The 3D needled C/SiC brake materials modified with graphite were prepared by a combined process of the chemical vapor infiltration,slurry infiltration and liquid silicon infiltration process.The microstructure and fri...The 3D needled C/SiC brake materials modified with graphite were prepared by a combined process of the chemical vapor infiltration,slurry infiltration and liquid silicon infiltration process.The microstructure and frictional properties of the brake materials were investigated.The density and open porosity of the materials as-received were about(2.1±0.1)g/cm3and(5±1)%,respectively.The brake materials were composed of 59%C,39%SiC,and 2%Si(mass fraction).The content of Si in the C/SiC brake materials modified with graphite was far less than that in the C/SiC brake materials without being modified with graphite,and the Si was dispersed.The braking curve of the 3D needled C/SiC modified with graphite was smooth,which can ensure the smooth and comfortable braking.The frictional properties under wet condition of the 3D needled C/SiC modified with graphite showed no fading.And the linear wear rate of the C/SiC modified with graphite was lower than that of the C/SiC unmodified.展开更多
MXene,a transition metal carbide/nitride,has been prominent as an ideal electrochemical active material for supercapacitors.However,the low MXene load limits its practical applications.As environmental concerns and su...MXene,a transition metal carbide/nitride,has been prominent as an ideal electrochemical active material for supercapacitors.However,the low MXene load limits its practical applications.As environmental concerns and sustainable development become more widely recognized,it is necessary to explore a greener and cleaner technology to recycle textile by-products such as cotton.The present study proposes an effective 3D fabrication method that uses MXene to fabricate waste denim felt into ultralight and flexible supercapacitors through needling and carbonization.The 3D structure provided more sites for loading MXene onto Z-directional fiber bundles,resulting in more efficient ion exchange between the electrolyte and electrodes.Furthermore,the carbonization process removed the specific adverse groups in MXenes,further improving the specific capacitance,energy density,power density and electrical conductivity of supercapacitors.The electrodes achieve a maximum specific capacitance of 1748.5 mF cm-2 and demonstrate remarkable cycling stability maintaining more than 94%after 15,000 galvanostatic charge/discharge cycles.Besides,the obtained supercapacitors present a maximum specific capacitance of 577.5 mF cm^(-2),energy density of 80.2μWh cm^(-2)and power density of 3 mW cm^(-2),respectively.The resulting supercapacitors can be used to develop smart wearable power devices such as smartwatches,laying the foundation for a novel strategy of utilizing waste cotton in a high-quality manner.展开更多
Objective:To investigate the mechanism of fire needling in improving autophagy and oxidative stress in rats with cervical spondylosis of vertebral artery type(CSA)by regulating protein kinase B(PKB/Akt)/mammalian targ...Objective:To investigate the mechanism of fire needling in improving autophagy and oxidative stress in rats with cervical spondylosis of vertebral artery type(CSA)by regulating protein kinase B(PKB/Akt)/mammalian target of rapamycin(mTOR)signaling pathway.Methods:The rats were randomly divided into a sham-operation group(Sham group)and a model group.After successful modeling,the rats were randomly divided into a CSA group,a fire needling group,and a fire needling+insulin-like growth factor 1(IGF-1)group.No intervention was performed in the Sham and CSA groups;the fire needling group received fire needling intervention;the fire needling+IGF-1 group received both fire needling and intraperitoneal injection of IGF-1 solution intervention.The inclined plate test was used to detect the exercise ability of rats.Laser Doppler was used to detect the blood flow in the pia mater microcirculation.Multi-mode high-frequency acoustic was used to detect the blood flow velocity of both sides of the vertebral artery.The serum levels of endothelin-1(ET-1),nitric oxide(NO),superoxide dismutase(SOD),and malondialdehyde(MDA)were measured.A transmission electron microscope was used to observe vertebral artery autophagosomes.Western blotting was used to detect the ratios of phosphorylated(phospho)-phosphoinositide 3-kinase(PI3K)/PI3K,phospho-Akt/Akt,phospho-mTOR/mTOR,autophagy-related proteins(Beclin-1 and p62),and the ratios of microtubule-associated protein 1A/1B light chain 3(LC3Ⅱ/LC3Ⅰ)in vertebral artery tissues.Results:Compared to the Sham group,the inclination angle of the inclined plate,pia mater microcirculation blood flow,blood flow velocity of the left vertebral artery(LVA),right vertebral artery(RVA),NO level,and SOD activity were significantly decreased(P<0.05),and the serum ET-1 and MDA levels were significantly increased(P<0.05)in the CSA group.Compared to the CSA group,the inclination angle of the inclined plate,blood flow of pia mater microcirculation,blood flow velocity of the LVA and RVA,NO level,and SOD activity were significantly increased(P<0.05),and the serum ET-1 and MDA levels were significantly decreased(P<0.05)in the fire needling group.The inclination angle of the inclined plate,blood flow of pia mater microcirculation,blood flow velocity of the LVA and RVA,NO level,and SOD activity in the fire needling+IGF-1 group were significantly lower than those in the fire needling group(P<0.05),and the serum ET-1 and MDA levels were higher than those in the fire needling group(P<0.05).Compared to the Sham group,a large number of autophagosomes and autophagy degradation vesicles were found in the vertebral artery tissues of the CSA group.Compared to the CSA group,autophagosomes and autophagy degradation vesicles in rat vertebral artery tissues of the fire needling group were significantly reduced.Compared to the fire needling group,the autophagosomes and autophagy degradation vesicles in the vertebral artery tissues of the fire needling+IGF-1 group were increased significantly.The expression ratios of phospho-PI3K/PI3K,phospho-Akt/Akt,phospho-mTOR/mTOR,LC3Ⅱ/LC3Ⅰ,and Beclin protein expression in rat vertebral artery tissues of the CSA group were higher than those in the Sham group(P<0.05),and p62 protein expression was lower than that in the Sham group(P<0.05).The above expression ratios in rat vertebral artery tissues of the fire needling group were lower than those of the CSA group(P<0.05),and p62 protein expression was higher than that of the CSA group(P<0.05).The above protein expression ratios in rat vertebral artery tissues of the fire needling+IGF-1 group were higher than those of the fire needling group(P<0.05),and p62 protein expression was lower than that of the fire needling group(P<0.05).Conclusion:Fire needling can reduce oxidative stress levels by promoting autophagy in CSA rats.The mechanism may be related to the inhibition of PI3K/Akt/mTOR signaling pathway activation.展开更多
Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels.Methods:A tota...Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels.Methods:A total of 80 patients with depression after ischemic stroke were divided into a control group and an observation group using the random number table method,with 40 cases in each group.The two groups were treated with Wen Yang Jie Yu Tang(decoction for warming Yang and relieving depression).The observation group was treated with additional acupuncture and moxibustion therapy.The therapeutic effect was evaluated after 4 weeks of treatment.The traditional Chinese medicine(TCM)main symptoms and depression symptoms were scored before and after 4 weeks of treatment.Neurological function was assessed using the National Institutes of Health stroke scale(NIHSS),depressive symptoms were evaluated by the 17-item Hamilton depression scale(HAMD-17),and sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Meanwhile,the serum levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),noradrenaline(NE),and dopamine(DA),were measured.The incidence of adverse reactions during treatment was compared between the two groups.Results:The total effective rates in improving depression symptoms and TCM main symptoms in the observation group were both higher than those in the control group(P<0.05).After treatment,the scores of each TCM main symptom,NIHSS,HAMD-17,and PSQI in both groups were all lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum levels of 5-HT,NE,and DA in both groups were all higher than those before treatment(P<0.05),and the serum levels in the observation group were higher than those in the control group(P<0.05).During the treatment period,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The treatment of acupuncture and moxibustion plus traditional Chinese herbs has significant efficacy in treating depression after ischemic stroke;it can effectively relieve the symptoms,improve neurological function and sleep quality,increase monoamine neurotransmitter levels,and has high safety.展开更多
International patients are flocking to Hainan for healing through the ancient technique of traditional Chinese medicine.SAREN,a traditional Chinese medicine(TCM)doctor,keeps vipbooks filled with warm messages in var...International patients are flocking to Hainan for healing through the ancient technique of traditional Chinese medicine.SAREN,a traditional Chinese medicine(TCM)doctor,keeps vipbooks filled with warm messages in various languages in her consulting room at Sanya International Friendship Sanatorium of TCM.These expressions of gratitude not only document a long medical career,but also vividly testify to how a Chinese doctor has used acupuncture to cure patients from around the world.展开更多
Objective:To evaluate the clinical efficacy of umbilical herbal application combined with pestle needle therapy in the treatment of functional diarrhea(FD)due to deficient cold of the spleen and stomach.Methods:A tota...Objective:To evaluate the clinical efficacy of umbilical herbal application combined with pestle needle therapy in the treatment of functional diarrhea(FD)due to deficient cold of the spleen and stomach.Methods:A total of 72 patients with FD were enrolled and randomly assigned to two groups using the random number table method,with 36 patients in each group.Both groups received conventional Western medication treatment.The observation group additionally received umbilical application of Wen Yang Bu Pi Gao(Yang-warming and spleenstrengthening herbal paste)combined with pestle needle therapy.After 7 d of treatment,the clinical efficacy was assessed.Traditional Chinese medicine(TCM)symptom scores,irritable bowel syndrome-quality of life(IBS-QOL)score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 91.7%,which was significantly higher than 69.4%in the control group(P<0.05).After treatment,TCM symptom and IBS-QOL scores in both groups were significantly reduced compared to those before treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.05).No adverse reactions occurred in either group during the treatment period.Conclusion:Compared to conventional Western medication treatment alone,the addition of umbilical application of Wen Yang Bu Pi Gao combined with pestle needle therapy can more effectively alleviate clinical symptoms and improve the quality of life in patients with FD due to deficient cold of the spleen and stomach.展开更多
Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is importan...Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced EUS.Clinical studies have reported varying diagnostic and adverse event rates with these modalities.In addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different recommendations.In this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.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
The introduction of wireless capsule endoscopy has brought a revolutionary change in the diagnostic procedures for gastrointestinal disorders.Biopsy,an essential procedure for disease diagnosis,has been integrated int...The introduction of wireless capsule endoscopy has brought a revolutionary change in the diagnostic procedures for gastrointestinal disorders.Biopsy,an essential procedure for disease diagnosis,has been integrated into robotic capsule endoscopy to augment diagnostic capabilities.In this study,we propose a magnetically driven biopsy robot based on a Kresling origami.Considering the bistable properties of Krelsing origami and the elasticity of the creases,a foldable structure of the robot with constant force characteristics is designed.The folding motion of the structure is used to deploy the needle into the target tissue.The robot is capable of performing rolling motion under the control of an external magnetic drive system,and a fine needle biopsy technique is used to collect deep tissue samples.We also conduct in vitro rolling experiments and sampling experiments on apple tissues and pork tissues,which verify the performance of the robot.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 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
A young artist seeks to make Suzhou silk embroidery,a millennia-old art,more contemporary and alive.THE city of Suzhou in east China’s Jiangsu Province is the birthplace of the famous Su embroidery,one of the four ma...A young artist seeks to make Suzhou silk embroidery,a millennia-old art,more contemporary and alive.THE city of Suzhou in east China’s Jiangsu Province is the birthplace of the famous Su embroidery,one of the four main styles of Chinese silk embroidery,used to make a wealth of things from screens and garments to dazzling pictures.In Zhenhu,a small,picturesque town in Suzhou,the tradition of Suzhou embroidery goes back 2,000 years and of its nearly 20,000 residents,more than 40 percent are engaged in the embroidery business.Zhou Xiaojing is one of them.With her nimble needle and threads,the young embroiderer has created many captivating pieces of art.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
BACKGROUND Liver biopsy is an important diagnostic tool to investigate patients with suspected liver disease.The efficacy and safety of endoscopic ultrasound-guided liver biopsy(EUS-LB)as a method for liver tissue acq...BACKGROUND Liver biopsy is an important diagnostic tool to investigate patients with suspected liver disease.The efficacy and safety of endoscopic ultrasound-guided liver biopsy(EUS-LB)as a method for liver tissue acquisition remain uncertain.AIM To study the diagnostic yield and safety of EUS-LB in patients with suspected parenchymal liver disease.METHODS This is a retrospective observational cohort study of patients undergoing EUS-LB in 2 tertiary-care centers in Kuwait in the period between January 2022-June 2025.The primary outcome was sample adequacy,while secondary outcomes included histological quality of the specimen and adverse events.Predictors of increased diagnostic adequacy and specimen quality were explored.RESULTS A total of 50 patients[mean age 43.9(15.5)years,40%males]were included.The left liver lobe was targeted for biopsy in most patients(96%),and 19-gauge fine needle aspiration(FNA)was used in most cases(52%).The median number of passes performed was 3(range 2-5),and the heparin-wet suction technique was used in 40%of patients.The overall diagnostic adequacy of EUS-LB was 86%,with no significant difference between 19-gauge FNA and 19-gauge fine needle biopsy(FNB)needles.Fulfillment of the European Association for the Study of Liver(EASL)and the American Association for the Study of Liver Diseases criteria was achieved in 54%and 34%,respectively,with a significantly higher number of patients fulfilling these criteria when FNB needle was used compared to FNA needle(83.3%vs 26.9%,P<0.0001)and(62.5%vs 7.7%,P<0.0001),respectively.Only 1 patient(2.0%)developed adverse post-procedure events,namely bleeding requiring transfusion.Multivariate regression analysis did not identify any factor that increased diagnostic adequacy;however,the use of FNB needles and wet heparin suction methods were associated with significantly increased odds of fulfilling EASL criteria,while performing more than 2 passes reduced the quality of the specimen.CONCLUSION EUS-LB is an effective and safe method for obtaining liver biopsy in patients with suspected parenchymal liver disease.EUS-LB demonstrated a favorable safety profile in our cohort,although larger prospective studies are required to validate bleeding risk.The use of 19-gauge FNB needles,wet-heparin suction technique,and performing≤2 passes is associated with improved quality of the specimen obtained without increasing the risk of adverse events.展开更多
BACKGROUND Endoscopic ultrasound(EUS)is crucial for diagnosing solid pancreatic lesions,especially pancreatic ductal adenocarcinoma(PDAC),a highly aggressive cancer which represents the majority with a prevalence of a...BACKGROUND Endoscopic ultrasound(EUS)is crucial for diagnosing solid pancreatic lesions,especially pancreatic ductal adenocarcinoma(PDAC),a highly aggressive cancer which represents the majority with a prevalence of approximately 85%.AIM To identify EUS features that differentiate PDAC from other lesions such as neuroendocrine tumors(NETs)and helping in the differential diagnosis,by analyzing a large sample of solid pancreatic lesions.METHODS This observational,retrospective,multicenter study analyzed the endosonographic characteristics of 761 patients with a radiological diagnosis of solid pancreatic lesion,who underwent pancreatic EUS for typing and staging with needle biopsies between 2015 and 2023.General patient characteristics(age and sex)and solid lesion features were collected and described,such lesion size(Bmode),vessel involvement(compression or invasion),ductal dilation,lymphadenopathy,echogenicity,echopattern,margin regularity,multifocality,internal vascularization and elastography.Subsequently,a predictive analysis was performed through univariate and multivariate logistic regression to identify predictive features for PDAC or NET diagnoses.RESULTS Our study enrolled 761 patients,predominantly male with a mean age of 68.6.PDACs were generally larger(mean 33 mm×27 mm),often had irregular margins,and displayed significant upstream ductal dilation.Hypoechogenicity was common across malignant lesions.In contrast,NETs were smaller(mean 20 mm×17 mm)and typically had regular margins with multiple lesions.Vascular involvement,although predominant in PDAC,is a common feature of all malignant neoplasms.Multifocality,however,although a rare finding,is more typical of NETs and metastases,and practically absent in the remaining lesions.Predictive analyses showed that ductal dilation and irregular margins were the most significant predictors for PDAC[odds ratio(OR)=5.75 and 3.83],with hypoechogenicity,heterogeneous echopattern and lymphadenopathies also highly significant(OR=3.51,2.56 and 1.99).These features were inversely associated with NETs,with regular margins and absence of ductal involvement or lymphadenopathies(OR=0.24,0.86 and 0.45 respectively),as already shown by the descriptive analysis.Finally,age,despite achieving statistical significance,lacks clinical value given an OR trending towards 1.CONCLUSION This study provides a comprehensive overview of EUS features for solid pancreatic lesions,identifying distinct features like upstream ductal dilation and irregular margins for PDAC vs regular margins for NETs as strong diagnostic predictors.These findings enhance the understanding of pancreatic pathologies,offering valuable insights for improved differential diagnosis and clinical management,especially in complex cases.Further prospective studies could build on these results.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
[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
基金Project(46-QP-2009)supported by the Research Fund of State Key Laboratory of Solidification Processing(NWPU),ChinaProject supported by the Program for Changjiang Scholars and Innovative Research Team in Chinese University
文摘The 3D needled C/SiC brake materials modified with graphite were prepared by a combined process of the chemical vapor infiltration,slurry infiltration and liquid silicon infiltration process.The microstructure and frictional properties of the brake materials were investigated.The density and open porosity of the materials as-received were about(2.1±0.1)g/cm3and(5±1)%,respectively.The brake materials were composed of 59%C,39%SiC,and 2%Si(mass fraction).The content of Si in the C/SiC brake materials modified with graphite was far less than that in the C/SiC brake materials without being modified with graphite,and the Si was dispersed.The braking curve of the 3D needled C/SiC modified with graphite was smooth,which can ensure the smooth and comfortable braking.The frictional properties under wet condition of the 3D needled C/SiC modified with graphite showed no fading.And the linear wear rate of the C/SiC modified with graphite was lower than that of the C/SiC unmodified.
基金The authors acknowledge the financial support from the National Natural Science Foundation of China(Nos.52073224,32201491)the Textile Vision Basic Research Program of China(No.J202110)+3 种基金the Scientific Research Project of Shaanxi Provincial Education Department,China(No.22JC035)the Advanced Manufacturing Technology Program of Xi’an Science and Technology Bureau,China(No.21XJZZ0019)the Research Fund for the Doctoral Program of Xi’an Polytechnic University(No.BS202053)the Youth Innovation Team of Shaanxi Universities and Institute of Flexible electronics and Intelligent Textile.
文摘MXene,a transition metal carbide/nitride,has been prominent as an ideal electrochemical active material for supercapacitors.However,the low MXene load limits its practical applications.As environmental concerns and sustainable development become more widely recognized,it is necessary to explore a greener and cleaner technology to recycle textile by-products such as cotton.The present study proposes an effective 3D fabrication method that uses MXene to fabricate waste denim felt into ultralight and flexible supercapacitors through needling and carbonization.The 3D structure provided more sites for loading MXene onto Z-directional fiber bundles,resulting in more efficient ion exchange between the electrolyte and electrodes.Furthermore,the carbonization process removed the specific adverse groups in MXenes,further improving the specific capacitance,energy density,power density and electrical conductivity of supercapacitors.The electrodes achieve a maximum specific capacitance of 1748.5 mF cm-2 and demonstrate remarkable cycling stability maintaining more than 94%after 15,000 galvanostatic charge/discharge cycles.Besides,the obtained supercapacitors present a maximum specific capacitance of 577.5 mF cm^(-2),energy density of 80.2μWh cm^(-2)and power density of 3 mW cm^(-2),respectively.The resulting supercapacitors can be used to develop smart wearable power devices such as smartwatches,laying the foundation for a novel strategy of utilizing waste cotton in a high-quality manner.
基金supported by Chongqing Science and Technology Project of Traditional Chinese Medicine Jointly Launched by Science and Health Commission in 2018(重庆市2018年科卫联合中医药科技项目,No.ZY201802027).
文摘Objective:To investigate the mechanism of fire needling in improving autophagy and oxidative stress in rats with cervical spondylosis of vertebral artery type(CSA)by regulating protein kinase B(PKB/Akt)/mammalian target of rapamycin(mTOR)signaling pathway.Methods:The rats were randomly divided into a sham-operation group(Sham group)and a model group.After successful modeling,the rats were randomly divided into a CSA group,a fire needling group,and a fire needling+insulin-like growth factor 1(IGF-1)group.No intervention was performed in the Sham and CSA groups;the fire needling group received fire needling intervention;the fire needling+IGF-1 group received both fire needling and intraperitoneal injection of IGF-1 solution intervention.The inclined plate test was used to detect the exercise ability of rats.Laser Doppler was used to detect the blood flow in the pia mater microcirculation.Multi-mode high-frequency acoustic was used to detect the blood flow velocity of both sides of the vertebral artery.The serum levels of endothelin-1(ET-1),nitric oxide(NO),superoxide dismutase(SOD),and malondialdehyde(MDA)were measured.A transmission electron microscope was used to observe vertebral artery autophagosomes.Western blotting was used to detect the ratios of phosphorylated(phospho)-phosphoinositide 3-kinase(PI3K)/PI3K,phospho-Akt/Akt,phospho-mTOR/mTOR,autophagy-related proteins(Beclin-1 and p62),and the ratios of microtubule-associated protein 1A/1B light chain 3(LC3Ⅱ/LC3Ⅰ)in vertebral artery tissues.Results:Compared to the Sham group,the inclination angle of the inclined plate,pia mater microcirculation blood flow,blood flow velocity of the left vertebral artery(LVA),right vertebral artery(RVA),NO level,and SOD activity were significantly decreased(P<0.05),and the serum ET-1 and MDA levels were significantly increased(P<0.05)in the CSA group.Compared to the CSA group,the inclination angle of the inclined plate,blood flow of pia mater microcirculation,blood flow velocity of the LVA and RVA,NO level,and SOD activity were significantly increased(P<0.05),and the serum ET-1 and MDA levels were significantly decreased(P<0.05)in the fire needling group.The inclination angle of the inclined plate,blood flow of pia mater microcirculation,blood flow velocity of the LVA and RVA,NO level,and SOD activity in the fire needling+IGF-1 group were significantly lower than those in the fire needling group(P<0.05),and the serum ET-1 and MDA levels were higher than those in the fire needling group(P<0.05).Compared to the Sham group,a large number of autophagosomes and autophagy degradation vesicles were found in the vertebral artery tissues of the CSA group.Compared to the CSA group,autophagosomes and autophagy degradation vesicles in rat vertebral artery tissues of the fire needling group were significantly reduced.Compared to the fire needling group,the autophagosomes and autophagy degradation vesicles in the vertebral artery tissues of the fire needling+IGF-1 group were increased significantly.The expression ratios of phospho-PI3K/PI3K,phospho-Akt/Akt,phospho-mTOR/mTOR,LC3Ⅱ/LC3Ⅰ,and Beclin protein expression in rat vertebral artery tissues of the CSA group were higher than those in the Sham group(P<0.05),and p62 protein expression was lower than that in the Sham group(P<0.05).The above expression ratios in rat vertebral artery tissues of the fire needling group were lower than those of the CSA group(P<0.05),and p62 protein expression was higher than that of the CSA group(P<0.05).The above protein expression ratios in rat vertebral artery tissues of the fire needling+IGF-1 group were higher than those of the fire needling group(P<0.05),and p62 protein expression was lower than that of the fire needling group(P<0.05).Conclusion:Fire needling can reduce oxidative stress levels by promoting autophagy in CSA rats.The mechanism may be related to the inhibition of PI3K/Akt/mTOR signaling pathway activation.
基金supported by the Science and Technology Research and Development Program Project of Qinhuangdao(秦皇岛市科学技术研究与发展计划项目,No.202301A067).
文摘Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels.Methods:A total of 80 patients with depression after ischemic stroke were divided into a control group and an observation group using the random number table method,with 40 cases in each group.The two groups were treated with Wen Yang Jie Yu Tang(decoction for warming Yang and relieving depression).The observation group was treated with additional acupuncture and moxibustion therapy.The therapeutic effect was evaluated after 4 weeks of treatment.The traditional Chinese medicine(TCM)main symptoms and depression symptoms were scored before and after 4 weeks of treatment.Neurological function was assessed using the National Institutes of Health stroke scale(NIHSS),depressive symptoms were evaluated by the 17-item Hamilton depression scale(HAMD-17),and sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Meanwhile,the serum levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),noradrenaline(NE),and dopamine(DA),were measured.The incidence of adverse reactions during treatment was compared between the two groups.Results:The total effective rates in improving depression symptoms and TCM main symptoms in the observation group were both higher than those in the control group(P<0.05).After treatment,the scores of each TCM main symptom,NIHSS,HAMD-17,and PSQI in both groups were all lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum levels of 5-HT,NE,and DA in both groups were all higher than those before treatment(P<0.05),and the serum levels in the observation group were higher than those in the control group(P<0.05).During the treatment period,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The treatment of acupuncture and moxibustion plus traditional Chinese herbs has significant efficacy in treating depression after ischemic stroke;it can effectively relieve the symptoms,improve neurological function and sleep quality,increase monoamine neurotransmitter levels,and has high safety.
文摘International patients are flocking to Hainan for healing through the ancient technique of traditional Chinese medicine.SAREN,a traditional Chinese medicine(TCM)doctor,keeps vipbooks filled with warm messages in various languages in her consulting room at Sanya International Friendship Sanatorium of TCM.These expressions of gratitude not only document a long medical career,but also vividly testify to how a Chinese doctor has used acupuncture to cure patients from around the world.
基金supported by 2023 Annual Public Welfare Technological Application Research Project of Jinhua City(2023年度金华市公益性技术应用研究项目,No.2023-4-256).
文摘Objective:To evaluate the clinical efficacy of umbilical herbal application combined with pestle needle therapy in the treatment of functional diarrhea(FD)due to deficient cold of the spleen and stomach.Methods:A total of 72 patients with FD were enrolled and randomly assigned to two groups using the random number table method,with 36 patients in each group.Both groups received conventional Western medication treatment.The observation group additionally received umbilical application of Wen Yang Bu Pi Gao(Yang-warming and spleenstrengthening herbal paste)combined with pestle needle therapy.After 7 d of treatment,the clinical efficacy was assessed.Traditional Chinese medicine(TCM)symptom scores,irritable bowel syndrome-quality of life(IBS-QOL)score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 91.7%,which was significantly higher than 69.4%in the control group(P<0.05).After treatment,TCM symptom and IBS-QOL scores in both groups were significantly reduced compared to those before treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.05).No adverse reactions occurred in either group during the treatment period.Conclusion:Compared to conventional Western medication treatment alone,the addition of umbilical application of Wen Yang Bu Pi Gao combined with pestle needle therapy can more effectively alleviate clinical symptoms and improve the quality of life in patients with FD due to deficient cold of the spleen and stomach.
文摘Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced EUS.Clinical studies have reported varying diagnostic and adverse event rates with these modalities.In addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different recommendations.In this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.
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.
基金supported by the National Natural Science Foundation of China(Grant Nos.51805047 and 52175003)the Outstanding Youth Program of Hunan Education Department(Grant No.23B0335)the Natural Science Foundation of Hunan Province(Grant Nos.2023JJ30021 and 2023JJ50077).
文摘The introduction of wireless capsule endoscopy has brought a revolutionary change in the diagnostic procedures for gastrointestinal disorders.Biopsy,an essential procedure for disease diagnosis,has been integrated into robotic capsule endoscopy to augment diagnostic capabilities.In this study,we propose a magnetically driven biopsy robot based on a Kresling origami.Considering the bistable properties of Krelsing origami and the elasticity of the creases,a foldable structure of the robot with constant force characteristics is designed.The folding motion of the structure is used to deploy the needle into the target tissue.The robot is capable of performing rolling motion under the control of an external magnetic drive system,and a fine needle biopsy technique is used to collect deep tissue samples.We also conduct in vitro rolling experiments and sampling experiments on apple tissues and pork tissues,which verify the performance of the robot.
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.
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A young artist seeks to make Suzhou silk embroidery,a millennia-old art,more contemporary and alive.THE city of Suzhou in east China’s Jiangsu Province is the birthplace of the famous Su embroidery,one of the four main styles of Chinese silk embroidery,used to make a wealth of things from screens and garments to dazzling pictures.In Zhenhu,a small,picturesque town in Suzhou,the tradition of Suzhou embroidery goes back 2,000 years and of its nearly 20,000 residents,more than 40 percent are engaged in the embroidery business.Zhou Xiaojing is one of them.With her nimble needle and threads,the young embroiderer has created many captivating pieces of art.
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.
文摘BACKGROUND Liver biopsy is an important diagnostic tool to investigate patients with suspected liver disease.The efficacy and safety of endoscopic ultrasound-guided liver biopsy(EUS-LB)as a method for liver tissue acquisition remain uncertain.AIM To study the diagnostic yield and safety of EUS-LB in patients with suspected parenchymal liver disease.METHODS This is a retrospective observational cohort study of patients undergoing EUS-LB in 2 tertiary-care centers in Kuwait in the period between January 2022-June 2025.The primary outcome was sample adequacy,while secondary outcomes included histological quality of the specimen and adverse events.Predictors of increased diagnostic adequacy and specimen quality were explored.RESULTS A total of 50 patients[mean age 43.9(15.5)years,40%males]were included.The left liver lobe was targeted for biopsy in most patients(96%),and 19-gauge fine needle aspiration(FNA)was used in most cases(52%).The median number of passes performed was 3(range 2-5),and the heparin-wet suction technique was used in 40%of patients.The overall diagnostic adequacy of EUS-LB was 86%,with no significant difference between 19-gauge FNA and 19-gauge fine needle biopsy(FNB)needles.Fulfillment of the European Association for the Study of Liver(EASL)and the American Association for the Study of Liver Diseases criteria was achieved in 54%and 34%,respectively,with a significantly higher number of patients fulfilling these criteria when FNB needle was used compared to FNA needle(83.3%vs 26.9%,P<0.0001)and(62.5%vs 7.7%,P<0.0001),respectively.Only 1 patient(2.0%)developed adverse post-procedure events,namely bleeding requiring transfusion.Multivariate regression analysis did not identify any factor that increased diagnostic adequacy;however,the use of FNB needles and wet heparin suction methods were associated with significantly increased odds of fulfilling EASL criteria,while performing more than 2 passes reduced the quality of the specimen.CONCLUSION EUS-LB is an effective and safe method for obtaining liver biopsy in patients with suspected parenchymal liver disease.EUS-LB demonstrated a favorable safety profile in our cohort,although larger prospective studies are required to validate bleeding risk.The use of 19-gauge FNB needles,wet-heparin suction technique,and performing≤2 passes is associated with improved quality of the specimen obtained without increasing the risk of adverse events.
基金Supported by the Italian Ministry of Health-Current research IRCCS(Funds Dedicated to the Research of the Gastroenterology and Digestive Endoscopy Unit,Fondazione IRCCS Ca’Granda,Ospedale Maggiore Policlinico,Milano).
文摘BACKGROUND Endoscopic ultrasound(EUS)is crucial for diagnosing solid pancreatic lesions,especially pancreatic ductal adenocarcinoma(PDAC),a highly aggressive cancer which represents the majority with a prevalence of approximately 85%.AIM To identify EUS features that differentiate PDAC from other lesions such as neuroendocrine tumors(NETs)and helping in the differential diagnosis,by analyzing a large sample of solid pancreatic lesions.METHODS This observational,retrospective,multicenter study analyzed the endosonographic characteristics of 761 patients with a radiological diagnosis of solid pancreatic lesion,who underwent pancreatic EUS for typing and staging with needle biopsies between 2015 and 2023.General patient characteristics(age and sex)and solid lesion features were collected and described,such lesion size(Bmode),vessel involvement(compression or invasion),ductal dilation,lymphadenopathy,echogenicity,echopattern,margin regularity,multifocality,internal vascularization and elastography.Subsequently,a predictive analysis was performed through univariate and multivariate logistic regression to identify predictive features for PDAC or NET diagnoses.RESULTS Our study enrolled 761 patients,predominantly male with a mean age of 68.6.PDACs were generally larger(mean 33 mm×27 mm),often had irregular margins,and displayed significant upstream ductal dilation.Hypoechogenicity was common across malignant lesions.In contrast,NETs were smaller(mean 20 mm×17 mm)and typically had regular margins with multiple lesions.Vascular involvement,although predominant in PDAC,is a common feature of all malignant neoplasms.Multifocality,however,although a rare finding,is more typical of NETs and metastases,and practically absent in the remaining lesions.Predictive analyses showed that ductal dilation and irregular margins were the most significant predictors for PDAC[odds ratio(OR)=5.75 and 3.83],with hypoechogenicity,heterogeneous echopattern and lymphadenopathies also highly significant(OR=3.51,2.56 and 1.99).These features were inversely associated with NETs,with regular margins and absence of ductal involvement or lymphadenopathies(OR=0.24,0.86 and 0.45 respectively),as already shown by the descriptive analysis.Finally,age,despite achieving statistical significance,lacks clinical value given an OR trending towards 1.CONCLUSION This study provides a comprehensive overview of EUS features for solid pancreatic lesions,identifying distinct features like upstream ductal dilation and irregular margins for PDAC vs regular margins for NETs as strong diagnostic predictors.These findings enhance the understanding of pancreatic pathologies,offering valuable insights for improved differential diagnosis and clinical management,especially in complex cases.Further prospective studies could build on these results.
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.
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.
