The emergence of nine needles in Nèijīng（《内经》, The Inner Classic） laid a foundation for the formation and development of needling instruments and acupuncture manipulation in later ages, but the application...The emergence of nine needles in Nèijīng（《内经》, The Inner Classic） laid a foundation for the formation and development of needling instruments and acupuncture manipulation in later ages, but the application of nine needles was not realized during clinical practice of acupuncture-moxibustion in later ages. Round-sharp needle is one of the nine needles. In this study, round-sharp needle was taken as an example to introduce the excavation and revitalization of nine needles and diagnosis and treatment rules explored by Mr. CHEN Lixin according to The Inner Classic. The needle shape, needling manipulation and clinical application of round-sharp needle based on The Inner Classic were described in detail.展开更多
Objective The analgesic effect of acupuncture has been widely accepted.Nevertheless,the mechanism behind its analgesic effect remains elusive,thus impeding the progress of research geared toward enhancing the analgesi...Objective The analgesic effect of acupuncture has been widely accepted.Nevertheless,the mechanism behind its analgesic effect remains elusive,thus impeding the progress of research geared toward enhancing the analgesic effect of acupuncture.This paper investigated the role of acupuncture needle surface textures on acupuncture’s analgesic effect by creating four experimental acupuncture needles with different patterns of surface augmentation.Methods Four types of acupuncture needles with different surface textures(the lined needle,circle needle,sandpaper needle,and threaded needle)were designed.Additionally,the force/torque measurement system used a robot arm and mechanical sensor to measure the force on the needle during insertion and manipulation.To perform acupuncture analgesia experiments,four experimental acupuncture needles and a normal needle were inserted into the Zusanli(ST36)acupoint of rats with inflammatory pain.By comparing the force and torque and the analgesic efficacy of the different acupuncture needles,these experiments tested the role of acupuncture needle body texture on acupuncture analgesia.Results The analgesic effects of different acupuncture needle body textures varied.Specifically,the force required to penetrate the skin with the lined needle was not greater than that for the normal needle;however,the needle with inscribed circles and the sandpaper-roughened needle both required greater force for insertion.Additionally,the torque of the lined needle reached 2×10^(-4)N·m under twisting manipulation,which was four times greater the torque of a normal needle(5×10^(-5)N·m).Furthermore,the lined needle improved pain threshold and mast cell degranulation rate compared to the normal needle.Conclusion Optimizing the texture of acupuncture needles can enhance acupuncture analgesia.The texture of our experimental acupuncture needles had a significant impact on the force needed to penetrate the skin and the torque needed to manipulate the needle;it was also linked to variable analgesic effects.This study provides a theoretical basis for enhancing the analgesic efficacy of acupuncture through the modification of needles and promoting the development of acupuncture therapy.展开更多
BACKGROUND This is a randomized study to compare the diagnostic accuracy of endoscopic ultrasound(EUS)-guided sampling of pancreatic solid lesions obtained with the 22-gauge Franseen(EUS-fine needle biopsy)vs the 22-g...BACKGROUND This is a randomized study to compare the diagnostic accuracy of endoscopic ultrasound(EUS)-guided sampling of pancreatic solid lesions obtained with the 22-gauge Franseen(EUS-fine needle biopsy)vs the 22-gauge standard needle(EUS-fine needle aspiration)without rapid onsite evaluation(ROSE),since,in most endoscopy units around the world ROSE is not routinely available.AIM To investigate the accuracy of EUS-guided sampling of pancreatic solid lesions obtained between two different needles without ROSE.METHODS Patients with a solid pancreatic were included.Patients were biopsied in a randomized order.The primary endpoint was the diagnostic sensitivity for pancreatic malignancy(PM).Secondary outcomes were adequacy of the sample,the mean tissue area,the mean tumor area,and the adverse event rate.RESULTS The final diagnosis was pancreatic adenocarcinoma in 38(76%),neuroendocrine tumor in 4(8%),chronic pancreatitis in 3(6%)patients.The sensitivity for PM with Franseen needle was 0.91[95%confidence interval(CI):0.80-0.98],vs 0.8(95%CI:0.67-0.91)(P=0.025)with standard needle.The specificity for PM did not differentiate.The accuracy of the standard needle for PM was 0.80(95%CI:0.66-0.90),and the Franseen group was 0.90(95%CI:0.78-0.97)(P=0.074).The technical success rates for the standard and Franseen needle groups were 94%(95%CI:0.83-0.99)and 100%(95%CI:0.92-1.00),respectively.The mean total tissue area in mm2(SD)was greater in the Franseen group,2.07(0.22)vs 1.16(0.17)(P<0.01).The mean tumor area in mm2(SD)was not different in Franseen group vs standard group,0.42(0.09)vs 0.47(0.09)(P=0.80).There were no adverse events.CONCLUSION The sensitivity for PM and mean total tissue area,was greater in the as compared with standard needle.The mean tumor area did not differ between the groups.展开更多
Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on ne...Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on needle insertion.It is necessary to summarize and analyze the existing results to promote the future development of theories and applications of needle insertion.Thus,a survey of the state of the art of research is presented on algorithms of needle steering techniques,the surgical robots and devices.Based on the analysis of the needle insertion procedure,the concept of needle steering is defined as a kinematics problem,which is to place the needle at the target and avoid the obstacles.The needle steering techniques,including the artificial potential field method and the nonholonomic model,are introduced to control the needles for improving the accuracy.Based on the quasi-static thinking,the virtual spring model and the cantilever-beam model are developed to calculate the amount of needle deflection and generate the needle path.The phantoms instead of the real tissue are used to verify the models mentioned in most of the experimentations.For the desired needle trajectories,the image-guided robotic devices and some novel needles are presented to achieve the needle steering.Finally,the challenges are provided involving the controllability of the long flexible needle and the properties of soft tissue.The results and investigations can be used for further study on the precision and accuracy of needle insertion.展开更多
AIM: To determine which modification to a vascular puncture needle results in increased visualization during ultrasound (US)-guided vascular puncture. METHODS: We evaluated US images of a phantom made of degassed gela...AIM: To determine which modification to a vascular puncture needle results in increased visualization during ultrasound (US)-guided vascular puncture. METHODS: We evaluated US images of a phantom made of degassed gelatin and each of the following four modified versions of a commercially available vascular puncture needle (18 G): re-cut needle, dimple needle, rough-surface needle (rough over the sections of needle located 3-6 mm from the tip), and a needle with four side holes (side holes covered by the sheath). An unmodified commercially available puncture needle was used as a control. Five interventional radiologists evaluated image quality according to the following classification grade:?I, invisible; II, poor; III, moderate; IV, good; V, excellent. RESULTS: The highest score for needle visualization was obtained for the needle with four side holes. The re-cut needle scored the same as the control. Multiple comparisons were conducted using overall evaluation scores among the commercially available needle, dimple needle, rough-surface needle (3-6 mm), and the needle with four side holes. A significantly higher score was obtained for the needle with four side holes (P < 0.05/6). CONCLUSION: The needle with four side holes was prominently visualized and gained a significantly higher score (compared with the other needles) in a phantom evaluation.展开更多
OBJECTIVE:To assess the efficacy and safety of the Qingyanyin formulated granules(轻燕饮配方颗粒,QYY),press needles(PN),and their combined application in addressing abdominal obesity(AO).This trial aims to offer a mor...OBJECTIVE:To assess the efficacy and safety of the Qingyanyin formulated granules(轻燕饮配方颗粒,QYY),press needles(PN),and their combined application in addressing abdominal obesity(AO).This trial aims to offer a more scientifically grounded therapeutic regimen for clinical interventions.METHODS:From March 2021 to July 2021,a multicenter,triple-blind,randomized 2×2 factorial design clinical trial was conducted across 7 centers in 4 major cities within China's mainland.The trial participants were patients diagnosed with AO.The trial followed a 1∶1∶1∶1 random allocation ratio,assigning participants to one of four groups:QYY placebo plus simulated press needles(SPN)(placebo+SPN),QYY plus SPN(QYY+SPN),QYY placebo plus PN(placebo+PN),and QYY plus PN(QYY+PN).The trial participants received treatment for 12 weeks.Observe the changes in waist circumference,body weight,body mass index(BMI),Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI)scores,and Pittsburgh Sleep Quality Index(PSQI)before and after treatment.RESULTS:The QYY+PN group exhibited significant improvements in waist circumference compared to placebo+PN[Difference=-1.59,95%CI(-3.03,-0.16)]and placebo+SPN groups[Difference=-2.01,95%CI(-3.46,-0.57)].QYY+PN demonstrated a significant advantage over placebo+SPN[Difference=-2.01,95%CI(-3.46,-0.57)],and no statistically significant interaction was observed between the two interventions(P>0.05).In terms of weight and BMI improvements,the QYY+PN,QYY+SPN,and the PN+placebo groups all experienced trending greater reductions in weight compared to the placebo group.In terms of the total scores of PSQI,BAI,and BDI,all four groups exhibited improvements compared to the baseline.Specifically,concerning the change in total PSQI scores,the QYY+PN group exhibited a greater reduction;Regarding the change in total BAI scores,the PN+placebo group demonstrated a greater decrease;As for the change in total BDI scores,the QYY+SPN group displayed a greater reduction.CONCLUSION:This study confirmed that QYY+PN can effectively reduce the waist circumference of patients with AO.Furthermore,the combined approach offers greater benefits than either treatment alone,all without any reported serious adverse events.展开更多
Development of sensor needles for chinese traditional medicine is a long term re- search project in our university. Now, temperature. PH, PO_2 and potential sensor needles have been developed. These new elements are d...Development of sensor needles for chinese traditional medicine is a long term re- search project in our university. Now, temperature. PH, PO_2 and potential sensor needles have been developed. These new elements are derived from the combination between a sensor and an ac- tuator. The design principle, functional materials, fabrication technic, calibration method and clin- ical application of these needles are reported in this paper.展开更多
Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Met...Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle （SEIRIN pyonexes） were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale （VAS） values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.展开更多
[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patie...[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.展开更多
OBJECTIVE:To investigate the effect of pestle needle therapy(PNT)on the posterior cervical muscle(PCM)in a rabbit model of cervical spondylosis(CS)and explore the underlying mechanisms.METHODS:Rabbits were divided int...OBJECTIVE:To investigate the effect of pestle needle therapy(PNT)on the posterior cervical muscle(PCM)in a rabbit model of cervical spondylosis(CS)and explore the underlying mechanisms.METHODS:Rabbits were divided into control,CS modelsⅠandⅡ(CS1 and CS2),electroacupuncture(EA),PNTⅠandⅡ(PN1 and PN2),activator(AVT),and PNT combined with activator(C-AVT)groups.A long-term neck immobilization technique was used to establish a rabbit model of CS.Following completion of modeling,the EA group received electroacupuncture intervention,whereas the CS1,CS2,and C-AVT groups received PNT intervention.The AVT and C-AVT groups received local 740 Y-P injections into the PCM daily.The inflammatory injury to PCM was evaluated based on pain threshold,morphological changes,and interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-αlevels.PCM fibrosis was evaluated by measuring the positive area(PA)of collagen fibrils(CFs)and collagen type 1 alpha 1(Col1α1)using Masson's and immunohistochemical staining.Terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling assay and transmission electron microscopy were used to identify apoptotic cells and assess autophagy,respectively.Western blotting was used to determine B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax),cysteine aspartate-specific protease(caspase)-3,sequestosome-1(P62),microtubuleassociated protein light chain 3(LC3-Ⅰ/Ⅱ),phosphatidylinositol 3-kinase(PI3K),protein kinase B(AKT),and mammalian target of rapamycin(mTOR)levels.Real-time quantitative polymerase chain reaction was used to determine mRNA expression levels of PI3K,AKT,mTOR,autophagy protein(ATG),and ATG7.RESULTS:PNT alleviated PCM cell degeneration and necrosis,inhibited inflammatory cell infiltration,decreased IL-1β,IL-6,and TNF-αlevels,and decreased the PA of CFs and Col1α1.In the PN1 group,cell apoptosis in the PCM decreased,autophagy increased,Bcl-2 and LC3-Ⅱ/Ⅰlevels increased,Bax,Caspase-3,and P62 levels decreased,and the mRNA expression of ATG5 and ATG7 increased.PNT inhibits protein and mRNA expression of PI3K,AKT,and mTOR.Finally,the trend in the results of the rescue experiment was consistent with previous results.CONCLUSION:PNT inhibited apoptosis and promoted autophagy of PCM cells in CS rabbits and alleviated inflammation and fibrosis injury of PCM by inhibiting the PI3K/AKT/mTOR pathway.展开更多
Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).W...Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.展开更多
Semiconductor electronic devices are prone to charge accumulation during production and transportation,which usually causes device breakdown.Ionizers are widely used for electrostatic elimination,and utilizing semicon...Semiconductor electronic devices are prone to charge accumulation during production and transportation,which usually causes device breakdown.Ionizers are widely used for electrostatic elimination,and utilizing semiconductor silicon for the discharge needle material in ionizers can effectively prevent metal contamination.To investigate the discharge characteristics of silicon needles and their mode modulation mechanism,this study has established an experimental platform for silicon needle-plate discharge under positive polarity voltage.Discharge pulse parameters and optical signals were measured at varying electrode spacings.The experimental results reveal that silicon needle discharge progresses through four regimes:the spontaneous streamer,the periodic streamer,the cluster streamer,and the glow discharge.Among these,the pulse amplitude is most uniform and stable in the periodic streamer regime.In addition,shorter-gap discharge exhibits higher pulse amplitude and repetition frequency but is easier to transition into the filament regime.The formation process of a single pulse is closely related to the field strength in the ionization region near the needle tip.Hence,parameters such as the pulse rising edge time and falling edge time show minimal variation with voltage.The amount of charge generated per unit time is primarily influenced by the repetition frequency.Consequently,the electrostatic ionizer produces the highest,most stable,and most uniform charges if it operates in the periodic streamer regime.展开更多
The laparoscopic abdominal cerclage is an established approach in the management of selected cases of cervical insufficiency.The main challenge is to safely insert the cerclage at the level of cervico-isthmic junction...The laparoscopic abdominal cerclage is an established approach in the management of selected cases of cervical insufficiency.The main challenge is to safely insert the cerclage at the level of cervico-isthmic junction,medial to the uterine vessels.This narrated video demonstrated the step-by-step laparoscopic cervico-isthmic cerclage technique using a handheld Berci fascial closure needle to accurately place the suture,medial to the uterine vasculature.展开更多
Double-shaft-driven needle punching machine is a specialized equipment designed for processing C/C crucible preforms.Its main needle punching module is operated by two sets of reciprocating crank-slider mechanisms.The...Double-shaft-driven needle punching machine is a specialized equipment designed for processing C/C crucible preforms.Its main needle punching module is operated by two sets of reciprocating crank-slider mechanisms.The intense vibration during needle punching not only generates huge noise,but also substantially reduces the quality of the preform.It is imperative to perform a dynamic analysis and optimization of the entire needle punching machine.In this paper,the three-dimensional(3D)model of the entire double-shaft-driven needle punching machine for C/C crucible preforms is established.Based on the modal analysis theory,the modal characteristics of the needle punching machine under various operating conditions are analyzed and its natural frequencies and vibration modes are determined.The harmonic response analysis is then employed to obtain the amplitude of the needle plate at different frequencies,and the structural weak points of the needle punching machine are identified and improved.The feasibility of the optimized scheme is subsequently reevaluated and verified.The results indicate that the first six natural frequencies of the machine increase,and the maximum amplitude of the needle plate decreases by 70.3%.The enhanced dynamic characteristics of the machine significantly improve its performance,enabling more efficient needle punching of C/C crucible preforms.展开更多
BACKGROUND Laparoscopic surgery,with the advantage of less trauma,has been predominantly performed to treat pediatric inguinal hernia.However,the traditional three-port laparoscopic surgery remains extremely traumatic...BACKGROUND Laparoscopic surgery,with the advantage of less trauma,has been predominantly performed to treat pediatric inguinal hernia.However,the traditional three-port laparoscopic surgery remains extremely traumatic for children,whereas singleport laparoscopic surgery causes less damage to children than traditional laparoscopy.However,single-port laparoscopic surgery is more challenging;thus,studies on the effect of its application in pediatric inguinal hernia remain relatively limited.AIM To analyze the association of single-incision laparoscopic herniorrhaphy needle treatment with surgical outcomes,postoperative complications,and serum inflammation in pediatric inguinal hernia.METHODS This retrospective study included 113 pediatric patients with inguinal hernia who underwent surgery at the Children’s Hospital,Capital Institute of Pediatrics,from April 2022 to May 2023.Participants were categorized into the observation group(single-incision laparoscopic herniorrhaphy needle,n=60)and the control group(two-port laparoscopic surgery,n=53).Comparative analyses involved surgical duration,intraoperative blood loss,and length of hospital stay.C-reactive protein(CRP)and white blood cell count(WBC)levels were measured preoperatively and 24 hours postoperatively.Postoperative pain was evaluated with the face,legs,activity,cry,and Consolability scale.Further,the incidence of complications,recurrence,and reoperation rates was assessed.Logistic regression was employed to determine independent risk factors related to poor prognosis.RESULTS The observation group demonstrated significantly reduced intraoperative blood loss and shorter hospitalization compared to the control group(P<0.05).Both groups demonstrated increased CRP and WBC levels postoperatively,but the observation group exhibited significantly lower levels(P<0.05).Further,pain scores at 24 hours postoperatively were significantly lower in the observation group(P<0.05).Additionally,the observation group experienced fewer adverse events,recurrence rates,and reoperations compared to the control group(P<0.05).Logistic regression analysis determined increased postoperative stress markers and surgical technique as independent predictors of recurrence(P<0.05).CONCLUSION Single-incision laparoscopic herniorrhaphy needle treatment for pediatric inguinal hernia exhibits significant efficacy,effectively reduces postoperative complications,ensures a more concealed surgical incision,and promotes faster postoperative recovery than conventional two-port laparoscopy.This approach merits wider application.展开更多
Objective: To explore the effectiveness of applying an infusion project team in the safety risk management of indwelling needle use. Methods: A total of 200 patients who used intravenous indwelling needles during hosp...Objective: To explore the effectiveness of applying an infusion project team in the safety risk management of indwelling needle use. Methods: A total of 200 patients who used intravenous indwelling needles during hospital treatment from July to October 2022 were selected and randomly divided into an observation group and a control group, with 100 patients in each group. Patients in the control group received routine nursing methods, while those in the observation group were managed using the safety risk management method of the infusion project team. The tube blocking rate and tube removal rate were compared between the two groups. Results: The one-time puncture success rate and the standard implementation rate of intravenous indwelling needle use in the observation group were significantly higher than those in the control group. The total incidence of complications in the observation group was significantly lower than that in the control group, and patient satisfaction in the observation group was notably higher, with statistically significant differences (P < 0.05). Conclusion: The application of an infusion project team in the safety risk management of indwelling needle use is effective and has positive impacts on improving the one-time puncture success rate, the standard implementation rate of intravenous indwelling needle use, and patient satisfaction. It is a practice worth promoting in clinical settings.展开更多
The single-port laparoscopic hernia needle technique is gaining attention in the treatment of pediatric inguinal hernias due to its unique advantages.This editorial highlights the superiority and challenges of single-...The single-port laparoscopic hernia needle technique is gaining attention in the treatment of pediatric inguinal hernias due to its unique advantages.This editorial highlights the superiority and challenges of single-port laparoscopic hernia needles in the treatment of inguinal hernias in children.We hope that the study by Wang et al and this editorial will draw the attention of more physicians to the single-port laparoscopic hernia needle technique and promote its widespread use in the treatment of pediatric inguinal hernias.展开更多
Objective:To investigate the efficacy and safety of combined spinal-epidural(CSE)anesthesia using a 25G spinal fine needle via a single puncture for lower limb surgery in children.Methods:Sixty pediatric patients sche...Objective:To investigate the efficacy and safety of combined spinal-epidural(CSE)anesthesia using a 25G spinal fine needle via a single puncture for lower limb surgery in children.Methods:Sixty pediatric patients scheduled for surgery were randomly divided into two groups,with 30 patients in each.The control group received subarachnoid anesthesia with 2–2.5 mL of 0.33%ropivacaine.The experimental group received the same ropivacaine dose,followed by withdrawal of the needle to the epidural space and administration of 0.1 mg hydromorphone diluted to 5 mL.The anesthetic and analgesic effects,incidence of complications,and postoperative family satisfaction were observed in both groups.Results:Compared with the control group,the experimental group showed a higher anesthesia success rate,a shorter onset time,and a longer maintenance time of anesthesia(p<0.05).Postoperative analgesia at various time points was significantly better in the experimental group(p<0.05).The total incidence of complications was lower in the experimental group,though the difference was not statistically significant(p>0.05).Family satisfaction was significantly higher in the experimental group(p<0.05).Conclusion:CSE anesthesia using a 25G fine needle via a single puncture for pediatric lower limb surgery is safe and effective.It can significantly improve surgical outcomes and is worthy of clinical promotion.展开更多
Endoscopic ultrasound-guided minimally invasive tissue acquisition can be performed by two approaches as follows: Endoscopic ultrasound-guided fineneedle aspiration(EUS-FNA) and endoscopic ultrasound-guided fine-needl...Endoscopic ultrasound-guided minimally invasive tissue acquisition can be performed by two approaches as follows: Endoscopic ultrasound-guided fineneedle aspiration(EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB). These have been evolved into leading approaches and widely used for the histological diagnosis of tumors in the gastrointestinal tract and adjacent organs. However, the role of EUS-FNA and EUS-FNB in disease diagnosis and evaluation remains controversial. Although the incidence of surgery-associated complications remains low, the consequences of needle tract seeding can be serious or even life-threatening. Recently, increasing case reports of needle tract seeding are emerging, especially caused by EUS-FNA. This complication needs serious consideration. In the present work, we integrated these case reports and the related literature, and summarized the relevant cases and technical characteristics of needle tract seeding caused by EUS-FNA and EUSFNB. Collectively, our findings provided valuable insights into the prevention and reduction of such serious complication.展开更多
AIM To compare the accuracy of endoscopic ultra-sonography(EUS) 19 G core biopsies and 22 G core biopsies in diagnosing the correct etiology for a solid mass.METHODS Articles were searched in Medline, Pub Med, and Ovi...AIM To compare the accuracy of endoscopic ultra-sonography(EUS) 19 G core biopsies and 22 G core biopsies in diagnosing the correct etiology for a solid mass.METHODS Articles were searched in Medline, Pub Med, and Ovid journals. Pooling was conducted by both fixed and random effects models. RESULTS Initial search identified 4460 reference articles for 19 G and 22 G, of these 670 relevant articles were selected and reviewed. Data was extracted from 6 studies for 19G(n = 289) and 16 studies for 22G(n = 592) which met the inclusion criteria. EUS 19 G core biopsies had a pooled sensitivity of 91.6%(95%CI: 87.1-95.0) and pooled specificity of 95.9%(95%CI: 88.6-99.2), whereas EUS 22 G had a pooled sensitivity of 83.3%(95%CI: 79.7-86.6) and pooled specificity of 64.3%(95%CI: 54.7-73.1). The positive likelihood ratio of EUS 19 G core biopsies was 9.08(95%CI: 1.12-73.66) and EUS 22 G core biopsies was 1.99(95%CI: 1.09-3.66).The negative likelihood ratio of EUS 19 G core biopsies was 0.12(95%CI: 0.07-0.24) and EUS 22 G core biopsies was 0.25(95%CI: 0.14-0.41). The diagnostic odds ratio was 84.74(95%CI: 18.31-392.26) for 19 G core biopsies and 10.55(95% CI: 3.29-33.87) for 22 G needles. CONCLUSION EUS 19 G core biopsies have an excellent diagnostic value and seem to be better than EUS 22 G biopsies in detecting the correct etiology for a solid mass.展开更多
基金Supported by Science and technology research project of institution of higher education in Hebei Province:QN2015139planned project of science and technology support in Hebei Province:132777268planned scientific research project of Administration of Traditional Chinese Medicine of Hebei Province:2014014
文摘The emergence of nine needles in Nèijīng（《内经》, The Inner Classic） laid a foundation for the formation and development of needling instruments and acupuncture manipulation in later ages, but the application of nine needles was not realized during clinical practice of acupuncture-moxibustion in later ages. Round-sharp needle is one of the nine needles. In this study, round-sharp needle was taken as an example to introduce the excavation and revitalization of nine needles and diagnosis and treatment rules explored by Mr. CHEN Lixin according to The Inner Classic. The needle shape, needling manipulation and clinical application of round-sharp needle based on The Inner Classic were described in detail.
基金funded by National Natural Science Foundation of China(No.12172092,82174488,and 82305416)Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function(No.21DZ2271800)+1 种基金Shanghai Municipal Science and Technology Commission(No.23YF1418300)Scientific Research Project on Traditional Chinese Medicine of Shanghai Municipal Health Commission—Youth Guidance Category(No.2022QN018).
文摘Objective The analgesic effect of acupuncture has been widely accepted.Nevertheless,the mechanism behind its analgesic effect remains elusive,thus impeding the progress of research geared toward enhancing the analgesic effect of acupuncture.This paper investigated the role of acupuncture needle surface textures on acupuncture’s analgesic effect by creating four experimental acupuncture needles with different patterns of surface augmentation.Methods Four types of acupuncture needles with different surface textures(the lined needle,circle needle,sandpaper needle,and threaded needle)were designed.Additionally,the force/torque measurement system used a robot arm and mechanical sensor to measure the force on the needle during insertion and manipulation.To perform acupuncture analgesia experiments,four experimental acupuncture needles and a normal needle were inserted into the Zusanli(ST36)acupoint of rats with inflammatory pain.By comparing the force and torque and the analgesic efficacy of the different acupuncture needles,these experiments tested the role of acupuncture needle body texture on acupuncture analgesia.Results The analgesic effects of different acupuncture needle body textures varied.Specifically,the force required to penetrate the skin with the lined needle was not greater than that for the normal needle;however,the needle with inscribed circles and the sandpaper-roughened needle both required greater force for insertion.Additionally,the torque of the lined needle reached 2×10^(-4)N·m under twisting manipulation,which was four times greater the torque of a normal needle(5×10^(-5)N·m).Furthermore,the lined needle improved pain threshold and mast cell degranulation rate compared to the normal needle.Conclusion Optimizing the texture of acupuncture needles can enhance acupuncture analgesia.The texture of our experimental acupuncture needles had a significant impact on the force needed to penetrate the skin and the torque needed to manipulate the needle;it was also linked to variable analgesic effects.This study provides a theoretical basis for enhancing the analgesic efficacy of acupuncture through the modification of needles and promoting the development of acupuncture therapy.
文摘BACKGROUND This is a randomized study to compare the diagnostic accuracy of endoscopic ultrasound(EUS)-guided sampling of pancreatic solid lesions obtained with the 22-gauge Franseen(EUS-fine needle biopsy)vs the 22-gauge standard needle(EUS-fine needle aspiration)without rapid onsite evaluation(ROSE),since,in most endoscopy units around the world ROSE is not routinely available.AIM To investigate the accuracy of EUS-guided sampling of pancreatic solid lesions obtained between two different needles without ROSE.METHODS Patients with a solid pancreatic were included.Patients were biopsied in a randomized order.The primary endpoint was the diagnostic sensitivity for pancreatic malignancy(PM).Secondary outcomes were adequacy of the sample,the mean tissue area,the mean tumor area,and the adverse event rate.RESULTS The final diagnosis was pancreatic adenocarcinoma in 38(76%),neuroendocrine tumor in 4(8%),chronic pancreatitis in 3(6%)patients.The sensitivity for PM with Franseen needle was 0.91[95%confidence interval(CI):0.80-0.98],vs 0.8(95%CI:0.67-0.91)(P=0.025)with standard needle.The specificity for PM did not differentiate.The accuracy of the standard needle for PM was 0.80(95%CI:0.66-0.90),and the Franseen group was 0.90(95%CI:0.78-0.97)(P=0.074).The technical success rates for the standard and Franseen needle groups were 94%(95%CI:0.83-0.99)and 100%(95%CI:0.92-1.00),respectively.The mean total tissue area in mm2(SD)was greater in the Franseen group,2.07(0.22)vs 1.16(0.17)(P<0.01).The mean tumor area in mm2(SD)was not different in Franseen group vs standard group,0.42(0.09)vs 0.47(0.09)(P=0.80).There were no adverse events.CONCLUSION The sensitivity for PM and mean total tissue area,was greater in the as compared with standard needle.The mean tumor area did not differ between the groups.
基金supported by National Natural Science Foundation of China (Grant Nos. 51165040,50775119)Visiting Scholar Foundation of Key Lab in University of China (Grant No. GZKF-201020)
文摘Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on needle insertion.It is necessary to summarize and analyze the existing results to promote the future development of theories and applications of needle insertion.Thus,a survey of the state of the art of research is presented on algorithms of needle steering techniques,the surgical robots and devices.Based on the analysis of the needle insertion procedure,the concept of needle steering is defined as a kinematics problem,which is to place the needle at the target and avoid the obstacles.The needle steering techniques,including the artificial potential field method and the nonholonomic model,are introduced to control the needles for improving the accuracy.Based on the quasi-static thinking,the virtual spring model and the cantilever-beam model are developed to calculate the amount of needle deflection and generate the needle path.The phantoms instead of the real tissue are used to verify the models mentioned in most of the experimentations.For the desired needle trajectories,the image-guided robotic devices and some novel needles are presented to achieve the needle steering.Finally,the challenges are provided involving the controllability of the long flexible needle and the properties of soft tissue.The results and investigations can be used for further study on the precision and accuracy of needle insertion.
文摘AIM: To determine which modification to a vascular puncture needle results in increased visualization during ultrasound (US)-guided vascular puncture. METHODS: We evaluated US images of a phantom made of degassed gelatin and each of the following four modified versions of a commercially available vascular puncture needle (18 G): re-cut needle, dimple needle, rough-surface needle (rough over the sections of needle located 3-6 mm from the tip), and a needle with four side holes (side holes covered by the sheath). An unmodified commercially available puncture needle was used as a control. Five interventional radiologists evaluated image quality according to the following classification grade:?I, invisible; II, poor; III, moderate; IV, good; V, excellent. RESULTS: The highest score for needle visualization was obtained for the needle with four side holes. The re-cut needle scored the same as the control. Multiple comparisons were conducted using overall evaluation scores among the commercially available needle, dimple needle, rough-surface needle (3-6 mm), and the needle with four side holes. A significantly higher score was obtained for the needle with four side holes (P < 0.05/6). CONCLUSION: The needle with four side holes was prominently visualized and gained a significantly higher score (compared with the other needles) in a phantom evaluation.
基金National Key Research and Development Project:Clinical Evaluation of the Interventional Techniques for Abdominal Obesity(No.2019YFC1710102)。
文摘OBJECTIVE:To assess the efficacy and safety of the Qingyanyin formulated granules(轻燕饮配方颗粒,QYY),press needles(PN),and their combined application in addressing abdominal obesity(AO).This trial aims to offer a more scientifically grounded therapeutic regimen for clinical interventions.METHODS:From March 2021 to July 2021,a multicenter,triple-blind,randomized 2×2 factorial design clinical trial was conducted across 7 centers in 4 major cities within China's mainland.The trial participants were patients diagnosed with AO.The trial followed a 1∶1∶1∶1 random allocation ratio,assigning participants to one of four groups:QYY placebo plus simulated press needles(SPN)(placebo+SPN),QYY plus SPN(QYY+SPN),QYY placebo plus PN(placebo+PN),and QYY plus PN(QYY+PN).The trial participants received treatment for 12 weeks.Observe the changes in waist circumference,body weight,body mass index(BMI),Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI)scores,and Pittsburgh Sleep Quality Index(PSQI)before and after treatment.RESULTS:The QYY+PN group exhibited significant improvements in waist circumference compared to placebo+PN[Difference=-1.59,95%CI(-3.03,-0.16)]and placebo+SPN groups[Difference=-2.01,95%CI(-3.46,-0.57)].QYY+PN demonstrated a significant advantage over placebo+SPN[Difference=-2.01,95%CI(-3.46,-0.57)],and no statistically significant interaction was observed between the two interventions(P>0.05).In terms of weight and BMI improvements,the QYY+PN,QYY+SPN,and the PN+placebo groups all experienced trending greater reductions in weight compared to the placebo group.In terms of the total scores of PSQI,BAI,and BDI,all four groups exhibited improvements compared to the baseline.Specifically,concerning the change in total PSQI scores,the QYY+PN group exhibited a greater reduction;Regarding the change in total BAI scores,the PN+placebo group demonstrated a greater decrease;As for the change in total BDI scores,the QYY+SPN group displayed a greater reduction.CONCLUSION:This study confirmed that QYY+PN can effectively reduce the waist circumference of patients with AO.Furthermore,the combined approach offers greater benefits than either treatment alone,all without any reported serious adverse events.
文摘Development of sensor needles for chinese traditional medicine is a long term re- search project in our university. Now, temperature. PH, PO_2 and potential sensor needles have been developed. These new elements are derived from the combination between a sensor and an ac- tuator. The design principle, functional materials, fabrication technic, calibration method and clin- ical application of these needles are reported in this paper.
基金supported by General scientific project for institutions of higher learning in Liaoning Province:L 2014370
文摘Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle （SEIRIN pyonexes） were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale （VAS） values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2019GG125).
文摘[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.
基金Suppoorted by Sichuan Provincial Administration of Traditional Chinese Medicine Key Project of Scientific Research in Traditional Chinese Medicine:Deep Learning-based Three-dimensional Finite Element Analysis of Pestle Needle Therapy for the Treatment of Cervical Spine Physiologic Curvature Abnormalities(2023zd025)Scientific Research Project of Sichuan Provincial Science and Technology Department:Improvement of cartilage Degeneration in Knee Osteoarthritis by Regulating Zn^(2+)Homeostasis via Autophagy in Duhuo Jisheng Decoction(23NFSC2298)。
文摘OBJECTIVE:To investigate the effect of pestle needle therapy(PNT)on the posterior cervical muscle(PCM)in a rabbit model of cervical spondylosis(CS)and explore the underlying mechanisms.METHODS:Rabbits were divided into control,CS modelsⅠandⅡ(CS1 and CS2),electroacupuncture(EA),PNTⅠandⅡ(PN1 and PN2),activator(AVT),and PNT combined with activator(C-AVT)groups.A long-term neck immobilization technique was used to establish a rabbit model of CS.Following completion of modeling,the EA group received electroacupuncture intervention,whereas the CS1,CS2,and C-AVT groups received PNT intervention.The AVT and C-AVT groups received local 740 Y-P injections into the PCM daily.The inflammatory injury to PCM was evaluated based on pain threshold,morphological changes,and interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-αlevels.PCM fibrosis was evaluated by measuring the positive area(PA)of collagen fibrils(CFs)and collagen type 1 alpha 1(Col1α1)using Masson's and immunohistochemical staining.Terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling assay and transmission electron microscopy were used to identify apoptotic cells and assess autophagy,respectively.Western blotting was used to determine B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax),cysteine aspartate-specific protease(caspase)-3,sequestosome-1(P62),microtubuleassociated protein light chain 3(LC3-Ⅰ/Ⅱ),phosphatidylinositol 3-kinase(PI3K),protein kinase B(AKT),and mammalian target of rapamycin(mTOR)levels.Real-time quantitative polymerase chain reaction was used to determine mRNA expression levels of PI3K,AKT,mTOR,autophagy protein(ATG),and ATG7.RESULTS:PNT alleviated PCM cell degeneration and necrosis,inhibited inflammatory cell infiltration,decreased IL-1β,IL-6,and TNF-αlevels,and decreased the PA of CFs and Col1α1.In the PN1 group,cell apoptosis in the PCM decreased,autophagy increased,Bcl-2 and LC3-Ⅱ/Ⅰlevels increased,Bax,Caspase-3,and P62 levels decreased,and the mRNA expression of ATG5 and ATG7 increased.PNT inhibits protein and mRNA expression of PI3K,AKT,and mTOR.Finally,the trend in the results of the rescue experiment was consistent with previous results.CONCLUSION:PNT inhibited apoptosis and promoted autophagy of PCM cells in CS rabbits and alleviated inflammation and fibrosis injury of PCM by inhibiting the PI3K/AKT/mTOR pathway.
基金Supported by Shaanxi Provincial Science and Technology Development Plan Project(No.2024SFYBXM-327).
文摘Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.
基金financially supported by Wuxi Yanping Electronic Technology Co.Ltd.
文摘Semiconductor electronic devices are prone to charge accumulation during production and transportation,which usually causes device breakdown.Ionizers are widely used for electrostatic elimination,and utilizing semiconductor silicon for the discharge needle material in ionizers can effectively prevent metal contamination.To investigate the discharge characteristics of silicon needles and their mode modulation mechanism,this study has established an experimental platform for silicon needle-plate discharge under positive polarity voltage.Discharge pulse parameters and optical signals were measured at varying electrode spacings.The experimental results reveal that silicon needle discharge progresses through four regimes:the spontaneous streamer,the periodic streamer,the cluster streamer,and the glow discharge.Among these,the pulse amplitude is most uniform and stable in the periodic streamer regime.In addition,shorter-gap discharge exhibits higher pulse amplitude and repetition frequency but is easier to transition into the filament regime.The formation process of a single pulse is closely related to the field strength in the ionization region near the needle tip.Hence,parameters such as the pulse rising edge time and falling edge time show minimal variation with voltage.The amount of charge generated per unit time is primarily influenced by the repetition frequency.Consequently,the electrostatic ionizer produces the highest,most stable,and most uniform charges if it operates in the periodic streamer regime.
文摘The laparoscopic abdominal cerclage is an established approach in the management of selected cases of cervical insufficiency.The main challenge is to safely insert the cerclage at the level of cervico-isthmic junction,medial to the uterine vessels.This narrated video demonstrated the step-by-step laparoscopic cervico-isthmic cerclage technique using a handheld Berci fascial closure needle to accurately place the suture,medial to the uterine vasculature.
基金Open Project of Shanghai Key Laboratory of Lightweight Composite,China(No.2232021A4-04)。
文摘Double-shaft-driven needle punching machine is a specialized equipment designed for processing C/C crucible preforms.Its main needle punching module is operated by two sets of reciprocating crank-slider mechanisms.The intense vibration during needle punching not only generates huge noise,but also substantially reduces the quality of the preform.It is imperative to perform a dynamic analysis and optimization of the entire needle punching machine.In this paper,the three-dimensional(3D)model of the entire double-shaft-driven needle punching machine for C/C crucible preforms is established.Based on the modal analysis theory,the modal characteristics of the needle punching machine under various operating conditions are analyzed and its natural frequencies and vibration modes are determined.The harmonic response analysis is then employed to obtain the amplitude of the needle plate at different frequencies,and the structural weak points of the needle punching machine are identified and improved.The feasibility of the optimized scheme is subsequently reevaluated and verified.The results indicate that the first six natural frequencies of the machine increase,and the maximum amplitude of the needle plate decreases by 70.3%.The enhanced dynamic characteristics of the machine significantly improve its performance,enabling more efficient needle punching of C/C crucible preforms.
基金Supported by Research Unit of Minimally Invasive Pediatric Surgery on Diagnosis and Treatment,Chinese Academy of Medical Sciences,No.2021RU016.
文摘BACKGROUND Laparoscopic surgery,with the advantage of less trauma,has been predominantly performed to treat pediatric inguinal hernia.However,the traditional three-port laparoscopic surgery remains extremely traumatic for children,whereas singleport laparoscopic surgery causes less damage to children than traditional laparoscopy.However,single-port laparoscopic surgery is more challenging;thus,studies on the effect of its application in pediatric inguinal hernia remain relatively limited.AIM To analyze the association of single-incision laparoscopic herniorrhaphy needle treatment with surgical outcomes,postoperative complications,and serum inflammation in pediatric inguinal hernia.METHODS This retrospective study included 113 pediatric patients with inguinal hernia who underwent surgery at the Children’s Hospital,Capital Institute of Pediatrics,from April 2022 to May 2023.Participants were categorized into the observation group(single-incision laparoscopic herniorrhaphy needle,n=60)and the control group(two-port laparoscopic surgery,n=53).Comparative analyses involved surgical duration,intraoperative blood loss,and length of hospital stay.C-reactive protein(CRP)and white blood cell count(WBC)levels were measured preoperatively and 24 hours postoperatively.Postoperative pain was evaluated with the face,legs,activity,cry,and Consolability scale.Further,the incidence of complications,recurrence,and reoperation rates was assessed.Logistic regression was employed to determine independent risk factors related to poor prognosis.RESULTS The observation group demonstrated significantly reduced intraoperative blood loss and shorter hospitalization compared to the control group(P<0.05).Both groups demonstrated increased CRP and WBC levels postoperatively,but the observation group exhibited significantly lower levels(P<0.05).Further,pain scores at 24 hours postoperatively were significantly lower in the observation group(P<0.05).Additionally,the observation group experienced fewer adverse events,recurrence rates,and reoperations compared to the control group(P<0.05).Logistic regression analysis determined increased postoperative stress markers and surgical technique as independent predictors of recurrence(P<0.05).CONCLUSION Single-incision laparoscopic herniorrhaphy needle treatment for pediatric inguinal hernia exhibits significant efficacy,effectively reduces postoperative complications,ensures a more concealed surgical incision,and promotes faster postoperative recovery than conventional two-port laparoscopy.This approach merits wider application.
文摘Objective: To explore the effectiveness of applying an infusion project team in the safety risk management of indwelling needle use. Methods: A total of 200 patients who used intravenous indwelling needles during hospital treatment from July to October 2022 were selected and randomly divided into an observation group and a control group, with 100 patients in each group. Patients in the control group received routine nursing methods, while those in the observation group were managed using the safety risk management method of the infusion project team. The tube blocking rate and tube removal rate were compared between the two groups. Results: The one-time puncture success rate and the standard implementation rate of intravenous indwelling needle use in the observation group were significantly higher than those in the control group. The total incidence of complications in the observation group was significantly lower than that in the control group, and patient satisfaction in the observation group was notably higher, with statistically significant differences (P < 0.05). Conclusion: The application of an infusion project team in the safety risk management of indwelling needle use is effective and has positive impacts on improving the one-time puncture success rate, the standard implementation rate of intravenous indwelling needle use, and patient satisfaction. It is a practice worth promoting in clinical settings.
文摘The single-port laparoscopic hernia needle technique is gaining attention in the treatment of pediatric inguinal hernias due to its unique advantages.This editorial highlights the superiority and challenges of single-port laparoscopic hernia needles in the treatment of inguinal hernias in children.We hope that the study by Wang et al and this editorial will draw the attention of more physicians to the single-port laparoscopic hernia needle technique and promote its widespread use in the treatment of pediatric inguinal hernias.
文摘Objective:To investigate the efficacy and safety of combined spinal-epidural(CSE)anesthesia using a 25G spinal fine needle via a single puncture for lower limb surgery in children.Methods:Sixty pediatric patients scheduled for surgery were randomly divided into two groups,with 30 patients in each.The control group received subarachnoid anesthesia with 2–2.5 mL of 0.33%ropivacaine.The experimental group received the same ropivacaine dose,followed by withdrawal of the needle to the epidural space and administration of 0.1 mg hydromorphone diluted to 5 mL.The anesthetic and analgesic effects,incidence of complications,and postoperative family satisfaction were observed in both groups.Results:Compared with the control group,the experimental group showed a higher anesthesia success rate,a shorter onset time,and a longer maintenance time of anesthesia(p<0.05).Postoperative analgesia at various time points was significantly better in the experimental group(p<0.05).The total incidence of complications was lower in the experimental group,though the difference was not statistically significant(p>0.05).Family satisfaction was significantly higher in the experimental group(p<0.05).Conclusion:CSE anesthesia using a 25G fine needle via a single puncture for pediatric lower limb surgery is safe and effective.It can significantly improve surgical outcomes and is worthy of clinical promotion.
基金Supported by National Natural Science Foundation of China,No. 81800489。
文摘Endoscopic ultrasound-guided minimally invasive tissue acquisition can be performed by two approaches as follows: Endoscopic ultrasound-guided fineneedle aspiration(EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB). These have been evolved into leading approaches and widely used for the histological diagnosis of tumors in the gastrointestinal tract and adjacent organs. However, the role of EUS-FNA and EUS-FNB in disease diagnosis and evaluation remains controversial. Although the incidence of surgery-associated complications remains low, the consequences of needle tract seeding can be serious or even life-threatening. Recently, increasing case reports of needle tract seeding are emerging, especially caused by EUS-FNA. This complication needs serious consideration. In the present work, we integrated these case reports and the related literature, and summarized the relevant cases and technical characteristics of needle tract seeding caused by EUS-FNA and EUSFNB. Collectively, our findings provided valuable insights into the prevention and reduction of such serious complication.
文摘AIM To compare the accuracy of endoscopic ultra-sonography(EUS) 19 G core biopsies and 22 G core biopsies in diagnosing the correct etiology for a solid mass.METHODS Articles were searched in Medline, Pub Med, and Ovid journals. Pooling was conducted by both fixed and random effects models. RESULTS Initial search identified 4460 reference articles for 19 G and 22 G, of these 670 relevant articles were selected and reviewed. Data was extracted from 6 studies for 19G(n = 289) and 16 studies for 22G(n = 592) which met the inclusion criteria. EUS 19 G core biopsies had a pooled sensitivity of 91.6%(95%CI: 87.1-95.0) and pooled specificity of 95.9%(95%CI: 88.6-99.2), whereas EUS 22 G had a pooled sensitivity of 83.3%(95%CI: 79.7-86.6) and pooled specificity of 64.3%(95%CI: 54.7-73.1). The positive likelihood ratio of EUS 19 G core biopsies was 9.08(95%CI: 1.12-73.66) and EUS 22 G core biopsies was 1.99(95%CI: 1.09-3.66).The negative likelihood ratio of EUS 19 G core biopsies was 0.12(95%CI: 0.07-0.24) and EUS 22 G core biopsies was 0.25(95%CI: 0.14-0.41). The diagnostic odds ratio was 84.74(95%CI: 18.31-392.26) for 19 G core biopsies and 10.55(95% CI: 3.29-33.87) for 22 G needles. CONCLUSION EUS 19 G core biopsies have an excellent diagnostic value and seem to be better than EUS 22 G biopsies in detecting the correct etiology for a solid mass.
