The effect of drive laser wavelength on the growth of ablative Rayleigh–Taylor instability(ARTI)in inertial confinemen fusion(ICF)is studied with two-dimensional numerical simulations.The results show that in the pla...The effect of drive laser wavelength on the growth of ablative Rayleigh–Taylor instability(ARTI)in inertial confinemen fusion(ICF)is studied with two-dimensional numerical simulations.The results show that in the plasma acceleration phase,shorter wavelengths lead to more efficien coupling between the laser and the kinetic energy of the implosion fluid Under the condition that the laser energy coupled to the implosion flui is constant,the ARTI growth rate decreases as the laser wavelength moves toward the extreme ultraviolet band,reaching its minimum value near λ=65 nm,and when the laser wavelength continuously moves toward the X-ray band,the ARTI growth rate increases rapidly.It is found that the results deviate from the theoretical ARTI growth rate.As the laser intensity benchmark increases,the position of the minimum ARTI growth rate shifts toward shorter wavelengths.As the initial sinusoidal perturbation wavenumber decreases,the position of the minimum ARTI growth rate shifts toward longer wavelengths.We believe that the conclusions drawn from the present simulations and analysis will help provide a better understanding of the ICF process and improve the theory of ARTI growth.展开更多
Objective and Impact Statement:A clinically viable technology for comprehensive esophagus surveillance and potential treatment is lacking.Here,we report a novel multifunctional ablative gastrointestinal imaging capsul...Objective and Impact Statement:A clinically viable technology for comprehensive esophagus surveillance and potential treatment is lacking.Here,we report a novel multifunctional ablative gastrointestinal imaging capsule(MAGIC)technology platform to address this clinical need.The MAGIC technology could also facilitate the clinical translation and adoption of the tethered capsule endomicroscopy(TCE)technology.Introduction:Recently developed optical coherence tomography(OCT)TCE technologies have shown a promising potential for surveillance of Barrett’s esophagus and esophageal cancer in awake patients without the need for sedation.However,it remains challenging with the current TCE technology for detecting early lesions and clinical adoption due to its suboptimal resolution,imaging contrast,and lack of visual guidance during imaging.Methods:Our technology reported here integrates dual-wavelength OCT imaging(operating at 800 and 1300 nm),an ultracompact endoscope camera,and an ablation laser,aiming to enable comprehensive surveillance,guidance,and potential ablative treatment of the esophagus.Results:The MAGIC has been successfully developed with its multimodality imaging and ablation capabilities demonstrated by imaging swine esophagus ex vivo and in vivo.The 800-nm OCT imaging offers exceptional resolution and contrast for the superficial layers,well suited for detecting subtle changes associated with early neoplasia.The 1300-nm OCT imaging provides deeper penetration,essential for assessing lesion invasion.The built-in miniature camera affords a conventional endoscopic view for assisting capsule deployment and laser ablation.Conclusion:By offering complementary and clinically viable functions in a single device,the reported technology represents an effective solution for endoscopic screening,diagnosis,and potential ablation treatment of the esophagus of a patient in an office setting.展开更多
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 fl...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.展开更多
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 O...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.展开更多
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 p...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.展开更多
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...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.展开更多
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...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.展开更多
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 resect...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.展开更多
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...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.展开更多
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 d...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.展开更多
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 ave...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.展开更多
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 ...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.展开更多
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 gra...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.展开更多
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 clini...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.展开更多
1.Introduction to ablative TPS The Mars 2020 mission underscored the critical role of ablative Thermal Protection Systems(TPS)during atmospheric entry,where spacecraft encounter extreme aerodynamic heating.Established...1.Introduction to ablative TPS The Mars 2020 mission underscored the critical role of ablative Thermal Protection Systems(TPS)during atmospheric entry,where spacecraft encounter extreme aerodynamic heating.Established in the mid-20th century,blunt body theories led to the creation of ablative heat shields that effectively manage thermal loads through thermo-chemo-mechanical decomposition.This paper revisits the development and application of ablative TPS materials,which are single-mission solutions capable of withstanding entry velocities surpassing 10 km/s.展开更多
In the direct drive inertial confinement fusion(ICF)scheme,a rippled interface between the ablator and the deuterium–tritium ice fuel can feed out and form perturbation seeds for the ablative Rayleigh–Taylor instabi...In the direct drive inertial confinement fusion(ICF)scheme,a rippled interface between the ablator and the deuterium–tritium ice fuel can feed out and form perturbation seeds for the ablative Rayleigh–Taylor instability,with undesirable effects.However,the evolution of this instability remains insufficiently studied,and the effects of high-Z dopant on this instability remain unclear.In this paper,we develop a theoretical model to calculate the feedout seeds and describe this instability.Our theory suggests that the feedout seeds are determined by the ablation pressure and the adiabatic index,while the subsequent growth depends mainly on the ablation velocity.Two-dimensional radiation hydrodynamic simulations confirm our theory.It is shown that targets with high-Z dopant in the outer ablator exhibit more severe feedout seeds,because of their higher ionization compared with undoped targets.The X-ray pre-ablation in high-Z doped targets significantly suppresses subsequent growth,leading to suppression of short-wavelength perturbations.However,for long-wavelength perturbations,this suppression is weakened,resulting in increased instability in high-Z doped targets.The results are helpful for understanding the innerinterface-initiated instability and the influence of high-Z dopant on it,providing valuable insights for target design and instability control in ICF.展开更多
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 pat...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.展开更多
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 ablat...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.展开更多
Introduction:Papular scarring of the nose and chin due to acne is an under-reported,under-recognized,and under-treated condition.Ablative carbon dioxide laser therapy(10,600 nm,continuous mode,energy of 15W)under loca...Introduction:Papular scarring of the nose and chin due to acne is an under-reported,under-recognized,and under-treated condition.Ablative carbon dioxide laser therapy(10,600 nm,continuous mode,energy of 15W)under local anesthesia is one of the choice.Here,we report series of patients with papular acne scars successfully treated with ablative carbon dioxide laser.Cases presentation:Five patients with papular scars of the nose and chin due to acne were treated at an outpatient dermatology clinic.All had type V skin according to the Fitzpatrick skin classification.Ablative carbon dioxide laser therapy(10,600 nm,continuous mode,energy of 15W)was performed under topical anesthesia.The patients were re-examined at 2-to 3-week intervals,and laser treatment was repeated as needed.Discussion:All of the five patients showed encouraging results.Good cosmetic results were achieved in all patients.The drawbacks of treatment were mild to moderate pain during the procedure and the need for posttreatment skin care.Conclusion:Ablative carbon dioxide laser therapy can potentially be used as a safe and effective treatment for papular scars of the nose and chin due to acne.展开更多
Patients with hepatocellular carcinoma(HCC)often present with underlying liver disease and significant comorbidities,limiting treatment tolerance.With the development of improved toxicity models and highly conformal r...Patients with hepatocellular carcinoma(HCC)often present with underlying liver disease and significant comorbidities,limiting treatment tolerance.With the development of improved toxicity models and highly conformal radiation delivery systems,external beam radiotherapy has become a valuable treatment option for liver cancer.Using cutting edge technology,stereotactic ablative radiotherapy(SABR)allows for the delivery of ablative doses in few fractions while sparing uninvolved liver tissue.This approach permits dose escalation and precise tumor targeting with minimal risk of radiation induced liver disease.This review clarifies SABR's role alongside liver-directed treatments such as radiofrequency ablation,transarterial radioembolization,and transarterial chemoembolization in the management of HCC.It also examines the promising potential of SABR combined with immunotherapy to treat advanced HCC.展开更多
基金supported by the National Natural Science Foundation of China(NSFC)(Grant Nos.12074399,12204500,and 12004403)the Key Projects of the Intergovernmental International Scientifi and Technological Innovation Cooperation(Grant No.2021YFE0116700)+1 种基金the Shanghai Natural Science Foundation(Grant No.20ZR1464400)the Shanghai Sailing Program(Grant No.22YF1455300)。
文摘The effect of drive laser wavelength on the growth of ablative Rayleigh–Taylor instability(ARTI)in inertial confinemen fusion(ICF)is studied with two-dimensional numerical simulations.The results show that in the plasma acceleration phase,shorter wavelengths lead to more efficien coupling between the laser and the kinetic energy of the implosion fluid Under the condition that the laser energy coupled to the implosion flui is constant,the ARTI growth rate decreases as the laser wavelength moves toward the extreme ultraviolet band,reaching its minimum value near λ=65 nm,and when the laser wavelength continuously moves toward the X-ray band,the ARTI growth rate increases rapidly.It is found that the results deviate from the theoretical ARTI growth rate.As the laser intensity benchmark increases,the position of the minimum ARTI growth rate shifts toward shorter wavelengths.As the initial sinusoidal perturbation wavenumber decreases,the position of the minimum ARTI growth rate shifts toward longer wavelengths.We believe that the conclusions drawn from the present simulations and analysis will help provide a better understanding of the ICF process and improve the theory of ARTI growth.
基金supported in part by the National Institutes of Health under grants R01 CA153023 and P41 EB032840.
文摘Objective and Impact Statement:A clinically viable technology for comprehensive esophagus surveillance and potential treatment is lacking.Here,we report a novel multifunctional ablative gastrointestinal imaging capsule(MAGIC)technology platform to address this clinical need.The MAGIC technology could also facilitate the clinical translation and adoption of the tethered capsule endomicroscopy(TCE)technology.Introduction:Recently developed optical coherence tomography(OCT)TCE technologies have shown a promising potential for surveillance of Barrett’s esophagus and esophageal cancer in awake patients without the need for sedation.However,it remains challenging with the current TCE technology for detecting early lesions and clinical adoption due to its suboptimal resolution,imaging contrast,and lack of visual guidance during imaging.Methods:Our technology reported here integrates dual-wavelength OCT imaging(operating at 800 and 1300 nm),an ultracompact endoscope camera,and an ablation laser,aiming to enable comprehensive surveillance,guidance,and potential ablative treatment of the esophagus.Results:The MAGIC has been successfully developed with its multimodality imaging and ablation capabilities demonstrated by imaging swine esophagus ex vivo and in vivo.The 800-nm OCT imaging offers exceptional resolution and contrast for the superficial layers,well suited for detecting subtle changes associated with early neoplasia.The 1300-nm OCT imaging provides deeper penetration,essential for assessing lesion invasion.The built-in miniature camera affords a conventional endoscopic view for assisting capsule deployment and laser ablation.Conclusion:By offering complementary and clinically viable functions in a single device,the reported technology represents an effective solution for endoscopic screening,diagnosis,and potential ablation treatment of the esophagus of a patient in an office setting.
基金National Natural Science Foundation of China(1180500311947102+4 种基金12004005)Natural Science Foundation of Anhui Province(2008085MA162008085QA26)University Synergy Innovation Program of Anhui Province(GXXT-2022-039)State Key Laboratory of Advanced Electromagnetic Technology(Grant No.AET 2024KF006)。
文摘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.
基金Supported by National Natural Science Foundation of China,No.30872490 and 81172320Dr.Wu Jie-ping Medical Foundation,No.320675012712 and 320675007131
文摘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.
文摘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.
文摘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.
基金Supported by The Ottawa Hospital Foundationthe Ethel Ward Cushing Legacy Endowment Fund for a stereotactic ablative radiotherapy fellowship
文摘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.
文摘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.
基金Supported by the National Natural Science Foundation of China under Grant Nos 11675026,11875091 and 11575034
文摘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.
文摘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.
基金Sponsored by the National Natural Science Foundation of China(Grant No.1057244)
文摘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.
文摘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.
文摘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.
基金North Norway Regional Health Authority (Helse Nord) Aakre Foundation
文摘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.
文摘1.Introduction to ablative TPS The Mars 2020 mission underscored the critical role of ablative Thermal Protection Systems(TPS)during atmospheric entry,where spacecraft encounter extreme aerodynamic heating.Established in the mid-20th century,blunt body theories led to the creation of ablative heat shields that effectively manage thermal loads through thermo-chemo-mechanical decomposition.This paper revisits the development and application of ablative TPS materials,which are single-mission solutions capable of withstanding entry velocities surpassing 10 km/s.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Science(Grant Nos.XDA25050200 and XDA25010100)the National Natural Science Foundation of China(Grant Nos.12175309,12475252,and 12275356)+2 种基金the Defense Industrial Technology Development Program(Grant No.JCKYS2023212807)the Natural Science Foundation of Hunan Province,China(Grant No.2025JJ20007)the Postgraduate Scientific Research Innovation Project of Hunan Province,China(Grant No.CX20230005).
文摘In the direct drive inertial confinement fusion(ICF)scheme,a rippled interface between the ablator and the deuterium–tritium ice fuel can feed out and form perturbation seeds for the ablative Rayleigh–Taylor instability,with undesirable effects.However,the evolution of this instability remains insufficiently studied,and the effects of high-Z dopant on this instability remain unclear.In this paper,we develop a theoretical model to calculate the feedout seeds and describe this instability.Our theory suggests that the feedout seeds are determined by the ablation pressure and the adiabatic index,while the subsequent growth depends mainly on the ablation velocity.Two-dimensional radiation hydrodynamic simulations confirm our theory.It is shown that targets with high-Z dopant in the outer ablator exhibit more severe feedout seeds,because of their higher ionization compared with undoped targets.The X-ray pre-ablation in high-Z doped targets significantly suppresses subsequent growth,leading to suppression of short-wavelength perturbations.However,for long-wavelength perturbations,this suppression is weakened,resulting in increased instability in high-Z doped targets.The results are helpful for understanding the innerinterface-initiated instability and the influence of high-Z dopant on it,providing valuable insights for target design and instability control in ICF.
基金supported by the Special Scientific Research Fund of the Public Welfare Profession of China(201502028)the Excellent Discipline Leader Training Program of Shanghai Health System(No.2017BR037)+2 种基金the NationalNatural Science Foundation of China(No.81772091)Clinical Research Plan of Shanghai Hospital Devel-opment Center(No.SHDC2020CR3039B)Shanghai Rising-Star Program(17QB1403300).
文摘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.
基金supported by the National Nature Science Foundation of China(81701899)the Youth Incubation Plan of the Military Medical Science and Technology(16QNP091)+1 种基金the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-076)the high level achievement cultivation plan of the Naval Medical University(2018-CGPZ-B03).
文摘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.
文摘Introduction:Papular scarring of the nose and chin due to acne is an under-reported,under-recognized,and under-treated condition.Ablative carbon dioxide laser therapy(10,600 nm,continuous mode,energy of 15W)under local anesthesia is one of the choice.Here,we report series of patients with papular acne scars successfully treated with ablative carbon dioxide laser.Cases presentation:Five patients with papular scars of the nose and chin due to acne were treated at an outpatient dermatology clinic.All had type V skin according to the Fitzpatrick skin classification.Ablative carbon dioxide laser therapy(10,600 nm,continuous mode,energy of 15W)was performed under topical anesthesia.The patients were re-examined at 2-to 3-week intervals,and laser treatment was repeated as needed.Discussion:All of the five patients showed encouraging results.Good cosmetic results were achieved in all patients.The drawbacks of treatment were mild to moderate pain during the procedure and the need for posttreatment skin care.Conclusion:Ablative carbon dioxide laser therapy can potentially be used as a safe and effective treatment for papular scars of the nose and chin due to acne.
文摘Patients with hepatocellular carcinoma(HCC)often present with underlying liver disease and significant comorbidities,limiting treatment tolerance.With the development of improved toxicity models and highly conformal radiation delivery systems,external beam radiotherapy has become a valuable treatment option for liver cancer.Using cutting edge technology,stereotactic ablative radiotherapy(SABR)allows for the delivery of ablative doses in few fractions while sparing uninvolved liver tissue.This approach permits dose escalation and precise tumor targeting with minimal risk of radiation induced liver disease.This review clarifies SABR's role alongside liver-directed treatments such as radiofrequency ablation,transarterial radioembolization,and transarterial chemoembolization in the management of HCC.It also examines the promising potential of SABR combined with immunotherapy to treat advanced HCC.
