Efficacy of the 'Five-Needle' method for pancreatojejunostomy in laparoscopic pancreaticoduodenectomy: an observational study.

Objective: The five-needle pancreato-intestinal anastomosis method is used in laparoscopic pancreaticoduodenectomy (LPD). The aim of this study was to explore the clinical efficacy and adverse reactions of this new surgical method and to provide a scientific reference for promoting this new surgical method in the future. Methods: A single-centre observational study was conducted to evaluate the safety and practicality of the five-needle method for pancreatojejunostomy in LPD surgeries. The clinical data of 78 patients who were diagnosed with periampullary malignancies and underwent LPD were collected from the 1st of August 2020 to the 31st of June 2023 at Lanzhou University First Hospital. Forty-three patients were treated with the 'Five-Needle' method (test groups), and 35 patients were treated with the 'Duct-to-Mucosa' method (control group) for pancreatojejunostomy. These two methods are the most commonly used and highly preferred pancreatointestinal anastomosis methods worldwide. The primary outcome was pancreatic fistula, and the incidence of which was compared between the two groups. Results: The incidence of pancreatic fistula in the five-needle method group and the duct-to-mucosa method group was not significantly different (25.6% vs. 28.6%, p=0.767). Additionally, there were no significant differences between the two groups in terms of intraoperative blood loss (Z=-1.330, p=0.183), postoperative haemorrhage rates (p=0.998), length of postoperative hospital stay (Z=-0.714, p=0.475), bile leakage rate (p=0.745), or perioperative mortality rate (p=0.999). However, the operative time in the 'Five-Needle' method group was significantly shorter than that in the 'Duct-to-Mucosa' method group (270 ± 170 mins vs. 300 ± 210 mins, Z=-2.336, p=0.019). Further analysis revealed that in patients with pancreatic ducts smaller than 3 mm, the incidence of pancreatic fistula was lower for the 'Five-Needle' method than for the 'Duct-to-Mucosa' method (12.5% vs. 53.8%, p=0.007). Conclusion: The five-needle method is safe and efficient for pancreatojejunostomy in LPD, and is particularly suitable for anastomosis in nondilated pancreatic ducts. It is a promising, valuable, and recommendable surgical method worthy of wider adoption.

["SHAO's five-needle method" as the main treatment for allergic rhinitis and asthma syndrome: a multi-center randomized controlled trial].

OBJECTIVE: To compare the clinical effect differences between "SHAO's five-needle method" and routine acupoint selection on allergic rhinitis and asthma syndrome. METHODS: A total of 210 patients with allergic rhinitis and asthma syndrome were randomly divided into an observation group (105 cases, 4 cases dropped off) and a control group (105 cases, 4 cases dropped off). The patients in the observation group were treated with "SHAO's five-needling method", and the acupoints of Feishu (BL 13), Dazhui (GV 14), Fengmen (BL 12), Yintang (GV 29), Shangyingxiang (EX-HN 8) and Hegu (LI 4), etc. were selected; the patients in the control group was treated with routine acupuncture, and the acupoints of Feishu (BL 13), Zhongfu (LU 1), Taiyuan (LU 9), Dingchuan (EX-B 1), Danzhong (CV 17), Yintang (GV 29), Fengmen (BL 12) and Zusanli (ST 36), etc. were selected. The treatment in the two groups was given once a day, 6 times a week, for 4 weeks. The score of symptoms and signs was observed before and after treatment as well as 1 month, 2 months and 3 months after treatment. The forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF) and eosinophils in peripheral blood were measured before and after treatment in the two groups. After treatment, the clinical therapeutic effect was compared between the two groups. RESULTS: The total effective rate was 98.0% (99/101) in the observation group, which was superior to 94.1% (95/101) in the control group (P<0.01). Compared before treatment, the total score of symptoms and signs in the two groups was significantly decreased at 1, 2, 3 and 4 weeks of treatment (P<0.01); after treatment and at each time point of follow-up, the total score of symptoms and signs in the observation group was lower than that in the control group (P<0.01). Compared with 4 weeks of treatment, the total score of symptoms and signs at each time point of follow-up was not statistically different in the observation group (P>0.05), and the total score of symptoms and signs in the third month of follow-up in the control group was significantly increased (P<0.05). After treatment, FEV1 and PEF in the two groups were increased (P<0.01), eosinophil count in peripheral blood was decreased (P<0.01), and the improvement in the observation group was greater than that in the control group (P<0.01, P<0.05). CONCLUSION: "SHAO's five-needle method" can improve the clinical symptoms and pulmonary function, reduce the count of eosinophils in peripheral blood in patients with allergic rhinitis and asthma syndrome, and the curative effect is better than routine acupuncture.

"'s five-needle method" as the main treatment for allergic rhinitis and asthma syndrome: a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect differences between "'s five-needle method" and routine acupoint selection on allergic rhinitis and asthma syndrome.@*METHODS@#A total of 210 patients with allergic rhinitis and asthma syndrome were randomly divided into an observation group (105 cases, 4 cases dropped off) and a control group (105 cases, 4 cases dropped off). The patients in the observation group were treated with "'s five-needling method", and the acupoints of Feishu (BL 13), Dazhui (GV 14), Fengmen (BL 12), Yintang (GV 29), Shangyingxiang (EX-HN 8) and Hegu (LI 4), etc. were selected; the patients in the control group was treated with routine acupuncture, and the acupoints of Feishu (BL 13), Zhongfu (LU 1), Taiyuan (LU 9), Dingchuan (EX-B 1), Danzhong (CV 17), Yintang (GV 29), Fengmen (BL 12) and Zusanli (ST 36), etc. were selected. The treatment in the two groups was given once a day, 6 times a week, for 4 weeks. The score of symptoms and signs was observed before and after treatment as well as 1 month, 2 months and 3 months after treatment. The forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF) and eosinophils in peripheral blood were measured before and after treatment in the two groups. After treatment, the clinical therapeutic effect was compared between the two groups.@*RESULTS@#The total effective rate was 98.0% (99/101) in the observation group, which was superior to 94.1% (95/101) in the control group (0.05), and the total score of symptoms and signs in the third month of follow-up in the control group was significantly increased (<0.05). After treatment, FEV1 and PEF in the two groups were increased (<0.01), eosinophil count in peripheral blood was decreased (<0.01), and the improvement in the observation group was greater than that in the control group (<0.01, <0.05).@*CONCLUSION@#"'s five-needle method" can improve the clinical symptoms and pulmonary function, reduce the count of eosinophils in peripheral blood in patients with allergic rhinitis and asthma syndrome, and the curative effect is better than routine acupuncture.

Adverse events associated with continuous interscalene block administered using the catheter-over-needle method: a retrospective analysis.

BACKGROUND: Continuous interscalene block is widely used for pain management in shoulder surgery. However, continuous interscalene block performed using the catheter-through-needle method is reportedly associated with adverse events such as pericatheter leakage of the local anesthetic, phrenic nerve paralysis, and hoarseness. Because we expected that the catheter-over-needle method would reduce these adverse events, we examined cases in which continuous interscalene block was performed using the catheter-over-needle method to determine what adverse events occurred and when. METHODS: We retrospectively reviewed the anesthesia and medical records of adult patients who underwent catheter insertion to receive a continuous interscalene block performed using the catheter-over-needle method at our hospital from July 2015 to July 2017. RESULTS: During the surveillance period, 122 adult patients underwent catheter insertion to receive a continuous interscalene block administered using the catheter-over-needle method. No case of pericatheter local anesthetic leakage was observed. Adverse events, such as dyspnea, hoarseness, insufficient anesthetic effect, dizziness, cough reflex during drinking, or ptosis, were observed in 42 patients (34.4%; 95% confidence interval 26-42.7). Most of the adverse events occurred on postoperative day 2. The median time between surgery and the onset of adverse events was 28.5 h. CONCLUSIONS: The catheter-over-needle method may prevent the pericatheter leakage of the local anesthetic. However, adverse events occurred in more than one-third of the patients. During continuous interscalene block, patients must be carefully observed for adverse events, especially on postoperative day 2. TRIAL REGISTRATION: This study was registered at the UMIN Clinical Trials Registry on August 13th, 2019 ( UMIN000037673 ).

A semi-blinded study comparing 2 methods of measuring nasal potential difference: Subcutaneous needle versus dermal abrasion.

BACKGROUND: According to European and US protocols, two nasal potential difference (NPD) measurement methods are considered acceptable, although they have not been formally compared: subcutaneous agar-filled needle with calomel (Ndl) and dermal abrasion with conducting cream and Ag/AgCl electrodes (Abr). We compared both in CF and healthy volunteers (HV), assessing their discriminative value and subject's preference. METHODS: Twelve classic CF and 17 HV underwent both NPD methods, performed by one operator in random order. A written questionnaire, assessing preference, was completed after each test. Tracings were coded, scored in a semi-blinded fashion and categorised as CF/non-CF. RESULTS: 110 tracings (56 Ndl/54 Abr) were collected: 42/110 scored CF and 68/110 non-CF, showing a good correlation. No significant preference for either method was reported. CONCLUSION: Both NPD methods are similar in terms of discriminative value and subject's preference, comparing classical CF and HV. For diagnosing CF, the operator's preferred NPD-method may be used.

A novel knot method for individually measurable aortic constriction in rats.

A novel knot method in rats is reported that addresses several drawbacks in the current model of aortic constriction-induced heart hypertrophy. Using a rat model, we developed a two-step procedure that includes 1) measurement of individual aorta circumference using a surgical thread; and 2) constriction of the aorta using a thread with the desired length predefined by a knot at each end for a measurable reduction of the aortic circumference as referenced to the measurement in step 1. This knot approach produces a manageable gradient of aortic constriction in each rat, reaching a consistency among experimental animals that cannot be achieved by the traditional needle method. Notably, the animal model produced by our knot method showed cardiac hypertrophy and dysfunction with the severity proportional to the percentage reduction of the aorta circumference (50% vs. 60%). Additionally, our new procedure produced a lower mortality rate compared with the traditional needle method. Therefore, we recommend this knot method as an alternative procedure for aortic constriction with desired gradient in rats and larger-animal models.

Metrology Research of Wrist-Ankle Needle Method in Clinical Application / 世界科学技术-中医药现代化

This study was aimed to analyze documents of wrist-ankle needle method in clinical application by metrology from 2002 to 2011 . The analysis showed that the wrist-ankle needle method was widely used in more than 50 kinds of diseases of locomotor system disease , nervous system disease , surgical disease , urogeni-tal system disease, integumentary system, and etc. There is still a high clinical value for further research.

Clinical Study on Warming Needle Moxibustion plus Tuina for Shoulder Periarthritis / 针灸推拿医学（英文版）

Objective: In order to compare the therapeutic effects between warming needle moxibustion plus Tuina therapy and single Tuina therapy for shoulder periarthritis. Methods: By random single blind control method, 80 cases were divided randomly into Group A (single Tuina group) and Group B (warming needle method plus Tuina group), 40 cases in each group. Results: The effective rate was 95.0% in Group B and 85.0% in Group A, without significant difference (P>0.05) in comparison between two groups. In assessment of Visual Analogue Scale, there was obvious decrease in both groups before and after the treatments (PO.01). In comparison of VAS score differences between the two groups after the treatments, there was remarkable significant difference (P<0.0l). Conclusion: Warming needle moxibustion plus Tuina is better than single Tuina therapy in stopping pain.

Access Recirculation Measurement in Variable Temporary Central Catheters by Low-flow Two-needle Method for CRF / 대한신장학회잡지

Blood recirculation in hemodialysis access is one of the factors decreasing dialysis efficiency. The purpose of this study was to evaluate access recirculation by the site of veins, length of catheters using the low-flow two-needle method in recently inserted temporary central vein catheterization used for hemodialysis in patients with chronic renal failure, and evaluate the reproducibility of low-flow method. A total of 56 measurements were performed in 15 chronic renal failure patients harboring 25 different catheters. Mean blood recirculation for the 56 measurements was 11.1+/-7.9%, it was significantly higher in the femoral catheters than in the subclavian catheters, reaching respective means of 17.9+/-6.5%, 5.2+/-2.3%. Blood recirculation rate was not different between 13.5cm and 19.5cm long subclavian catheters(5.3+/-2.7%, versus 5.5+/-1.7%), but was significantly higher in 13.5cm than in 19.5cm long femoral catheters(20.3+/-6.1% versus 13.3+/-4.8%, P=0.0067). Mean URR for the 56 dialysis sessions was 52.7+/-10.3%, it was significantly higher for sessions performed with subclavian than with femoral catheters(56.0+/-9.8% versus 48.8+/-9.7%, P=0.0088). An overall weak negative correlation of -0.42 was observed between blood recirculation and URR; the correlation was stronger for the sub-group of 19.5cm long femoral catheters, reaching -0.63. The obtained results were reproducible with a mean difference between two measurements in 18 cases of only 3.62+/-5.3% and a correlation of 0.68. The difference between blood recirculation rates in temporary femoral and subclavian catheters may be consequent to an anatomical factor. It may relate to the size of the vein, the blood probably having less possibility to recirculate near the tip of the catheter in a wider vein. In conclusion, femoral catheters particularily the shorter ones, are associated with significantly higher blood recirculation, and thus may consequently reduce the dialysis efficiency. In patients for whom dialysis dose is a priority, such as cases of intoxication for whom rapid and efficient toxic substance removal is mandatory, we think the subclavian catheters may become a first choice.