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Background: The success of haemodialysis (HD) critically depends on the effective use of arteriovenous fistulas (AVFs). The precise needling technique is vital to minimise complications and ensure functional vascular access. Objective: This study assesses the effectiveness of a nursing consultation protocol, which integrates physical examination (PE) with Doppler Ultrasound (DUS), in preparing patients for the first AVF needling. Design/Participants: A cross‐sectional analysis at a Portuguese National Health Service Hospital engaged thirty new HD patients, four HD needling experienced nurses and one HD vascular access nurse. This study examines the accuracy of PE in assessing the matured AVF by the four nurses compared to a trained vascular access nurse encompassing systematic PE and DUS. Measurements: The primary data incorporated AVF characteristics derived from PE (inspection, palpation, and auscultation) and DUS findings (vein depth, diameter, and blood flow). A secondary focus was evaluating the change in nurses' perceived needling complexity following the nursing consultation. Results: The nursing consultation significantly enhanced the identification of crucial AVF features, such as accessory veins (p = 0.002), and improved the accuracy of AVF morphology assessments. This led to identifying longer needling tracks (p = 0.031) and a higher number of safe needling points (p = 0.016). Nurses reported a notable reduction in perceived complexity and potential adverse events following this method (p = 0.027). Conclusions: Integrating structured PE with DUS in a nursing consultation framework significantly improves the preparation for AVF needling. This approach enhances the efficiency and safety of AVF needling and boosts nurse confidence and patient care in HD settings. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff calcific tendinitis is a common shoulder joint disorder. Nonsurgical treatment methods, including multiple needling and extracorporeal shock wave therapy (ESWT), can effectively treat calcific tendinitis. Purpose: To evaluate the clinical results and radiological outcomes of treatment with ultrasound-guided needling (UGN) alone versus UGN with high-energy ESWT (UGN-H) or UGN with low-energy ESWT (UGN-L) in patients with calcific tendinitis of the rotator cuff. Study Design: Cohort study; Level of evidence, 3. Methods: Outpatient records for patients with calcific tendinitis of the rotator cuff were evaluated retrospectively. Patients were grouped into those treated with UGN-H, UGN-L, or controls with UGN alone. The visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) scores, Constant-Murley scores, and radiographic evaluation to assess calcification size were available before treatment and at 3, 6, and 12 months after the first treatment. Post event pairwise analysis to analyze score differences between treatment groups was used. Results: Overall, 130 patients were included for analysis (42 UGN-H, 44 UGN-L, and 44 with UGN alone). At 3 months, the VAS scores were UGN-H (4.13 ± 0.84; P <.001) and UGN-L (4.47 ± 1.01; P <.001) which were significantly better than UGN alone (5.35 ± 1.00) in terms of the VAS score; however, the difference was not significant between UGN-H and UGN-L. These differences persisted at months 6 and 12 (6 months: UGN-H, 2.66 ± 1.00; P <.001; UGN-L, 3.16 ± 1.05; P =.033; 12 months: UGN-H, 1.93 ± 0.43; P <.001; UGN-L, 2.04 ± 0.46; P <.001). The results of the ASES and Constant-Murley scores were similar to those of the VAS score. In terms of radiographic outcome, follow-up at months 3, 6, and 12 revealed that UGN-H and UGN-L were superior to UGN alone at removing calcification (median 95% CI; 3 months: UGN-H, 1.4 mm2 [1.08, 7.25 mm2); P =.002; UGN-L, 5.79 mm2 (1.17, 7.85 mm2]; P =.041; 6 months: UGN-H, 0.91 mm2 [0, 1.15 mm2); P <.001; UGN-L, 1.13 mm2 [0.84, 5.10 mm2]; P <.001; 12 months: UGN-H, 0 mm2 [0, 0 mm2]; P <.001; UGN-L, 0 mm2 (0, 4.33 mm2]; P =.023). There was no significant difference between UGN-H and UGN-L at the month 3 follow-up, but the month 6 and 12 follow-ups revealed that UGN-H was more effective at removing calcification compared with UGN-L. Conclusion: The study demonstrated that, for pain relief and recovery of shoulder joint function, UGN + ESWT was significantly superior to UGN alone. No significant difference was observed between different energy levels of ESWT. UGN + ESWT was significantly superior to UGN alone on radiographic evaluation. Furthermore, UGN-H performed better radiographically with reducing calcifications compared with UGN-L at 12 months. [ABSTRACT FROM AUTHOR]

Needled preform and its composite using felt and base cloth stacked needled have small fiber volume fraction and relatively weak mechanical properties, which are difficult to meet the service requirements of structural and functional integrated components of high‐speed aircraft. Responding to this issue, this paper proposed a new method for preparing high load‐bearing needled composite preform based on ordered short fiber network needling. The high load‐bearing needled preforms were prepared by designing different structural parameters of ordered short fiber network and forming process parameters, and then preform structure was characterized and mechanical properties were tested. The results showed that using ordered short fiber network as carrier of the short fibers, the formed needled fiber bundles were longer and denser, volume content of needled fiber bundles and mechanical properties of needled preform were greatly improved, and needled fiber bundles volume content of ordered short fiber network reinforced needled preform was 1.5 times and 46.3 times that of half‐cut cloth and felt respectively. Compared with traditional felt needled preform and half‐cut cloth needled preform, the interlaminar peeling strength of the ordered short fiber network reinforced needled preform increased by up to 246.4% and 49.2%, respectively. The tensile strength of ordered short fiber network reinforced needled preform was 12.9% higher than that of half‐cut cloth in X‐axis direction. In addition, the effects of ordered short fiber network structure, short fiber length, areal density and needling density on the needled preform structure and properties were also revealed. Highlights: High load‐bearing needled composite preform was prepared based on novel ordered short fiber network needling method.The needled fiber bundles formed by using ordered short fiber network were longer and denser, and their volume content was 46.3 times that of felt needled preform.The interlaminar peeling strength of the ordered short fiber network reinforced needled preform increased by up to 246.4%.The tensile strength of ordered short fiber network reinforced needled preform was 12.9% greater than half‐cut cloth in the X‐axis direction. [ABSTRACT FROM AUTHOR]

The impulse grounding impedance of the tower grounding device affects the lightning trip-out rate of the transmission line. It is necessary to optimize the design of the grounding device for impedance reduction. In this paper, a finite element model for the impulse property of the grounding device is established. The thin-shell theory is introduced to solve the problem of mesh division singularity caused by excessive dimensional differences between the conductor sectional area and soil dispersion area. Physical quantities such as potential, electric field strength, and current density of tower grounding devices were analyzed, and the impedance reduction mechanism of the needle-shaped grounding device was obtained. A simulation study of the needle-shaped tower grounding device was carried out to obtain the effects of five factors related to the needling: position, number, distance, length, and angle on the impulse grounding impedance, as well as their optimal values. The results show that adding the needling at the end of a star grounding electrode branch can effectively reduce the impulse grounding resistance. The number of needling is not the more the better, and the unit length utilization is maximum when 2 needles are used. Changes in the length of the needling have a greater impact on the impulse grounding resistance relative to changes in spacing. When the spacing between the two needles is 2 m and the length is 5 m, it is appropriate to set the angle in the range of 30°–60°. The optimized design of the tower grounding device can effectively reduce the impulse grounding impedance. [ABSTRACT FROM AUTHOR]

There are several treatment modalities for Palmoplantar Warts (PPW) introduced, but none have been proven to be significantly effective in all patients. The study aims to assess the efficacy and safety of cryotherapy compared to other modalities for PPW. Searches were conducted in Medline, Embase, Scopus, and CENTRAL databases, along with additional reference and citation tracking from included studies. Randomized Controlled Trials (RCTs) comparing various treatments for PPW were included. Two independent pairs extracted the data from the included studies. Outcomes assessed included cure rates, pain scores, recurrence rates, and adverse events. Network meta-analysis using Netmeta in R software was utilized, with treatments ranked by p-scores. A total of 27 RCTs that enrolled 2,539 participants were deemed eligible. As per p-scores, needling yielded the highest odd for the cure rate (p=1.00), followed by intralesional injection of the Measles, Mumps, and Rubella (MMR) vaccine (p=0.90). For the pain score, 76% topical monochloroacetic acid (p=0.13) showed the lowest mean pain score, while cryotherapy yielded the highest score (p=0.90). Furthermore, cryotherapy showed the highest odds for recurrence rate (p=0.75), followed by intralesional injection of Candida antigen (p=0.61). 0.05% intralesional bleomycin (p=0.93) was the highest agent for adverse events rate, followed by cryotherapy (p=0.61). Needling was the most effective in achieving a cure rate. Cryotherapy has the highest odds for pain score and recurrence rate, while 0.05% intralesional bleomycin has the highest adverse events profile.

Background: Minimally invasive bleb surgery using the XEN-45 gel stent has not been established for the treatment of normal-tension glaucoma (NTG). The main objective of this study was to evaluate the long-term treatment efficacy and safety of XEN-45 in eyes with uncontrolled NTG. Methods: A retrospective analysis of patients with NTG who underwent XEN-45 gel stent implantation at university hospital Tuebingen between 2016 and 2021. The primary outcome measure was surgical success after three years defined as lowering of intraocular pressure (IOP) of ≥ 20%, with target IOP between 6 and 15 mmHg. Success was complete without and qualified irrespective of topical antiglaucoma medication use. The need for further glaucoma surgery, except for needling, was regarded as a failure. The secondary outcome measures included changes in mean IOP, number of antiglaucoma medications, and needling and complication rates. Results: Twenty-eight eyes from 23 patients were included in the final analysis. Complete and qualified success rates were 56.5% and 75% after three years, respectively. Mean postoperative IOP ± standard deviation decreased significantly after three years from 19.3 ± 2.0 mmHg at baseline to 13.7 ± 4.2 mmHg (n = 22; p < 0.0001). The median number of antiglaucoma medications decreased from 2 (range 0–4) to 0 after three years (range 0–3; p < 0.0001). Sixteen eyes (57%) required a median of 1 (range 1–3) needling procedures. One eye required further glaucoma surgery. No sight-threatening complications were observed. Conclusion: The XEN-45 stent is effective and safe for the long-term treatment of NTG. However, needling was frequently required to improve outcomes. [ABSTRACT FROM AUTHOR]

Background: Although laser Doppler imaging (LDI) accurately delineates a hypoperfused area to help target hyaluronidase treatment, laser speckle contrast imaging (LSCI) is more appropriate for assessing microvascular hemodynamics and has greater reproducibility than LDI. This study investigated the use of LSCI in the evaluation and treatment of six patients who developed vascular complications after facial dermal filler injections. Methods: The areas of vascular occlusion were accurately defined in real time by LSCI and were more precise than visual inspections or photographic evidence for guiding needling and hyaluronidase treatment. Results: All patients had achieved satisfactory outcomes as early as Day 2 of treatment and no procedure-related complications were reported after a median follow-up of 9.5 (7–37) days. Conclusion: LSCI accurately and noninvasively delineated vascular occlusions in real time among patients experiencing complications of facial dermal filler injections. Moreover, LSCI was more accurate than visual and photographic evaluations. Clinicians can use LSCI to reliably follow-up therapeutic outcomes after salvage interventions for vascular occlusions. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided procedures for the proper targeting of the interface between the plantar fascia and the flexor digitorum brevis with a solid needle. Methods: A crossover cadaveric study was conducted. Five experienced therapists performed a series of 20 needle insertions each (n = 100 in total, 10 landmark-guided and 10 ultrasound-guided) on 10 anatomical samples. The therapists were instructed to accurately place the needle on the interface between the plantar fascia and the flexor digitorum brevis muscle. The distance of the tip of the needle to the identified target (accuracy), the surrounding sensitive structures targeted (safety), the time needed for the procedure, the number of needle passes, and the needle length outside the skin were assessed. Results: The ultrasound-guided technique was associated with a significantly higher accuracy (p < 0.001) but without differences in safety (p = 0.249) as compared to the palpation-guided procedure. Conclusion: Our results suggest that ultrasound-guided insertion exhibits greater accuracy but not greater safety than palpation-guided insertion when targeting the interface between the plantar fascia and the flexor digitorum brevis. [ABSTRACT FROM AUTHOR]

Abstract Introduction Microinvasive glaucoma surgery (MIGS) is a growing trend, and XEN gel implant is one of the most effective types of MIGS. This study aimed to examine factors associated with the surgical success of XEN gel implants. Methods This retrospective cohort study enrolled patients with glaucoma receiving XEN implantation alone or combined with phacoemulsification (PHACOXEN) with a follow-up period of more than 6 months at Hualien Tzu Chi Hospital, Taiwan. If intraocular pressure (IOP) elevated above 20 mmHg during the follow-up, needling or open revision was performed. The primary outcome measures included IOP and the number of glaucoma medications. Results Male patients had lower postoperative IOP; male patients and higher preoperative IOP were associated with higher IOP change rates, and older patients had a higher chance of achieving IOP

Silk, as a natural protein fiber, is a crucial raw material for high-grade textile products due to its exceptional breathability, moisture permeability, and biocompatibility. Moreover, silk possesses delicate luster and a soft feel that are adored by people worldwide, earning it the title of “queen of fibers”. However, the yield of silk is heavily influenced by cocoon quality, and only approximately 20% of cocoons can be transformed into pure silk fibers. Traditional silk processing generates an alarming waste amounting to 55% due to this limitation. To enhance silk utilization efficiency and fully exploit its value, numerous researchers have employed nonwoven processing technology in silk production. The resulting nonwovens not only significantly improve the utilization rate but also offer advantages such as high production efficiency and low cost while harnessing the excellent performance characteristics of silk. The common nonwoven process mainly consists of two processes: mesh formation and reinforcement. The main methods of mesh formation include dry-laid nonwoven, wet-laid nonwoven, and electrostatic spinning method. Reinforcement methods include needling, hydroentanglement, chemical bonding, and thermal bonding. Silk nonwovens can be obtained through these processes. This paper provides a systematic summary of the production process and product characteristics of silk nonwovens. Silk nonwovens manufactured by needle reinforcement in dry-laid processing involve inserting hooked spines into the fiber mesh repeatedly to form physical entanglement. It offers advantages such as permeability, good mechanical properties and high production efficiency, making it suitable for thermal materials, filter materials and bedding products. Dry-laid hydroentangled nonwovens are achieved by using high-pressure water flow and reflection flow to intertwine the fiber mesh. It possesses characteristics like good air permeability and soft feel without damaging the fibers. This method is suitable for medical protective materials and health materials. The dry-laid silk nonwovens reinforced by chemical method, thermal bonding method and wet-laid silk nonwovens are seldom used at present. Electrospinning is a method in which polymer melt/solution is stretched into fiber mesh under the action of high voltage electrostatic field. The resulting regenerated silk fibroin fiber has the advantages of small diameter, large specific surface area and good filtration performance, and can be used in various high-end medical materials and tissue engineering materials, but there are difficulties in industrialization. When the material cannot meet the performance requirements, the method of post-finishing is often used to improve the performance or aesthetics of nonwovens to meet the requirements of different uses of products. In practical applications, different fields have different performance requirements for nonwovens. Nonwovens used in sanitary products require antibacterial properties and hydrophilic properties. Nonwovens for medical protection require water, blood, alcohol, and static resistance. Hydrophilic finishing, antibacterial finishing, flame retardant finishing, UV resistant finishing and other finishing methods are commonly used to improve the performance of silk nonwovens. Because of the biocompatibility, biodegradability, richness in amino acids, hand feel, and mild luster of silk fiber, silk nonwoven materials can be widely used in beauty, medical health, tissue engineering, insulation and other fields. The utilization of nonwoven technology in silk fiber production offers a novel approach to fully harnessing the potential of silk fibers, expanding their application scope, and driving their adoption across diverse fields. Blending silk with other materials addresses issues such as low wear resistance and susceptibility to creasing, while also enhancing various properties of silk. Simultaneously, multifunctional and high-performance modifications enable tailored enhancements for specific applications, thereby facilitating the broader implementation of silk nonwovens. [ABSTRACT FROM AUTHOR]

Copyright of Acta Materiae Compositae Sinica is the property of Acta Materiea Compositae Sinica Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

William Withers, a patient representative, outlines what matters to patients and how quality of life outcomes for the patient can be improved [ABSTRACT FROM AUTHOR]

Introduction: Microinvasive glaucoma surgery (MIGS) is a growing trend, and XEN gel implant is one of the most effective types of MIGS. This study aimed to examine factors associated with the surgical success of XEN gel implants. Methods: This retrospective cohort study enrolled patients with glaucoma receiving XEN implantation alone or combined with phacoemulsification (PHACOXEN) with a follow-up period of more than 6 months at Hualien Tzu Chi Hospital, Taiwan. If intraocular pressure (IOP) elevated above 20 mmHg during the follow-up, needling or open revision was performed. The primary outcome measures included IOP and the number of glaucoma medications. Results: Male patients had lower postoperative IOP; male patients and higher preoperative IOP were associated with higher IOP change rates, and older patients had a higher chance of achieving IOP < 18 mmHg and being medication-free at months 12, 24, and 36. The Kaplan–Meier curve showed that the probability of free-of-rescue intervention over the follow-up period was not different between the XEN alone and the PHACOXEN group (P = 0.859). Both needling and open revision were effective rescue interventions, but open revision had a higher chance of achieving IOP ≤ 18 mmHg and being medication-free (P = 0.031) and required less medication afterward (P = 0.044). Older age (P = 0.013) and male patients (P = 0.022) had a lower IOP after rescue interventions. Compared with open revision, needling was associated with higher IOP (P = 0.048) and more required medications (P = 0.048). Conclusions: XEN alone and PHACOXEN had comparable surgical outcomes, whereas open revision had a better IOP lowering effect than needling as a rescue intervention. Male and older patients had better surgical results in primary XEN implantations and rescue interventions. [ABSTRACT FROM AUTHOR]

The XEN45 is a minimally invasive glaucoma surgery device commonly used in clinical practice. This retrospective study included consecutive patients with open-angle glaucoma who underwent a XEN45 implant with mitomycin C, either alone or in combination with phacoemulsification, between June 2015 and March 2021. The primary end point was the mean change in intraocular pressure (IOP) from the baseline to month 6. A total of 677 eyes, 395 (58.3%) in the XEN alone group and 282 (41.7%) in the XEN+Phaco group, were included in this study. The preoperative IOP was significantly lowered from 28.7 ± 8.6 mmHg and 25.4 ± 6.9 mmHg to 13.5 ± 5.0 mmHg and 13.5 ± 4.1 mmHg at month 6 in the XEN solo and XEN+Phaco groups, respectively, with p < 0.0001 each. The mean (95% confidence interval) number of ocular hypotensive medications was significantly reduced from 3.3 (3.2–3.4) to 0.2 (0.1–0.2) and from 3.1 (2.9–3.2) to 0.2 (0.1–0.2) in the XEN solo and XEN+Phaco groups, respectively, with p < 0.0001 each. Needling was performed in 228 (33.7%) eyes. Conclusions: the XEN implant significantly reduces both IOP and the number of ocular hypotensive medications. IOP lowering was higher in the XEN solo group than in the XEN+Phaco one, although such a difference was only evident during the first month after surgery. [ABSTRACT FROM AUTHOR]

Ripasudil, a rho-associated protein kinase inhibitor ophthalmic solution, shows a protective effect in preventing excessive scarring in vitro. This study aims to evaluate the safety and efficacy of ripasudil for glaucoma patients submitted to the needling procedure. In this prospective, multicenter, single-arm study, we included 20 eyes of 20 patients with glaucoma who underwent the needling procedure without antimetabolites. All patients administered ripasudil after needling for three months. The primary endpoint of this study was the safety of ripasudil in patients, and the secondary endpoint was the change in IOP at 12 weeks after the needling procedure. No serious complications were found in the patients. One eye experienced pruritus and conjunctival follicle, while another eye had conjunctival follicle. These complications were transient and resolved quickly after discontinuation of ripasudil. The mean preoperative IOP was 14.6 ± 4.6 mmHg, which decreased to 11.0 ± 4.7 mmHg (p = 0.0062) at 1 week postoperatively. The IOP reduction effect continued to 12 weeks (11.8 ± 3.1 mmHg; p = 0.0448). The administration of the ROCK inhibitor, ripasudil, after the needling procedure is safe and effective in maintaining IOP for 12 weeks. [ABSTRACT FROM AUTHOR]

COVID-19 is a pandemic viral infection that has become a challenge for health systems worldwide having no definite antiviral treatment yet. The aim of this study is to evaluate the effect of a Persian-based method of needling (Ghamz with needle) on the clinical symptoms of COVID-19 patients as a pilot study. We conducted a single-blind randomized controlled clinical trial involving hospitalized adult patients with confirmed SARS-CoV-2 infection (COVID-19) by rRT-PCR method using a nasal swab. Nineteen patients who met the inclusion criteria were randomly allocated to receive Ghamz with needle in the intervention group and sham treatment group. The procedure was performed in six points (three bilateral), based on traditional Persian medicine (TPM) texts, compatible with LU5, LU7, and SP6 Chinese points with a duration of 20 minutes, every day, till the patients were discharged from the hospital. The clinical symptoms, laboratory data, and radiological findings were evaluated before and after the interventions in both groups. The results revealed that after comparing the values of the change in the study parameters, despite the significant improvement in the dyspnea (p=0.037) and O2 saturation (p=0.044) of the Ghamz group, no statistically significant difference was observed between Ghamz and sham groups using a visual analog scale (dyspnea: MD: -3.66, 95% CI: -6.49 to 0.84 vs MD: -2.20, 95% CI: -4.60 to 0.20, p= 0.217; O2 saturation: (MD: 2.61, 95% CI: -1.97 to 14.02 vs MD:4.50, 95% CI: -0.49 to 9.49, p=0.163). The radiological findings showed a better improvement in the intervention group than in the sham treatment group. In conclusion, Ghamz with needle in the mentioned points was not effective significantly in relieve the symptoms of the patients with COVID-19. However, further studies with larger samples are recommended.

Acupuncture is gaining popularity and wider acceptance as a treatment modality within the field of sports medicine. Our objective was to provide a comprehensive review of the existing literature pertaining to acupuncture in sports medicine to shed light on approaches utilized in acupuncture while revealing its personalized nature and its impact on athletes’ preparation, performance, and recovery. We evaluated acupuncture research in the context of medicine and sports-related injury treatment, assessing its impact on athletic performance across demographics of athletes. Athletes participating in most sports have shown positive outcomes from acupuncture interventions. Acupuncture improves peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex. Lastly, the acceptance of acupuncture is influenced by cultural factors, with Western and traditional East Asian cultures exhibiting distinct perspectives on its rationale and mechanisms of action. Traditional East Asian acupuncturists typically employ qi and meridian theories in their acupuncture practices, with the recent incorporation of Western concepts. Acupuncture shows promise as an effective treatment for musculoskeletal pain and neuropathies in athletes across different age groups and for addressing injuries in various sports. Our comprehensive review will enhance our understanding of acupuncture’s potential as a complementary or distinct therapeutic approach compared to conventional therapies. Additionally, our review explores its specific applications within different sports and delves into the cultural dimensions involved in integrating this practice into modern sports medicine.

Acupuncture is gaining popularity and wider acceptance as a treatment modality within the field of sports medicine. Our objective was to provide a comprehensive review of the existing literature pertaining to acupuncture in sports medicine to shed light on approaches utilized in acupuncture while revealing its personalized nature and its impact on athletes' preparation, performance, and recovery. We evaluated acupuncture research in the context of medicine and sports-related injury treatment, assessing its impact on athletic performance across demographics of athletes. Athletes participating in most sports have shown positive outcomes from acupuncture interventions. Acupuncture improves peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex. Lastly, the acceptance of acupuncture is influenced by cultural factors, with Western and traditional East Asian cultures exhibiting distinct perspectives on its rationale and mechanisms of action. Traditional East Asian acupuncturists typically employ qi and meridian theories in their acupuncture practices, with the recent incorporation of Western concepts. Acupuncture shows promise as an effective treatment for musculoskeletal pain and neuropathies in athletes across different age groups and for addressing injuries in various sports. Our comprehensive review will enhance our understanding of acupuncture's potential as a complementary or distinct therapeutic approach compared to conventional therapies. Additionally, our review explores its specific applications within different sports and delves into the cultural dimensions involved in integrating this practice into modern sports medicine. [ABSTRACT FROM AUTHOR]

Embroidery is a traditional craft in China, where needles are used to create patterns on fabric by leaving colored threads on the surface. It is an ancient handicraft with a rich history in China. There are various types of embroidery in the country, including the famous “Four Famous Embroideries” and unique regional styles. Han embroidery is an important type of embroidery in the Jingchu region. However, it is not accurate to determine the origin of Han embroidery solely based on its geographical location or the name “Han embroidery”, whether it developed from Chu embroidery or originated in the Han Dynasty or the Jianghan region. To explore the relationship between Han embroidery and Jingchu embroidery from multiple perspectives, including culture, history, and embroidery techniques, we used a two-dimensional method based on literary materials and archaeological artifacts. On one hand, we delved into the cultural connotations behind the patterns and colors of Han embroidery, connecting it with Chu culture. Han embroidery exhibits a strong Chu-style witchcraft atmosphere in its patterns and colors, with mysterious and vivid designs that are adept at exaggeration and transformation. On the other hand, from the aspect of composition, Han embroidery is notably influenced by Chu-style aesthetics, demonstrating a distinct style compared to other types of embroidery. Furthermore, Han embroidery not only inherits the basic needlework from Chu embroidery but also elevates the “flat gold and interlining embroidery” as the prominent feature of modern commercial embroidery. Through commercial development in modern times, Han embroidery continuously improves production efficiency and evolves from complex handicraft techniques to commercial embroidery techniques. We conclude that the exploration of the patterns, colors, composition aesthetics, and needlework in Han embroidery leads to the understanding that Han embroidery and Jingchu embroidery have a close connection. The research indicates that: (i) the thematic style of Han embroidery originates from Chu culture, reflecting the customs and beliefs of the Chu people; (ii) the preference for phoenix and the color red in Han embroidery is an inheritance of the Chu people’s reverence for ancestors and their spiritual beliefs in fire and life; (iii) the composition aesthetics of Han embroidery is a continuation of Chu people’s romantic and mysterious artistic expression; (iv) from a historical perspective, Han embroidery techniques have their roots in the Chu embroidery of the Spring and Autumn Period and the Warring States Period, and later evolved into a new commercial embroidery style during the late Qing Dynasty. Throughout history, ancient Chinese embroidery has constantly created new needlework techniques and aesthetic patterns, which have contributed to the continuous development and prosperity of embroidery. While preserving traditional needlework techniques, integrating new cultural content and aesthetic styles has led to the flourishing of Chinese embroidery art today. Jingchu Han embroidery, as an embroidery art that combines the strengths of various regions, needs to be understood through its essence in the research of Han embroidery art. By studying the relationship between Han embroidery and Jingchu embroidery, we can deeply appreciate the genes of Chu art, such as worship, witchcraft, phoenix, and red, that are inherited in Han embroidery. Through understanding the historical and commercial aspects of Jingchu Han embroidery techniques, we can discover the connection between its historical background and its stylistic formation. In summary, the development of Han embroidery art requires the promotion of its cultural connotations, a comprehensive understanding of the cultural background and future development direction of Jingchu Han embroidery from multiple perspectives, and the further enhancement and promotion of Han embroidery art as a unique cultural symbol in the Jingchu region, ensuring its enduring legacy throughout history. [ABSTRACT FROM AUTHOR]

Objectives:The aim of this study was to investigate the incidence of postoperative ptosis after primary trabeculectomy and the possible factors contributing to ptosis.Materials and Methods:A total of 312 patients (339 eyes) who underwent trabeculectomy with mitomycin-C between 2015 and 2020 were retrospectively evaluated. Patients who had regular follow-up for at least 6 months and no history of ptosis or ptosis surgery were included. Age, sex, glaucoma type, preoperative and postoperative intraocular pressure, preoperative and postoperative antiglaucoma medications, number of antiglaucoma drops, duration of antiglaucoma medication use, history of eye itching due to antiglaucoma medication-associated allergy, duration of follow-up, postoperative needling, needling time, and ocular massage were recorded. Ptosis was defined as ≥2 mm reduction in margin-reflex distance 1 from preoperative levels. Ptosis that had not improved for at least 6 months was considered persistent ptosis. Multivariate logistic regression was used to determine potential predictors of ptosis development.Results:Ptosis after trabeculectomy was observed in 35 of 339 eyes (10.3%). Thirty eyes of 30 patients (8.8%) had transient ptosis and 5 eyes of 4 patients (1.5%) had persistent ptosis. Preoperative duration of antiglaucoma medication use, drug(s) used (prostaglandin analogs, beta-blockers, alpha-2 agonists, carbonic anhydrase inhibitors, or combinations of these), needling time, and ocular massage after trabeculectomy did not differ significantly between groups (p>0.05). Rates of needling and eye itching due to antiglaucoma medication-associated allergy were significantly higher in patients with ptosis (p

Purpose: To assess the clinical presentation of pediatric patients having early traumatic glaucoma and to analyze early predictors for the need of filtration surgery. Methods: Patients with early traumatic glaucoma after close globe injury (CGI) from January 2014 to December 2020 were retrospectively reviewed. Clinical features, treatment provided (medical and surgical), and visual outcomes were documented. Patients were divided into two groups based on the management required: group A- trabeculectomy and group B- medication + minor surgery. Results: A total of 85 patients were studied after applying the necessary inclusion and exclusion criteria. Out of these, 46 underwent trabeculectomy for the control of intraocular pressure (IOP) and the remaining 39 were managed with antiglaucoma medications. Significant male predominance of 9.6:1 was observed. Patients presented to the hospital after a mean duration of 8.5 days posttrauma. Wooden objects were most commonly responsible for trauma. Mean best corrected visual acuity at presentation was 1.91 log of minimum angle of resolution (logMAR). Mean IOP at presentation was 40 mmHg. The common anterior segment finding were severe anterior chamber (AC) reaction (63.5%), followed by angle recession (56.4%). Severe AC reaction (P = 0.0001) and corneal microcystic edema (P = 0.04) were significant predictive factors for early need of trabeculectomy. Conclusion: Need of trabeculectomy was higher in patients with severe AC reaction and corneal microcystic edema. The threshold to perform trabeculectomy should be lower, as glaucoma is often relentless, severe, and may result in irreversible vision loss.

Abstract Background Rho-kinase inhibitors can inhibit fibrosis after glaucoma surgery. This study aimed to evaluate the effect of rho-kinase inhibitor after needling procedure with mitomycin C for the failure of filtering bleb with trabeculectomy. Methods This retrospective single-center study examined the effects of rho-kinase inhibitor after the needling procedure. We included 27 eyes of 27 patients with glaucoma who underwent needling procedure using mitomycin C and were subsequently treated with ripasudil—a rho-associated protein kinase inhibitor (ripasudil group)—or without ripasudil (control group). The ripasudil and control groups were compared in terms of intraocular pressure (IOP) and the number of antiglaucoma medications. Success at 12 months after the needling procedure was defined as a > 20% decrease in IOP from the preoperative period without surgical reintervention. Results At 12 months after the needling procedure, the mean IOP decreased from 16.9 ± 4.5 to 12.6 ± 1.1 mmHg in the control group and from 16.0 ± 5.3 to 12.2 ± 1.2 mmHg in the ripasudil group (p = 0.77). The 12-month success rates were 60.00% and 56.25% in the control and ripasudil groups (p = 0.98), respectively. In the preoperative period, the numbers of antiglaucoma drugs were 0.27 ± 0.46 and 0.92 ± 0.91 in the control and ripasudil groups (p = 0.022), respectively, and at 12 months after the needling procedure, they were 1.07 ± 1.44 and 0.73 ± 1.10 (p = 0.52), respectively. Conclusions Treatment with ripasudil (a rho-associated protein kinase inhibitor) after the needling procedure with mitomycin C did not show better results than treatment with the mitomycin C needling procedure alone at 12 months after the procedure.

Introduction/Purpose: The aim of this study was to compare two surgical revision techniques in failed trabeculectomies after 6 months. Methods: Patients diagnosed with open-angle glaucoma who underwent trabeculectomy in at least one eye with uncontrolled intraocular pressure (IOP) after trabeculectomy performed at least 6 months before were enrolled in this prospective trial. All participants underwent a complete ophthalmological examination at baseline. Randomization was performed to one eye per patient to double-masked trabeculectomy revision or needling. Patients were examined on the first day, 7 days, 14 days, and then monthly until completing 1 year after surgical intervention. All follow-up visits included the following: patients reported ocular and systemic events, best-corrected visual acuity, IOP, slit-lamp examination, and optic disc evaluation for cup-to-disc ratio. Gonioscopy and stereoscopic optic disc photographs were taken at baseline and 12 months. After 1-year, the IOP and number of medications were compared between the groups. Absolute success criteria in the study were IOP <16 mm Hg, for 2 consecutive measurements without using a hypotensive medication. Results: Forty patients were included in this study. Among them, 38 completed 1-year follow-up (18 in revision group and 20 in needling group). The age ranged from 21 to 86 years, with a mean of 66.82 ± 13.44. At baseline, the average IOP was 21.64 ± 5.12 mm Hg (range from 14 to 38 mm Hg) in the entire group. All patients were using at least two classes of hypotensive eye drops, and 3 patients were using oral acetazolamide. The mean use of hypotensive eye drop medications was 3.11 ± 0.67 at the baseline for the entire group. In the present study, 58% of the patients presented complete success, 18% qualified success, and 24% failed in both groups. After 1-year treatment, both techniques were similar for IOP parameters and also for number of medications (p = 0.834 and p = 0.433, respectively). Regarding intra- or postoperative complications, one patient in each group needed a new surgical intervention, one in the needling group due to shallow anterior chamber and one in the revision group due to spontaneous Seidel sign, and one patient in the needling group underwent posterior revision due to fail. Conclusions: Both techniques were safe and effective for IOP control after 1 year of follow-up in patients who underwent to trabeculectomy more than 6 months before. [ABSTRACT FROM AUTHOR]

Introduction: Tasks involving mental practice, relying on the cognitive rehearsal of physical motors or other activities, have been reported to have similar patterns of brain activity to overt execution. In this study, we introduced a novel imagination task called, acupuncture imagery and aimed to investigate the neural oscillations during acupuncture imagery. Methods: Healthy volunteers were guided to watch a video of real needling in the left and right KI3 (Taixi point). The subjects were then asked to perform tasks to keep their thoughts in three 1-min states alternately: resting state, needling imagery left KI3, and needling imagery right KI3. Another group experienced real needling in the right KI3. A 31-channel-electroencephalography was synchronously recorded for each subject. Microstate analyses were performed to depict the brain dynamics during these tasks. Results: Compared to the resting state, both acupuncture needling imagination and real needling in KI3 could introduce significant changes in neural dynamic oscillations. Moreover, the parameters involving microstate A of needling imagery in the right KI3 showed similar changes as real needling in the right KI3. Discussion: These results confirm that needling imagination and real needling have similar brain activation patterns. Needling imagery may change brain network activity and play a role in neural regulation. Further studies are needed to explore the effects of acupuncture imagery and the potential application of acupuncture imagery in disease recovery. [ABSTRACT FROM AUTHOR]

Spasticity, characterized by a velocity-dependent increase in muscle tone and exaggerated reflexes, is a common complication in individuals with upper motor neuron syndrome, such as stroke survivors. Sensitization, the heightened responsiveness of the nervous system to sensory stimuli, has emerged as a potential cause of spasticity. This perspective article explores three emerging treatments targeting sensitization. Recent studies have investigated novel treatment modalities for spasticity, including Extracorporeal Shockwave Therapy (ESWT), repetitive peripheral magnetic stimulation (rPMS), and needling. ESWT has shown promising results in reducing spasticity in both the upper and lower extremities, potentially through mechanisms such as nitric oxide production, rheological property changes, and neuromuscular transmission dysfunction. rPMS offers a non-invasive approach that may reduce spasticity by increasing sensory input, enhancing cortical activation, and exerting tissue-softening effects. Needling has also demonstrated positive effects on spasticity reduction. The high heterogeneity observed indicates the need for more rigorous research to confirm these findings. Recently, mechanical needling and sterile water injection invented by the author is also promising for reducing spasticity through removing sensitization. In conclusion, the emerging treatment options discussed in this perspective article provide promising avenues for addressing sensitization in spasticity and improving motor function. However, further research is needed to validate their findings, optimize treatment protocols, and investigate their long-term effects on motor recovery and overall quality of life in individuals with spasticity.

Ocular decompression retinopathy (ODR) is caused by a sudden lowering of high intraocular pressure. Trabeculectomy is the most common procedure preceding ODR. Various mechanical and vascular etiologies have been proposed to cause ODR, with autoregulation and hemodynamics playing a contributing role. Herein, we report a rare case of ODR occurring after bleb needling in a young child using ultrawide-field fundus photography, fluorescein angiography, and optical coherence tomography.

Qingguang Liu,1 Qiangmin Huang,2,3 Lin Liu,4 Thi-Tham Nguyen5 1International College of Football, Tongji University, Shanghai, People’s Republic of China; 2Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China; 3Shanghai Ciyuan Rehabilitation Hospital, Sinopharm Healthcare, Shanghai, People’s Republic of China; 4Department of Rehabilitation, School of Sport and Health, Nanjing Sport Institute, Nanjing, People’s Republic of China; 5Faculty of Sport Science, Ton Duc Thang University, Ho Chi Minh City, VietnamCorrespondence: Qiangmin Huang, Keyanlou 4-408, Hengren Road No. 188, Yangpu District, Shanghai, 200438, People’s Republic of China, Tel +8602155135072, Fax +8602155135076, Email huaqia404@aliyun.comPurpose: To determine the difference in maintenance of improvement of pain and disability for dry needling (DN) under needle electromyography (EMG) guidance technique in myofascial neck and shoulder pain patients, compared with DN alone.Patients and Methods: In this randomized single-blind clinical trial, 30 participants with myofascial pain in the neck and shoulder were randomly allocated to two groups: myofascial trigger points (MTrPs) DN with EMG guided (DN-EMG) group and MTrPs DN without EMG (DN) group. Needling treatment lasted for 2 weeks, twice a week. The primary outcome was pain intensity as assessed by visual analogue scale (VAS) and neck disability index (NDI). A number of mappings referred to pain and spontaneous muscle activity (SEA) were considered secondary outcomes. VAS and NDI were measured before treatment, after 2 weeks of intervention and at 4-, 6- and 12-week follow-up periods after the intervention. Secondary outcomes were assessed before each treatment (T1–T4). Data were analysed using mixed-model analyses of variance (ANOVA) with time as a within-subject variable and groups as between-subject variables followed by Bonferroni’s post-hoc test.Results: Mixed-model ANOVA revealed significant time-by-group interaction effects (F = 3.49, P = 0.01) for VAS. Post-hoc analysis showed a significant decrease in VAS and NDI after 2 weeks of intervention and at all follow-up periods compared with baseline in both groups (p < 0.01). The DN-EMG group exhibited higher improvements in VAS at 6- and 12-week follow-up period than the DN group (p < 0.05). In the SEA of MTrPs, we found positive sharp waves, fibrillation and fascicular potentials. DN-EMG group exhibited lower amplitudes at T2–T4 and frequencies at T2 and T3.Conclusion: DN under needle EMG guidance technique exhibited greater improvements in maintenance of improvement of pain and lower SEA value than the DN group due to sufficient MTrPs inactivation.Keywords: myofascial trigger point, muscle pain, needling

Background: There is no established method of maintaining or reducing intra ocular pressure after the needling procedure for failing blebs post trabeculectomy. Regarding newer antihypertensive medications, ripasudil, which is a rho-associated protein kinase inhibitor ophthalmic solution, was able to prevent excessive scarring in vitro. This study aims to evaluate the safety of glaucoma patients submitted to the needling procedure and administered ripasudil for preventing scarring after the procedure. We also investigate the efficacy of ripasudil after needling for bleb failure through suppression of fibrosis to the bleb. Methods: This study is a multicenter, open-label, single-arm, phase II trial to evaluate the safety and efficacy of ripasudil in glaucoma patients after the needling procedure. Forty patients who will undergo needling at least 3 months after trabeculectomy will be recruited in Hiroshima university hospital and Hiroshima eye clinic. All the patients will instill ripasudil two times per day for three months after the needling procedure. The primary endpoint is the safety of ripasudil. Conclusions: We plan to establish the safety of ripasudil and to collect information involving the efficacy of ripasudil widely in this study.

Purpose: To assess the clinical presentation of pediatric patients having early traumatic glaucoma and to analyze early predictors for the need of filtration surgery. Methods: Patients with early traumatic glaucoma after close globe injury (CGI) from January 2014 to December 2020 were retrospectively reviewed. Clinical features, treatment provided (medical and surgical), and visual outcomes were documented. Patients were divided into two groups based on the management required: group A- trabeculectomy and group B- medication + minor surgery. Results: A total of 85 patients were studied after applying the necessary inclusion and exclusion criteria. Out of these, 46 underwent trabeculectomy for the control of intraocular pressure (IOP) and the remaining 39 were managed with antiglaucoma medications. Significant male predominance of 9.6:1 was observed. Patients presented to the hospital after a mean duration of 8.5 days posttrauma. Wooden objects were most commonly responsible for trauma. Mean best corrected visual acuity at presentation was 1.91 log of minimum angle of resolution (logMAR). Mean IOP at presentation was 40 mmHg. The common anterior segment finding were severe anterior chamber (AC) reaction (63.5%), followed by angle recession (56.4%). Severe AC reaction (P = 0.0001) and corneal microcystic edema (P = 0.04) were significant predictive factors for early need of trabeculectomy. Conclusion: Need of trabeculectomy was higher in patients with severe AC reaction and corneal microcystic edema. The threshold to perform trabeculectomy should be lower, as glaucoma is often relentless, severe, and may result in irreversible vision loss. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the incidence of postoperative ptosis after primary trabeculectomy and the possible factors contributing to ptosis. Materials and Methods: A total of 312 patients (339 eyes) who underwent trabeculectomy with mitomycin-C between 2015 and 2020 were retrospectively evaluated. Patients who had regular follow-up for at least 6 months and no history of ptosis or ptosis surgery were included. Age, sex, glaucoma type, preoperative and postoperative intraocular pressure, preoperative and postoperative antiglaucoma medications, number of antiglaucoma drops, duration of antiglaucoma medication use, history of eye itching due to antiglaucoma medication-associated allergy, duration of follow-up, postoperative needling, needling time, and ocular massage were recorded. Ptosis was defined as >2 mm reduction in margin-reflex distance 1 from preoperative levels. Ptosis that had not improved for at least 6 months was considered persistent ptosis. Multivariate logistic regression was used to determine potential predictors of ptosis development. Results: Ptosis after trabeculectomy was observed in 35 of 339 eyes (10.3%). Thirty eyes of 30 patients (8.8%) had transient ptosis and 5 eyes of 4 patients (1.5%) had persistent ptosis. Preoperative duration of antiglaucoma medication use, drug(s) used (prostaglandin analogs, beta-blockers, alpha-2 agonists, carbonic anhydrase inhibitors, or combinations of these), needling time, and ocular massage after trabeculectomy did not differ significantly between groups (p>0.05). Needling and eye itching due to antiglaucoma medication-associated allergy were significantly higher in patients with ptosis (p<0.05). Conclusion: Ptosis after trabeculectomy is an important problem for glaucoma patients. It has been observed that needling and a history of eye itching due to antiglaucoma drug-associated allergy may increase the risk of ptosis. [ABSTRACT FROM AUTHOR]

The needled/stitched dual‐scale interlocking structure is a new fabric structure. However, the effect of stitching on the interlaminar bonding behavior of needled composite has not been elucidated. In this work, the needled/tufted dual‐scale interlocking composite was prepared, and experimental and numerical simulation of Mode I interlaminar property was carried out. The influence of stitching on the interfacial bonding behavior of needled composite was revealed. Results showed that the implantation of tufted fibers greatly improved the Mode I interlaminar property of the needled composite. The maximum experimental load of double cantilever beam (DCB) was 129.32 N, which increased by 248.53% compared to needled composites. And GIC increased by 3 times. Moreover，within a certain range, with the increase of the length of the head of the tufted fiber bundle, the interlaminar performance of Mode I was effectively improved. The typical failure mode of needled/tufted dual‐scale interlocking composite were matrix cracking, brittle fracture of needled fiber bundles, pulled out and brittle fracture of tufted fiber bundles. Moreover, the Tri‐cohesive zone models (TCZMs) was proposed, and DCB simulation of needled/tufted dual‐scale interlocking composite was conducted. The simulation of load–displacement curves was well closed to the experiment. The error range was within 7%. [ABSTRACT FROM AUTHOR]

Background Ultrasound (US)-guided techniques reported for the treatment of calcific tendinitis have mostly demonstrated good results. This study investigates the effect of US-guided barbotage using a spinal needle in patients with calcific tendinitis of the shoulder. Methods Thirty-six patients with calcific tendinitis of the shoulder treated by US-guided barbotage with a spinal needle and subacromial steroid injection were included in the study. We evaluated clinical outcomes based on American Shoulder and Elbow Surgeons (ASES) score, Constant score, and visual analog scale (VAS) for pain score. Radiological outcomes were assessed by X-ray imaging at each visit. Results Our results showed that US-guided barbotage and subacromial steroid injection produced good clinical and radiological outcomes in patients with calcific tendinitis of the shoulder. Of the 36 patients, only one required surgical treatment, while the others showed improvement without any complications. Compared to values before the procedure, calcific deposit size and VAS, ASES, and Constant scores showed significant improvement 6 weeks after the procedure. No significant correlation was found between the initial calcific deposit size and clinical outcomes at each time point. Conclusions In patients with calcific tendinitis of the shoulder, US-guided barbotage using a spinal needle and subacromial steroid injection can yield satisfactory clinical and radiological results.

Pseudo-unidirectional fiber networks are used in a variety of applications, such as woven fabrics and needling. A method for generating pseudo-unidirectional fiber networks by extruding linear portions of fibers is described here, and consists of two steps: (i) Initially, a deliberately disorganized pseudo-unidirectional fiber network was generated geometrically from a stochastic algorithm according to the fiber volume ratio and the distribution law of the angles formed between the portions. (i i) Then, the fibers were flattened and mechanically deformed using a finite element calculation until restoring the pseudo-unidirectional fiber network geometry, having stored elastic energy. Mechanical inter-fiber contact interactions were finally activated in a relaxation step to obtain a disorganized network in mechanical equilibrium. Angular deviation and migration criteria were defined to geometrically characterize the network disorder before and after mechanical rearrangement, and were shown to correlate with the algorithm's input parameters. Finally, the generated networks were mechanically characterized using a needle-punch, quantifying the transfer fraction. The mechanisms by which the needle carried and broke the fibers are discussed, and simulations demonstrate the influence of initial network disorder on fiber transfer. The particular case of needling involves transferring fibers present in a 2D web in its transverse direction in order to increase the out-of-plane stiffness of the final product. In this case, entanglement seemed to play a decisive role, as it favored fiber transfer. [Display omitted] • A fast algorithm generating pseudo-1D fiber networks has been developed. • Two geometric criteria characterizing fiber entanglement have been proposed. • A Finite element model of needle-punching without compaction has been developed. • Entanglement has significant effect on the results of needle-punch simulations. [ABSTRACT FROM AUTHOR]

Scars are among the most prevalent referral cases of dermatology clinics, including atrophic, hypertrophic, or keloidal scars. Approach to scar usually needs a holistic trend, attention to individualized characteristics, and combination therapy. Scars usually need multiple sessions of therapy and the use of combination therapeutic approaches to reach the most acceptable outcomes by safe modalities. Studies on scars are always one of the most important fields of research in medicine, especially in dermatology. For writing this review study, we searched all the databases to find the most relevant and the newest studies related to our topic, because based on expert opinion, this topic may be really practical and interesting for dermatologists and all physicians of various specialties or subspecialties who manage and treat various kinds of scars, including hypertrophic scars and keloids. Based on our results, we concluded that different procedures, which basically use needling, lasers, especially pulsed dye laser (PDL) and carbon dioxide (CO2) laser, and MesoBotox (micro-injection of botulinum toxin), are really promising therapeutic options for hypertrophic and keloidal scars and a combination of these therapies results in more efficacy and lesser side effects in the field of scar management.

Acupuncture is a minimally invasive therapeutic method that uses small caliber needles while inserting them through the skin into various areas of the body. Some empirical studies find evidence to support the use of acupuncture as a treatment for certain medical conditions, however, this peculiar practice is widely considered as the domain of alternative and non-evidence-based medicine. Several mechanisms have been suggested in an attempt to explain the therapeutic action of acupuncture, but the way in which acupuncture alleviates chronic non-cancer pain or psychosomatic and psychiatric disorders is not fully understood. A recent study suggested a theoretical model (coined “Fascial Armoring”) with a cellular pathway to help explain the pathogenesis of myofascial pain/fibromyalgia syndrome and functional psychosomatic syndromes. It proposes that these syndromes are a spectrum of a single medical entity that involves myofibroblasts with contractile activity in fascia and aberrant extracellular matrix (ECM) remodeling, which may lead to widespread mechanical tension and compression. This can help explain diverse psycho-somatic manifestations of fibromyalgia-like syndromes. Fascia is a continuous interconnected tissue network that extends throughout the body and has qualities of bio-tensegrity. Previous studies show that a mechanical action by needling induces soft tissue changes and lowers the shear modulus and stiffness in myofascial tissue. This hypothesis and theory paper offers a new mechanism for acupuncture therapy as a global percutaneous needle fasciotomy that respects tensegrity principles (tensegrity-based needling), in light of the theoretical model of “Fascial Armoring.” The translation of this model to other medical conditions carries potential to advance therapies. These days opioid overuse and over-prescription are ubiquitous, as well as chronic pain and suffering.

Background: Rho-kinase inhibitors can inhibit fibrosis after glaucoma surgery. This study aimed to evaluate the effect of rho-kinase inhibitor after needling procedure with mitomycin C for the failure of filtering bleb with trabeculectomy.Methods: This retrospective single-center study examined the effects of rho-kinase inhibitor after the needling procedure. We included 27 eyes of 27 patients with glaucoma who underwent needling procedure using mitomycin C and were subsequently treated with ripasudil-a rho-associated protein kinase inhibitor (ripasudil group)-or without ripasudil (control group). The ripasudil and control groups were compared in terms of intraocular pressure (IOP) and the number of antiglaucoma medications. Success at 12 months after the needling procedure was defined as a > 20% decrease in IOP from the preoperative period without surgical reintervention.Results: At 12 months after the needling procedure, the mean IOP decreased from 16.9 ± 4.5 to 12.6 ± 1.1 mmHg in the control group and from 16.0 ± 5.3 to 12.2 ± 1.2 mmHg in the ripasudil group (p = 0.77). The 12-month success rates were 60.00% and 56.25% in the control and ripasudil groups (p = 0.98), respectively. In the preoperative period, the numbers of antiglaucoma drugs were 0.27 ± 0.46 and 0.92 ± 0.91 in the control and ripasudil groups (p = 0.022), respectively, and at 12 months after the needling procedure, they were 1.07 ± 1.44 and 0.73 ± 1.10 (p = 0.52), respectively.Conclusions: Treatment with ripasudil (a rho-associated protein kinase inhibitor) after the needling procedure with mitomycin C did not show better results than treatment with the mitomycin C needling procedure alone at 12 months after the procedure. [ABSTRACT FROM AUTHOR]

Background: Microneedling was initially introduced for skin rejuvenation. This review analyzes the current literature on microneedling techniques, efficacy, and safety for vitiligo treatment. Methods: An extensive PubMed search was performed to identify literature on microneedling therapy for vitiligo. Case reports, case series, and clinical trials were included. Results: All 14 articles evaluated showed improvement of lesions after microneedling treatment. Combination of microneedling and topical tacrolimus, 5-FU, topical calcipotriol and betamethasone, NB-UVB with or without PDT, and triamcinolone acetonide solution yielded more efficacy than microneedling monotherapy. Conclusion: Microneedling is a safe and efficient technique and an adjuvant treatment for vitiligo treatment.

Verruca vulgaris is a viral infection with high recurrence rates and is very difficult to treat. It occurs due to the ability of the virus to evade immune recognition. This immune evasion by the human papillomavirus (HPV) can be circumvented by injecting HPV antigens subcutaneously and inducing inflammation and a systemic immune response. Falkner technique is an approved technique for the treatment of warts. In this observational study, we analyzed the recovery rate among patients undergoing this technique as part of their routine treatment. The aim of this study is to study the clinical outcome of Falkner's needling technique that is being used for the treatment of verruca vulgaris. Under local anaesthesia, only a single wart was vertically punctured using a 26-gauge needle up till the subcutis multiple times till bleeding was observed. No treatment was done for other warts. Patients were advised not to take any anti-inflammatory medications for pain and were observed for responses after 1 week as well as 1 and 3 months. Of 41 patients included in this study, the total resolution of both the punctured and distant warts occurred in 28 patients (68.29%) and partial response in 7 patients (17.1%) by the end of 3 months. Interestingly, individual warts that were subjected to needling showed complete resolution in 35 patients (85.4%). Falkner's needling method provides a high rate of complete resolution of multiple warts at both the needled and distant sites after a single treatment session of only a single lesion. This modality has a high cure rate, is easy to perform, requires minimal infrastructure support, is cost-effective, and can be undertaken at most peripheral settings with minimal training. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to NB-UVB phototherapy in the treatment of stable refractory patches of acral vitiligo, based upon clinical and immunohistochemical assessment of melanocyte count and distribution in response to needling/microneedling. Twenty patients with stable acral vitiligo (≥2 patches) were enrolled. One of the two index patches was randomized to receive needling or microneedling in conjunction with NB-UVB. Patients received phototherapy sessions 3 times weekly, while needling was carried out on biweekly basis for 6 months. Assessment was done clinically using point counting method, VESTA, and global patients' satisfaction, and immunohistochemically by quantitative assessment of melanocyte count by Melan-A. No statistically significant difference was observed between NB-UVB monotherapy and either of the combined therapy regimens as regards the mean percentage change in vitiligo surface area (p =.451), mean change in absolute melanocyte count from baseline (p =.589), and mean VESTA (p =.916). Patches subjected to adjuvant microneedling/needling were afflicted by koebnerization in 50% and 20% of cases, respectively. Neither microneedling nor needling appear to confer an added therapeutic value to NB-UVB phototherapy in the treatment of stable acral vitiligo. Moreover, both carry the risk of koebnerization. [ABSTRACT FROM AUTHOR]

Background: Lateral elbow tendinopathy is a disabling tendon overuse injury. It remains unknown if a corticosteroid injection (CSI) or tendon needling (TN) combined with heavy slow resistance (HSR) training is superior to HSR alone in treating lateral elbow tendinopathy. Purpose/Hypothesis: The purpose was to investigate the effects of HSR combined with either (1) a CSI, (2) TN, or (3) placebo needling (PN) as treatment for lateral elbow tendinopathy. We hypothesized that 12 weeks of HSR in combination with a CSI or TN would have superior effects compared with PN at 12, 26, and 52 (primary endpoint) weeks' follow-up on primary (Disabilities of the Arm, Shoulder and Hand [DASH] score) and secondary outcomes in patients with chronic unilateral lateral elbow tendinopathy. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 60 patients with chronic unilateral lateral elbow tendinopathy were randomized to perform 12 weeks of home-based HSR with elastic band exercises combined with either (1) a CSI, (2) TN, or (3) PN, and at 12, 26, and 52 weeks, we assessed the primary outcome, the DASH score, and secondary outcomes: shortened version of the DASH (QuickDASH) score, pain (numerical rating scale [NRS] score), pain-free grip strength, and hypervascularization (power Doppler area). Results: A CSI, TN, and PN improved patient outcomes equally based on the DASH (Δ20 points), QuickDASH (Δ21 points), and NRS (Δ2.5 points) scores after 12 weeks. Further, after 12 weeks, a CSI also resulted in decreased hypervascularization (power Doppler area) compared with PN (Δ–2251 pixels, P =.0418). Except for the QuickDASH score (CSI increased score by Δ15 points compared with PN; P =.0427), there were no differences between the groups after 52 weeks. Conclusion: These results suggest that 12 weeks of HSR improved symptoms in both the short and the long term and that a CSI or TN did not amplify this effect. In addition, a CSI seemed to impair patient-reported outcomes compared with HSR alone at long-term follow-up. Registration: NCT02521298 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Scars are among the most prevalent referral cases of dermatology clinics, including atrophic, hypertrophic, or keloidal scars. Approach to scar usually needs a holistic trend, attention to individualized characteristics, and combination therapy. Scars usually need multiple sessions of therapy and the use of combination therapeutic approaches to reach the most acceptable outcomes by safe modalities. Studies on scars are always one of the most important fields of research in medicine, especially in dermatology. For writing this review study, we searched all the databases to find the most relevant and the newest studies related to our topic, because based on expert opinion, this topic may be really practical and interesting for dermatologists and all physicians of various specialties or subspecialties who manage and treat various kinds of scars, including hypertrophic scars and keloids. Based on our results, we concluded that different procedures, which basically use needling, lasers, especially pulsed dye laser (PDL) and carbon dioxide (CO2) laser, and MesoBotox (micro-injection of botulinum toxin), are really promising therapeutic options for hypertrophic and keloidal scars and a combination of these therapies results in more efficacy and lesser side effects in the field of scar management. [ABSTRACT FROM AUTHOR]

A 32-week pregnant woman experienced moderate-to-severe sensorineural deafness in the left ear, diagnosed by pure tone audiometry. She was treated with Zhu's scalp acupuncture comprising one needle in the head-face area, two needles in the upper- jiāo area, three needles in the lower- jiāo area, and one needle puncturing the Bǎihuì (百会GV20). After dǎoyǐn (physical and breathing exercises), three needles were added to the auricular-temporal area, and the left Tīnggōng (听宫SI19), Tīnghuì (听会GB2), and Yīfēng (翳风TE17) were punctured. Dǎoyǐn was performed during each episode of needle puncture. After two sessions of scalp acupuncture treatment, the pure tone audiometry indicated that her hearing was normal. There was no recurrence of sensorineural deafness at the two-month follow-up, and her baby was born healthy. [ABSTRACT FROM AUTHOR]

Ocular decompression retinopathy (ODR) is caused by a sudden lowering of high intraocular pressure. Trabeculectomy is the most common procedure preceding ODR. Various mechanical and vascular etiologies have been proposed to cause ODR, with autoregulation and hemodynamics playing a contributing role. Herein, we report a rare case of ODR occurring after bleb needling in a young child using ultrawide-field fundus photography, fluorescein angiography, and optical coherence tomography. [ABSTRACT FROM AUTHOR]