Ablative strategies for recurrent hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is the most common primary liver cancer and is the fifth leading cause of cancer death worldwide and the third leading cause of all diseases worldwide.Liver transplantation,surgical resection and ablation are the three main curative treatments for HCC.Liver transplantation is the optimal treatment option for HCC,but its usage is limited by the shortage of liver sources.Surgical resection is considered the first choice for early-stage HCC,but it does not apply to patients with poor liver function.Therefore,more and more doctors choose ablation for HCC.However,intrahepatic recurrence occurs in up to 70%patients within 5 years after initial treatment.For patients with oligo recurrence after primary treatment,repeated resection and local ablation are both alternative.Only 20%patients with recurrent HCC(rHCC)indicate repeated surgical resection because of limitations in liver function,tumor location and intraperitoneal adhesions.Local ablation has become an option for the waiting period when liver transplantation is unavailable.For patients with intrahepatic recurrence after liver transplantation,local ablation can reduce the tumor burden and prepare them for liver transplantation.This review systematically describes the various ablation treatments for rHCC,including radiofrequency ablation,microwave ablation,laser ablation,high-intensity focused ultrasound ablation,cryablation,irreversible electroporation,percutaneous ethanol injection,and the combination of ablation and other treatment modalities.

Radiofrequency ablation of hepatocellular carcinoma sized> 3 and ≤ 5 cm: Is ablative margin of more than 1 cm justified?

AIM:To investigate whether an ablative margin(AM)>1.0 cm might reduce chance of recurrence for patients with hepatocellular carcinoma(HCC)tumors 3.1to 5.0 cm in size,compared with an AM of 0.5-1.0 cm.METHODS:From October 2005 to December 2012,936 consecutive patients with HCC who received radiofrequency ablation were screened.Of these,281 patients,each with a single primary HCC tumor of 3.1 to5.0 cm in size on its greatest diameter,were included in the study.Based on the AM width,we categorized patients into the 0.5-1.0 cm group and the>1.0 cm group.Local tumor progression(LTP)-free survival,intrahepatic distant recurrence(IDR)-free survival and overall survival(OS)rates were obtained using the Kaplan-Meier method.RESULTS:The 1-,2-,3-,4-,and 5-year LTP-free survival rates and IDR-free survival rates were significantly higher in the>1.0 cm group compared with the 0.5-1.0cm group(97.5%,86.3%,73.6%,49.5%and 26.4%vs 91.3%,78.4%,49.5%,27.8%,and 12.8%;95.1%,90.3%,77.0%,61.0%and 48.3%vs 95.2%,85.9%,62.6%,47.2%and 28.5%;P<0.05).The 1-,2-,3-,4-,and 5-year OS rates were 98.6%,91.5%,69.2%,56.0%and 42.2%,respectively,in the 0.5-1.0 cm group and 100%,98.9%,90.1%,68.7%and 57.4%,respectively,in the>1.0 cm group(P=0.010).There were no significant differences in complication rates between the two groups.Both univariate and multivariate analyses identified AM as an independent prognostic factor linked to LTP,IDR,and OS.CONCLUSION:For HCC tumors>3.0 cm and≤5.0cm,AM>1.0 cm could reduce chances of recurrence compared with AM of 0.5-1.0 cm,emphasizing the need for a more defensive strategy using AMs>1.0 cm for ablating HCC tumors of 3.1 to 5.0 cm.

Study on Low Density and Heat-resistant Ablative Coating

Low bulk density expanding vermiculite is prepared, and the surface modification of hollow Al2O3-SiO2 microspheres and the composition of the low density ablative coating are studied. Organic silicon epoxy resin and phenolic aldehyde resin are applied as film forming matters to get a series of ablative coating having a density of 0.4-0.6 g/cm^3. The performance of the low density ablative coating is evaluated by mechanical, thermodynamic and oxygen acetylene ablation tests, and the results are as follows, adhesion is in the range of 2.97-4.63 MPa, conductivity is no more than 0.1 kcal/（m·h·℃ ）, line ablation rate is no more than 0.30 mm/s, mass ablation rate is in the range of 0.11-0.18 mm/s.

Systematic review of ablative therapy for the treatment of renal allograft neoplasms

BACKGROUND To date,there are no guidelines on the treatment of solid neoplasms in the transplanted kidney.Historically,allograft nephrectomy has been considered the only reasonable option.More recently,nephron-sparing surgery (NSS) and ablative therapy (AT) have been proposed as alternative procedures in selected cases.AIM To review outcomes of AT for the treatment of renal allograft tumours.METHODS We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 Checklist.PubMed was searched in March 2019 without time restrictions for all papers reporting on radiofrequency ablation (RFA),cryoablation (CA),microwave ablation (MWA),high-intensity focused ultrasound (HIFU),and irreversible electroporation (IRE) of solid tumours of the kidney allograft.Only original manuscripts describing actual cases and edited in English were considered.All relevant articles were accessed in full text.Additional searches included all pertinent references.Selected studies were also assessed for methodological quality using a tool based on a modification of the Newcastle Ottawa scale.Data on recipient characteristics,transplant characteristics,disease characteristics,treatment protocols,and treatment outcomes were extracted and analysed.Given the nature and the quality of the studies available (mostly retrospective case reports and small retrospective uncontrolled case series),a descriptive summary was provided.RESULTS Twenty-eight relevant studies were selected describing a total of 100 AT procedures in 92 patients.Recipient age at diagnosis ranged from 21 to 71 years whereas time from transplant to diagnosis ranged from 0.1 to 312 mo.Most of the neoplasms were asymptomatic and diagnosed incidentally during imaging carried out for screening purposes or for other clinical reasons.Preferred diagnostic modality was Doppler-ultrasound scan followed by computed tomography scan,and magnetic resonance imaging.Main tumour types were: papillary renal cell carcinoma (RCC) and clear cell RCC.Maximal tumour diameter ranged from 5 to 55 mm.The vast majority of neoplasms were T1a N0 M0 with only 2 lesions staged T1b N0 M0.Neoplasms were managed by RFA (n = 78),CA (n = 15),MWA (n = 3),HIFU (n = 3),and IRE (n = 1).Overall,3 episodes of primary treatment failure were reported.A single case of recurrence was identified.Follow-up ranged from 1 to 81 mo.No cancer-related deaths were observed.Complication rate was extremely low (mostly < 10%).Graft function remained stable in the majority of recipients.Due to the limited sample size,no clear benefit of a single procedure over the other ones could be demonstrated.CONCLUSION AT for renal allograft neoplasms represents a promising alternative to radical nephrectomy and NSS in carefully selected patients.Properly designed clinical trials are needed to validate this therapeutic approach.

Treatment of metastatic liver tumors using stereotactic ablative radiotherapy

The prognosis of patients with metastatic liver disease remains dismal with a median survival of only 6-12 mo. As 80%-90% of patients are not candidates for surgical therapy, there is a need for effective non-surgical therapies that would improve outcomes in these patients. The body of evidence related to the use of stereotactic ablative radiotherapy(SABR) in metastatic liver disease has substantially grown and evolved over the past decade. This review summarizes the current evidence supporting liver SABR with particular attention given to patient selection, target delineation, organ at risk dose volume constraints, response evaluation imaging and the various SABR techniques for delivering ablative radiotherapy to the liver. Even though it is unclear what dose-fractionation scheme, delivery system, concomitant therapy or patient selection strategy yields the optimum liver SABR outcomes, clear and growing evidence is available that SABR is a safe and effective therapy for the treatment of oligometastatic liver disease.

Successive Picket Drive for Mitigating the Ablative Richtmyer–Meshkov Instability

The ablative Richtmyer–Meshkov instability(ARMI) is crucial to the successful ignition implosion of the inertial confinement fusion(ICF) because of its action as the seed of the Rayleigh–Taylor instability. In usual ICF implosions, the first shock driven by various foots of the pulses plays a central role in the ARMI growth. We propose a new scheme for refraining from ARMI with a pulse of successive pickets. With the successive-picket pulse design, a rippled capsule surface is compressed by three successive shocks with sequentially strengthening intensities and ablated stabilization, and the ablative Richtmyer–Meshkov growth is mitigated quite effectively.Our numerical simulations and theoretical analyses identify the validity of this scheme.

Oligometastases in prostate cancer:Ablative treatment

Technological advances in radiotherapy have led to the introduction of techniques such as stereotactic body radiation therapy(SBRT), allowing the administration of ablative doses. The hypothesis that oligometastatic disease may be cured through local eradication therapies has led to the increasing use of SBRT in patients with this type of disease. At the same time, scientific advances are being made to allow the confirmation of clinically suspected oligometastatic status at molecular level. There is growing interest in identifying patients with oligometastatic prostate cancer(PCa) who may benefit from curative intent metastasis-directed therapy, including SBRT. The aim is to complement, replace or delay the introduction of hormone therapy or other systemic therapies. The present review aims to compile the evidence from the main ongoing studies and results on SBRT in relation to oligometastatic PCa; examine aspects where gaps in knowledge or a lack of consensus persist(e.g., optimum schemes, response assessment, identification and diagnosis of oligometastatic patients); and document the lack of first-level evidence supporting the use of such techniques.

Optimum design of carbon/carbon ablative property based on genetic algorithm

An optimum design model has been proposed for carbon/carbon ablative property based on genetic algorithm,in which the optimum parameters are the number of woven satins,K of fiber bundles,layers per unit height,the average distance of puncture fibers in Z direction and Ply Stacking angle,and the constraint conditions are the density and diameter of carbon fibers and the density of carbon matrix.The results demonstrate that after optimization,the overall height of the ablative carbon/carbon surface is reduced by 56.5%,the standard deviation is reduced by 34.9% and the surface roughness is reduced by 12.6%,which suggests the remarkable improvement of ablative homogeneity.The present investigation can provide practical methodology for the optimum design of carbon/carbon ablative property and the development of new carbon/carbon composites.

Single-fraction stereotactic ablative body radiation therapy for primary and metastasic lung tumor:A new paradigm?

Stereotactic ablative body radiotherapy(SABR)is an effective technique comparable to surgery in terms of local control and efficacy in early stages of non-small cell lung cancer(NSCLC)and pulmonary metastasis.Several fractionation schemes have proven to be safe and effective,including the single fraction(SF)scheme.SF is an option costeffectiveness,more convenience and comfortable for the patient and flexible in terms of its management combined with systemic treatments.The outbreak of the severe acute respiratory syndrome coronavirus 2 pandemic has driven this not new but underutilized paradigm,recommending this option to minimize patients’visits to hospital.SF SABR already has a long experience,strong evidence and sufficient maturity to reliably evaluate outcomes in peripheral primary NSCLC and there are promising outcomes in pulmonary metastases,making it a valid treatment option;although its use in central locations,synchronous and recurrencies tumors requires more prospective safety and efficacy studies.The SABR radiobiology study,together with the combination with systemic therapies,(targeted therapies and immunotherapy)is a direction of research in both advanced disease and early stages whose future includes SF.

Ablative laser assisted topical delivery of antifibrotics in the management of cicatricial ectropion

A variety of surgical techniques have traditionally been used to manage cicatricial ectropion. These techniques primarily aim at vertical lengthening of the anterior lamella and include a variety of skin flaps and grafts. Alternative techniques such as dermal filler injection to support the eyelid margin may also be used in the management of select patients with cicatricial ectropion. The application of different types of laser for scar revision throughout the body has rapidly evolved; similar mechanisms, principles and treatment rationale can be applied to the use of lasers in the management of cicatricial ectropion. Additionally, ablative lasers, such as Carbon Dioxide and Erbium:yttrium-aluminumgarnet lasers, may be used in the transdermal delivery of antifibrotic agents, such as interferon gamma, interferon alpha, vitamin D, triamcinolone and 5-fluorouracil, resulting in efficient target tissue penetration, limitation of systemic drug toxicity and decreased degradation. Although the combination of ablative fractional resurfacing and topical antifibrotic agents is a new treatment modality, there is a great potential for its efficient utilityin the management of periocular scarring and cicatricial ectropion. The introduction of these innovative therapeutic modalities offers ophthalmologists a greater range of possible effective treatments to address periocular scar tissue and the resultant cicatricial ectropion.

Tumorigenic Responses of Cancer-Associated Stromal Fibroblasts after Ablative Radiotherapy: A Transcriptome-Profiling Study

Cancer-associated fibroblasts (CAFs) are key elements in the progression of cancer and thereby represent important targets for cancer therapies. Increased attention has been given to ablative radiotherapy in the clinics. Therefore, in this study we have aimed at identifying the transcriptional responses occurring in primary CAFs exposed to high-dose irradiation. Established primary CAFs obtained from non-small-cell lung cancer (NSCLC) patient material were irradiated with a single dose of 18 Gy and total RNA was isolated 24 hrs after treatment. Radiation-induced transcriptional alterations were investigated by gene expression analysis using genome-wide microarrays. Obtained results were verified by qRT-PCR of relevant genes. Confirmation of gene expression outcomes was achieved by diverse functional and expression assays including DNA damage response, measurements of reactive oxygen species (ROS) by flow cytometry and senescence-associated β-galactosidase. Irradiation resulted in differential expression of 680 genes of which 557 were up- and 127 down-regulated. Of those, 153 genes were differentially expressed with a fold-change greater than 1.0 and an adjusted p-value less than 0.05 across different comparisons (non-irradiated vs. irradiated). Expression patterns revealed profound changes in biological functions and processes involved in DNA repair, apoptosis, p53 pathway, autophagy, senescence, ROS production and immune response. CAFs display pro- and anti-tumorigenic effects after having received a single high-dose radiation. The measured effects will have an impact on the tumor microenvironment in respect to tumor growth and metastasis.

High-resolution reconstruction of the ablative RT instability flowfield via convolutional neural networks

High-resolution flow field data has important applications in meteorology,aerospace engineering,high-energy physics and other fields.Experiments and numerical simulations are two main ways to obtain high-resolution flow field data,while the high experiment cost and computing resources for simulation hinder the specificanalysis of flow field evolution.With the development of deep learning technology,convolutional neural networks areused to achieve high-resolution reconstruction of the flow field.In this paper,an ordinary convolutional neuralnetwork and a multi-time-path convolutional neural network are established for the ablative Rayleigh-Taylorinstability.These two methods can reconstruct the high-resolution flow field in just a few seconds,and further greatlyenrich the application of high-resolution reconstruction technology in fluid instability.Compared with the ordinaryconvolutional neural network,the multi-time-path convolutional neural network model has smaller error and canrestore more details of the flow field.The influence of low-resolution flow field data obtained by the two poolingmethods on the convolutional neural networks model is also discussed.

Evaluation of GALAD Score in Diagnosis and Follow-up of Hepatocellular Carcinoma after Local Ablative Therapy

Background and Aims:Strategies for detection of early hepatocellular carcinoma(HCC)are still limited.The GALAD score is a serum biomarker-based model designed to predict the probability of having HCC.We aimed to assess the ability of GALAD score to diagnose early HCC and its validity to follow patients after local ablation therapy.Methods:This multicenter prospective study included 108 patients in two groups,58 HCC patients(67 focal lesions)with local ablative therapy(study group),and a control group of 50 patients with liver cirrhosis.The GALAD scores of the study and control groups,and of the HCC patients before and after ablative therapy were compared.Results:Most patients were men(74.1%in study group and 76%in controls)with hepatitis C virus infection(98.30%in the study group,and 94%in controls).GALAD scores were significantly higher in HCC patients than in those with benign cirrhosis(2.65 vs.−0.37,p=0.001).Ablative therapy was successful in 94.4%of focal lesions<2 cm,and in 86.10%of 2–5 cm lesions.The GALAD score was also significantly lower at 1 month after ablation in patients with well-ablated tumors(2.19 vs.0.98,p=0.001).The best cutoff values of GALAD score for diagnosis of early HCC,and for prediction of well ablation of HCC were 0.74 and≤3.31(areas under the curve of 0.92 and 0.75,sensitivities of 84.48%and 76.19%,specificities of 89.13%and 83.33%,positive predictive values of 90.74%and 94.1%,and negative predictive values of 82%and 35.7%respectively).Conclusion:The GALAD score was effective for the diagnosis of early HCC and for followup after ablative therapy.

Advances in ablative treatment for human papillomavirus related cervical pre-cancer lesions

HPV infection is the primary cause of cervical intraepithelial neoplasia(CIN),with persistent high-risk HPV infection being the leading factor in the development of cervical cancer.In addition to the application of large loop excision of the transformation zone(LLETZ)for the treatment of cervical pre-cancerous lesions,various ablative techniques,including thermal ablation,cryotherapy,carbon dioxide(CO_(2))laser therapy,and focused ultrasound therapy also play significant roles in the management of cervical intraepithelial neoplasia.This review presents a comprehensive overview of the pathophysiology of cervical HPV infection and discusses the ablative methods commonly used in clinical practice,along with their indication and contradiction,especially in women with high-grade squamous intraepithelial lesions.The aim is to identify safe and effective treatment strategies for treating cervical intraepithelial neoplasia,thereby avoiding under-or over-treatment,which may reduce the incidenceandprogr ssion of cervical cancer through timely diagnosis and treatment.

Stereotactic body radiotherapy in pancreatic adenocarcinoma

Background:Stereotactic body radiotherapy(SBRT)in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding tissue.This review aimed at the SBRT application in the treatment of pancreatic cancer.Data sources:We retrieved articles published in MEDLINE/PubMed from January 2017 to December 2022.Keywords used in the search included:“pancreatic adenocarcinoma”OR“pancreatic cancer”AND“stereotactic ablative radiotherapy(SABR)”OR“stereotactic body radiotherapy(SBRT)”OR“chemoradiotherapy(CRT)”.English language articles with information on technical characteristics,doses and fractionation,indications,recurrence patterns,local control and toxicities of SBRT in pancreatic tumors were included.All articles were assessed for validity and relevant content.Results:Optimal doses and fractionation have not yet been defined.However,SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to CRT.Furthermore,the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic adenocarcinoma.Conclusions:SBRT is an effective modality for patients with pancreatic cancer,supported by clinical practice guidelines as it has demonstrated good tolerance and good disease control.SBRT opens a possibility of improving outcomes for these patients,both in neoadjuvant treatment and with radical intent.

不同风场中特高压换流站阀厅屋盖风压特性试验研究

特高压(ultra high voltage,UHV)换流站阀厅的金属屋面系统在风荷载作用下易发生屋面表层风揭事故。为深入探讨该类建筑屋面的风压极值特性,基于风洞试验分别探讨了大气边界层(atmospheric-boundary-layer,ABL)风、壁面射流、均匀湍流三种风场作用下的屋面风压特性,比较了平均风剖面、风速、风向、湍流强度等因素对屋面风压的影响。结果表明:阀厅屋盖迎风前缘负风压最大,且控制风向角在45°左右;壁面射流风场下平均风压系数与脉动风压系数均超过大气边界层风场的结果;风速对阀厅屋盖的负风压系数均值和极值影响较小,而湍流度对风压系数的极值影响较大;大气边界风场时,JGJ/T 481—2019《屋盖结构风荷载标准》的最不利风压系数建议值偏于安全;而在壁面射流风场下,阀厅屋盖全风向最不利风压系数在所有区域都大于JGJ/T 481—2019的建议值,设计中应加以重视。

荧光定量PCR法检测ABL1激酶区突变

目的:建立一种敏感性高且能定量分析ABL1激酶区突变的检测方法,为慢性髓系白血病(CML)的早期诊断和治疗提供有力支持。方法:收集35例经Sanger测序法检测为阴性的CML患者剩余标本。ABL1激酶区突变检测采用上海源奇生物医药科技有限公司的突变检测试剂盒采用^(△△)Ct值法分析突变率通过计算突变率并除以融合基因表达量,得出ABL1激酶区的相对突变率。结果:在35例经Sanger测序法检测为阴性患者中重新采用荧光定量PCR法检测ABL1激酶区突变,有7例出现T315I突变2例T315A突变2例Y253H突变,1例E255K突变,其相对突变率在0.1%-19.42%之间,均属于低频突变,超出了Sanger测序法的检测范围。随后应用该方法对126例CML患者进行ABL1突变检测与Sanger测序法相比,该方法的阳性率提高,显示出更高的敏感性。针对患者的突变情况进行相应的临床治疗调整后,观察到患者BCR-ABL1融合基因表达显著性下降或转为阴性。结论:与Sanger测序法相比,荧光定量PCR法在检测ABL1激酶区突变方面具有更高敏感性,能早期筛选出低频ABL1激酶区突变,并进行相对定量分析,该方法具有较好的临床应用前景。

慢性髓细胞白血病伴BCR::ABL1 e6a2转录本1例并文献复习

慢性髓细胞白血病伴BCR::ABL1 e6a2转录本发病率低,临床较为罕见,本文报道1例慢性髓细胞白血病伴BCR::ABL1 e6a2转录本患者的诊治经过,并复习相关文献,探讨其流行病学特点、诊治和预后。

Ablative fractional CO_(2)laser surgery improving sleep quality,pain and pruritus in adult hypertrophic scar patients:a prospective cohort study

Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of patients with scars.In the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study outcome.Methods:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was selected.Sleep quality,pain and pruritus were evaluated.Multiple linear regression analyses were performed to reveal the effect of CO_(2)-AFL surgery.Results:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical treatment.In the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep latency.Compared to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus scores.Correlation analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus scores.Multiple linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI total.Conclusions:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar patients.The alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency.Trial registration:The Chinese Clinical Trial Registry(ChiCTR200035268)approved retrospectively registration on 5 Aug 2020.

Combination of ablative fractional carbon dioxide laser and platelet-rich plasma treatment to improve hypertrophic scars:a retrospective clinical observational study

Background:Hypertrophic scars are one of the main complications that affect the quality of life of patients after burns.Many methods have been shown to be effective in the treatment of hypertrophic scars,such as ablative fractional CO_(2) laser(AFCL)and platelet-rich plasma(PRP).However,there are few studies on the effect of the combined application of these measures.The purpose of this study was to explore the therapeutic effect of AFCL combined with PRP on hypertrophic burn scars.Methods:A retrospective clinical observation study was conducted on 50 patients with hypertrophic burn scars.The AFCL+PRP group included 31 patients who received AFCL combined with PRP treatment;the AFCL group included 19 patients who received AFCL treatment only.The University of North Carolina 4P Scar Scale(UNC4P)and the Vancouver Scar Scale(VSS)scores that were collected before each treatment were used as indicators of the effectiveness of the previous treatment.The scores recorded at the second,fourth and seventh months were analysed.Results:The demographic data of the 2 groups were not significantly different.Before treatment,therewas no difference in the UNC4P and VSS scores between the 2 groups.Therewas a significant decline in the UNC4P and VSS total scores over 6 months in both groups(p<0.05)and scores in the 2 groups were comparable after 3 and 6 months(p<0.05).UNC4P scores in the AFCL+PRP group decreased from a mean of 8.26 to 2.61(p<0.05)with a concomitant drop in VSS scores from a mean of 11.74 to 6.06(p<0.01).In the AFCL group UNC4P and VSS scores decreased from 7.68 to 4.63(p<0.05)and from 10.89 to 8.16(p<0.05),respectively.The sub-items of these 2 assessments were analysed and the results suggest that AFCL combined with PRP can comprehensively improve scarring.Conclusions:This study shows that PRP is an effective adjunct for AFCL in the treatment of hypertrophic burn scars and that the combination of PRP and AFCL proved to be more useful than AFCL alone.This combination may be a new and effective clinical practice for the treatment of scars.However,larger and higher-level clinical studies are still needed to determine its efficacy and possible mechanisms.