Objective To explore the complications and the treatments of repeated cesarean delivery in scar uterus pregnancy accompanied by the placenta praevia. Methods We performed a retrospective study in 6832 cases underwent first cesarean delivery,within which 201 cases were accompanied by the placenta praevia;and 337 cases underwent repeated cesarean deliver, within which 26 cases were accompanied by the placenta praevia. All subjects accepted cesarean delivery from January2006 toApril 2010 in our hospital. Results The occurrence rate of placenta previa was significantly higher in the repeated cesarean delivery than first-ever cesarean delivery (7. 72% vs 2. 94%, x2 = 22. 33, P ＜ 0. 01 ) , especially the occurrence of complete placenta previa (42. 30% vs 0. 00%, x2 = 80. 43, P ＜ 0. 01 ). The rates of uterus rupture, placenta accreta, postpartum hemorrhage and hysterectomy (r = 26. 92% ,23.08% ,26. 92% and 7. 69%, respectively) in repeated cesarean delivery in scar uterus pregnancy accompanied by the placenta praevia were significantly higher than those of the cases ( r = 2. 57% ,0. 32%, 1.29% and 0. 00%, respectively ) had repeated cesarean delivery in scar uterus pregnancy but no placenta previa ( x2 = 27.97,50. 41,42. 16,12. 79, respectively, Ps ＜ 0. 01 ). Conclusion The incidence of placenta previa increased in scar uterus pregnancy, especially the complete placental previa.Scar uterus pregnancy accompanied by the placenta praevia are more likely to occur uterus rupture,placenta accreta,postpartum hemorrhage and had hysterectomy. Obstetricians should give more effort to reduce the cesarean section rate,improve the quality of medical care.

Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.

Objective To compare high-frequency ultrasonography and MRI in diagnosis of medial patellofemoral ligament (MPFL) injury after acute lateral traumatic patellar dislocation(LTPD).Methods According to surgical data of 35 patients with acute LTPD,the incidence and sites of MPFL injury were analyzed.Further,based on high frequency ultrasonography and MRI data,the sensitivity,specificity and accuracy of high-frequency ultrasonography and MRI in different MPFL injuries were analyzed and compared.Results Among 35 patients,there were 21 cases with complete MPFL tear and 14 cases with partial MPFL tear.Tear of MPFL at the femoral attachment in 19 cases,at the patellar attachment in 15 cases,and at the mid-substance in 1 case.The sensitivity,specificity,accuracy of high-frequency ultrasonography diagnosis were 78.6％,95.2％,88.6％ respectively on partial MPFL tear and 95.2％,78.6 ％,88.6 ％ respectively on complete MPFL tear.The sensitivity,specificity,accuracy of MRI diagnosis were 85.7％,90.5％,88.6％ respectively on partial MPFL tear and 90.5％,85.7％,88.6％ respectively on complete MPFL tear.There were no significant difference between high-frequency ultrasonography and MRI in diagnosis of partial and complete MPFL injury (x2 =0.243,0.267; P =0.622,0.599).Conclusions MPFL formoral attachment is most vulnerable to damage,followed by patellar attachment.High-frequency ultrasonography,as well as MRI,can be used clearly to diagnose MPFL injury and accurately classify the damage,and it is also an easy,reliable,rapid method,which can be applied routinely to diagnose MPFL injury after actue LTPD.