对照组为(46±9)mg/g湿组织,导入组明显低于对照组(t=5.967,P<0.01),超声波导入瘢痕康对增生性瘢痕的治疗效果优于单用瘢痕康组。结论超声波可以增强外用药物对瘢痕的治疗效果。