改进型超声引导下针状可视肾镜(Needle perc)钬激光碎石术治疗肾下盏结石的临床评价:与输尿管软镜对比

目的比较改进型超声引导下针状可视肾镜(Needle perc)钬激光碎石术和输尿管软镜下钬激光碎石术治疗1~2 cm肾下盏结石的效果,为临床治疗方式的选择提供参考。方法回顾性分析2022年1月—2023年5月郑州市第一人民医院收治的60例肾内单发下盏结石(最大径1~2 cm)患者的临床资料,比较行输尿管软镜钬激光碎石术的30例患者(软镜组)和改进型超声引导下Needle perc钬激光碎石术的30例患者(Needle perc组)的临床资料。结果Needle perc组较软镜组的整体住院时间[(3.00±1.25)d vs.(4.00±1.25)d]、手术时间[(44.63±5.42)min vs.(48.50±7.24)min]和住院花费[(15518±441)元vs.(16872±903)元]均较少(P<0.05)。Needle perc组术后清石率高于软镜组[93.3%(28/30)vs.50.7%(15/30),P<0.001]。术后降钙素原(PCT)上升幅度低于软镜组[(0.02±0.01)vs.(0.12±0.18),P=0.007],而并发症发生率低于软镜组[3.3%(1/30)vs.26.7%(8/30),P=0.030]。结论对于1~2 cm的肾下盏单发结石,改进型超声引导下Needle perc钬激光碎石术清石率较高、并发症发生率低,安全且有效。

Assessment of Knowledge, Attitude and Practices among Healthcare Workers in a Tertiary Care Hospital on Needle Stick Injury

Purpose: Needle-stick injury (NSI) is one of the most potential occupational hazards for healthcare workers because of the transmission of blood-borne pathogens. As per recent data, around 30 lakh healthcare workers sustain Needle stick injuries each year. This study was conducted to assess healthcare workers’ knowledge, attitude and practices regarding needle stick injury. Materials & Methods: A cross-sectional study was conducted in a Tertiary Care Hospital over the period of 3 months. The study population consisted of Intern Doctors, Post Graduate resident Doctors, Staff Nurses, laboratory technicians of Government Medical College and New Civil Hospital, Surat (n = 300). The data were collected using a self-administered questionnaire via the means of Google Forms. Questionnaire was made with prior review literature. The data obtained were entered and analysed in Microsoft Excel. Results: The prevalence of NSI in our study was 46%, with a higher prevalence among the PG residents (72%). Overall scores regarding knowledge and attitude were better in PG residents (knowledge score > 7 in 71% and Attitude Score > 7 in 68% of PG Residents). Even though the PG residents scored highest in the knowledge category, the majority of them suffered needle stick injuries as a result of poor practice scores. Among those who had NSI (n = 139/300), 70% of study participants had superficial injuries, only 9% reported the incident, 18% got medical attention within 2 hours of the incident, and 7% followed up to recheck their viral markers status. Most incidents of NSI were due to hypodermic needles while recapping needles. Conclusion: Exposure to needle stick injuries and their underreporting remains a common problem. It is imperative that healthcare workers receive regular training on the proper handling of sharp objects. We can also draw the conclusion that preventing NSIs requires putting knowledge into practice.

MXene Enhanced 3D Needled Waste Denim Felt for High‑Performance Flexible Supercapacitors

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.

Is magnesium deficiency the major cause of needle chlorosis of Pinus taeda in Brazil?

Needle chlorosis(NC)in Pinus taeda L.systems in Brazil becomes more frequent after second and third harvest rotation cycles.In a study to identify factors contributing to yellowing needle chorosis(YNC),trees were grown in soils originating from contrasting parent materials,and soils and needles(whole,green and chlorotic portions)from 1-and 2-year-old branches and the first and second needle flush release at four sites with YNC on P.taeda were analyzed for various elements and properties.All soils had very low base levels(Ca^(2+),Mg^(2+)and K^(+))and P,suggesting a possible lack of multiple elements.YNC symptoms started at needle tips,then extended toward the needle base with time.First flush needles had longer portions with YNC than second flush needles did.Needles from the lower crown also had more symptoms along their length than those higher in the canopy.Symptoms were similar to those reported for Mg.In chlorotic portions,Mg and Ca concentrations were well below critical values;in particular,Mg levels were only one third of the critical value of 0.3 g kg^(-1).Collectively,results suggest that Mg deficiency is the primary reason for NC of P.taeda in various parent soils in Brazil.

Percutaneous ultrasound-guided coaxial core needle biopsy for the diagnosis of multiple splenic lesions: A case report

BACKGROUND The overlap of imaging manifestations among distinct splenic lesions gives rise to a diagnostic dilemma.Consequently,a definitive diagnosis primarily relies on his-tological results.The ultrasound(US)-guided coaxial core needle biopsy(CNB)not only procures sufficient tissue to help clarify the diagnosis,but reduces the incidence of puncture-related complications.CASE SUMMARY A 41-year-old female,with a history of pulmonary tuberculosis,was admitted to our hospital with multiple indeterminate splenic lesions.Gray-scale ultrasono-graphy demonstrated splenomegaly with numerous well-defined hypoechoic ma-sses.Abdominal contrast-enhanced computed tomography(CT)showed an en-larged spleen with multiple irregular-shaped,peripherally enhancing,hypodense lesions.Positron emission CT revealed numerous abnormal hyperglycemia foci.These imaging findings strongly indicated the possibility of infectious disease as the primary concern,with neoplastic lesions requiring exclusion.To obtain the precise pathological diagnosis,the US-guided coaxial CNB of the spleen was ca-rried out.The patient did not express any discomfort during the procedure.CONCLUSION Percutaneous US-guided coaxial CNB is an excellent and safe option for obtaining precise splenic tissue samples,as it significantly enhances sample yield for exact pathological analysis with minimum trauma to the spleen parenchyma and sur-rounding tissue.

Indications for Renal Needle Biopsy and Histological Spectrum of Kidney Disease in Togo

Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.

Exploring the Dual Subjectivity of Kindergarten's Self-made Play and Teaching Aids Activities from the Perspective of Children's Play Development in China

The joint development of teachers and young children is the basis for promoting the development of high-quality preschool education in the new era,and encouraging early childhood teachers to make playthings according to local conditions is both the fine tradition of China's early childhood education and the direct orientation of China's preschool education policy.Homemade play and teaching aids are some of the methods often used in kindergartens,which skillfully combine young children's daily life objects with toys and early childhood teaching,not only enriching the collective activities of young children but also cultivating children's abilities in various aspects.Kindergarten homemade"play and teaching aids"for early childhood teachers and children have their special educational significance and value,therefore,this paper is based on the children and teachers double subject basis,discussing the homemade"play and teaching aids"for children and teachers of the double subject meanings,and puts forward the realization of the This paper discusses the double-subjective meaning of homemade teaching aids for children and teachers on the basis of the double-subjective foundation of children and teachers,and puts forward specific suggestions for realizing the double-subjectivity of kindergarten homemade teaching aids to enrich the theoretical value and practical significance of homemade teaching aids,to provide theoretical references and support for the relevant staff.

Shelton Vision pushes the needle on Al-assisted quality control

MANCHESTER,UK-Having successfully demonstrated its WebSpector automated fabric inspection system detecting faults on camouflage fabrics at speeds of up to 100metres a minute during ITMA 2023,BTMA member Shelton Vision has secured an unprecedented number of new orders in many fields of the textile industry.The company has subsequently been recruiting additional staff in order to beef up its operations to meet delivery times and to grow capacity for the ongoing increased demand.

Subretinal recombinant human tissue plasminogen activator injection using a 41G needle for the management of submacular hemorrhages:a 3-case report

Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].

Endoscopic ultrasound-guided fine-needle aspiration pancreatic adenocarcinoma samples yield adequate DNA for next-generation sequencing:A cohort analysis

BACKGROUND Genetic tests are increasingly performed for the management of unresectable pancreatic cancer.For genotyping aimed samples current guidelines recommend using core specimens,although based on moderate quality evidence.However,in clinical practice among the endoscopic ultrasound(EUS) guided tissue acquisition methods,fine needle aspiration(FNA) is the most widely performed.AIM To assess the adequacy for next generation sequencing(NGS) of the DNA yielded from EUS-FNA pancreatic adenocarcinoma(PDAC) samples.METHODS Between November 2018 and December 2021,105 patients with PDAC confirmed by EUS-FNA were included in the study at our tertiary gastroenterology center.Either 22 gauge(G) or 19G FNA needles were used.One pass was dedicated to DNA extraction.DNA concentration and purity(A260/280,A260/230) were assessed by spectrophotometry.We assessed the differences in DNA parameters according to needle size and tumor characteristics(size,location) and the adequacy of the extracted DNA for NGS(defined as A260/280 ≥ 1.7,and DNA yield:≥ 10 ng for amplicon based NGS,≥ 50 ng for whole exome sequencing [WES],≥ 100 ng for whole genome sequencing [WGS]) by analysis of variance and ttest respectively.Moreover,we compared DNA purity parameters across the different DNA yield categories.RESULTS Our cohort included 49% male patients,aged 67.02 ± 8.38 years.The 22G needle was used in 71%of the cases.The DNA parameters across our samples varied as follows:DNA yield:1289 ng(inter quartile range:534.75-3101),A260/280 = 1.85(1.79-1.86),A260/230 = 2.2(1.72-2.36).DNA yield was > 10 ng in all samples and > 100 ng in 93% of them(one sample < 50 ng).There were no significant differences in the concentration and A260/280 between samples by needle size.Needle size was the only independent predictor of A260/230 which was higher in the 22G samples(P =0.038).NGS adequacy rate was 90% for 19G samples regardless of NGS type,and for 22G samples it reached 89% for WGS adequacy and 91% for WES and amplicon based NGS.Samples with DNA yield > 100 ng had significantly higher A260/280(1.89 ± 0.32 vs 1.34 ± 0.42,P = 0.013).Tumor characteristics were not corelated with the DNA parameters.CONCLUSION EUS-FNA PDAC samples yield DNA adequate for subsequent NGS.DNA amount was similar between 22G and 19G FNA needles.DNA purity parameters may vary indirectly with needle size.

Nylon 6-cellulose composite hosted in a hypodermic needle: Biofluid extraction and analysis by ambient mass spectrometry in a single device

This study proposes a hypodermic needle(HN)as a sorbent holder and an electrospray(ESI)emitter,thus combining extraction and analysis in a single device.A novel nylon 6-cellulose(N6-Cel)composite sorbent is proposed to extract methadone from oral fluid samples.The cellulosic substrate provides the composite with high porosity,permitting the flow-through of the sample,while the polyamide contributes to the extraction of the analyte.The low price of the devices(considering the holder and the sorbent)contributes to the affordability of the method,and their small size allows easy transportation,opening the door to on-site extractions.Under the optimum conditions,the analyte can be determined by high-resolution ambient ionization mass spectrometry at a limit of detection(LOD)as low as 0.3 mg/L and precision(expressed as relative standard deviation,RSD)better than 9.3%.The trueness,expressed as relative recovery(RR),ranged from 90%to 109%.As high-resolution mass spectrometers are not available in many laboratories,the method was also adapted to low-resolution spectrometers.In this sense,the direct infusion of the eluates in a triple quadrupole-mass spectrometry provided an LOD of 2.2 mg/L.The RSD was better than 5.3%,and the RR ranged from 96%to 121%.

Extending the Lifetime of Copper-beryllium Alloys as Plastic Injection High-end Needle Valve Mold Nozzle Tips Through a Heat-treatment-based Microstructure Optimization Approach

The relationship between the microstructure and the practical performance of two different copper-beryllium alloys including their lifetime has been investigated.Herein,two valves made of two different alloys with very similar compositions and the same heat treatment methods were investigated by various standard techniques including metallography,X-ray diffraction,chemical composition,microhardness,and thermal conductivity measurements.Although both alloys experienced the same heat-treatment processes,they revealed different thermal and mechanical properties due to the minor difference in their chemical composition.The alloy providing a longer lifetime (40%more) as the tip had a higher thermal conductivity of 280.3 W(m·K)^(-1) (about two times that of the other alloy).Regarding the metallography images and the measured thermal conductivity values of the alloys,the extended lifetime of the nozzle with the optimum performance is ascribed to its biphasic microstructure and the minor grain boundaries and interfacial thermal resistance.And important difference in the chemical composition was investigated in this study.

Multi-point discharge model: study on corona discharge of double-ended needle in large space

Corona discharge, as a common means to obtain non-equilibrium plasma, can generally obtain high-concentration plasma by increasing discharge points to meet production needs. However,the existing numerical simulation models used to study multi-point corona discharge are all calculations of small-scale space models, which cannot obtain the distribution characteristics of plasma in large space. Based on our previous research, this paper proposes a hybrid model for studying the distribution of multi-point discharge plasma in large-scale spaces, which divides the computational domain and computes separately with the hydrodynamic model and the ion mobility model. The simulation results are verified by a needle–ball electrode device. Firstly, the electric field distribution and plasma distribution of the needle electrodes with single tip and double tips are compared and discussed. Secondly, the plasma distribution of the needle electrode with the double tip at different voltages is investigated. Both computational and experimental results indicate that the charged particle concentration and current of the needle electrode with double tips are both twice as high as those of the needle electrode with a single tip. This model can extend the computational area of the multi-point corona discharge finite element model to the sub-meter(25 cm) or meter level, which provides an effective means to study the plasma distribution generated by multiple discharge points in large-scale space.

Observation on Curative Effect of Self-made Wubeizi Decoction Combined with rhaFGF in Promoting Postoperative Wound Healing in Patients with Anal Fistula

[Objectives]To explore the curative effect of Self-made Wubeizi Decoction combined with recombinant human acidic fibroblast growth factor(rhaFGF)in promoting postoperative wound healing in patients with anal fistula.[Methods]A total of 82 patients with anal fistula who underwent anal fistula resection+use of setons in Luodian Hospital during January and March of 2020 were randomly divided into observation group and control group with 41 cases in each group.The control group was given rhaFGF external application regimen,and the observation group was treated with Self-made Wubeizi Decoction on the basis of the control group.After 3 weeks of treatment,the differences in curative effects of TCM syndromes were compared between the two groups.Besides,the changes in TCM symptom scores,inflammatory mediators[interleukin-12(IL-12),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)],anorectal functions[anal resting pressure(ARP),maximal systolic pressure(MSP)and maximum tolerated volume(MTV)of the anal canal],quality of life[GQOLI-74 scores]were compared.[Results]After 3 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the levels of TCM symptom scores,IL-12,TNF-α,IFN-γ,ARP,MSP,and MTV in both groups were significantly lower than those before treatment,and these levels in the observation group was significantly lower than that in the control group at the same time(P<0.05).The GQOLI-74 scores of both groups were significantly higher than those before treatment,and the observation group was significantly higher than the control group(P<0.05).[Conclusions]The Self-made Wubeizi Decoction combined with rhaFGF therapy has a significant effect in promoting postoperative wound healing in patients with anal fistula.It can effectively inhibit the local inflammation of patients,facilitate the recovery of anorectal function and improve the quality of life,thus has high clinical application value.

History and Development of Zhuang Medicine Shallow Needling from Bone Needle,Pottery Needle,and Bronze Needle to Electroacupuncture

Zhuang medicine shallow needling has a long history and plays a significant role in Chinese medicine.With the development of medical treatment in China,there is a constant improvement in the use of needles.Bone needles have been modified to pottery needles,bronze needles,and electroacupuncture.From this long development history,there are some improvements in terms of material and technology.By analyzing and comparing the primitive and current acupuncture instruments used in China and their therapeutic effects,it can be seen that China’s medical treatment is constantly improving and will continue to improve with technology.

Melnick Needles Syndrome: Computed Imaging and Management Difficulties

Melnick-Needles syndrome is an osteo-dysplasia caused by a mutation of a gene, FLNA, coding for filamine A. It is at the origin of a set of complex congenital malformations, mainly of interest to the members, but also to the cranio-facial region. Melnick-Needles syndrome was first described in 1966 by two Americans John Melnick, a radiologist, and Carl F Needles, a pediatrician. They described cases of families of several generations who had a characteristic severe congenital bone disorder. They thought that human-to-human transmission had occurred in one case. We report a case of Melnick-Needles syndrome which is a pathology with very high mortality especially in a male subject. This was an observational study of a case received in consultation with the pediatric service of the Souro Sanou University Hospital Center in Bobo Dioulasso in Burkina Faso. It was a 3-year-old boy born in a low-term pregnancy without any prenatal consultation, imaging test and prenatal biology performed. The exact pathogenesis of this condition is not established but is linked to a mutation of the Filamine A gene linked to sexual chromosomes X. Pathology is rare, around a hundred cases have been reported worldwide. Its incidence, according to the literature is around 1/100,000. The sex ratio is at 7. The malformations of this acquired embryo-fetopathy are multiple, polymorphic and asymmetrical. The diagnosis of this pathology is suspected by the clinic and established by molecular biology by sequencing the genes responsible for the mutation. However, imagery, in particular the scanner has a major role by its protocol with multi-planar reconstructions and its analysis in double windowing which allow a better description of the malformations of this syndrome. Its management is complex, and multidisciplinary, and the unfortunate prognosis in our context is because of the precarious technical platform. In our case despite the obvious malformations presented by the patient, the parents consulted late in a health center because of the automation and especially the socio-cultural constraints which incriminate this type of polymalformation as being a curse. The patient underwent abdominal surgery and even the operating procedures were simple, he died four months after leaving the hospital, due to an unspecified cause.

一种新的光学膜系设计方法——NEEDLE 法

针（ＮＥＥＤＬＥ）法是一种先进的光学膜系设计方法．它克服了传统优化方法中容易陷入局部极值的缺点．它通过在膜系中插入薄层，使得膜系评价函数降低，且优化设计可以从任意给定的单层膜开始．文中同时给出了其数学模型的详细推导，以及用ＮＥＥＤＬＥ法设计的光学膜系举例．

“假想层”在Needlee法膜系设计中的应用

Needle法是一种强大的膜系设计方法,它的突出特点是不依赖于初始膜系的给定,几乎对各种膜系设计目标都能给出比较令人满意的设计结果。但它的物理模型不够清楚,很难从直观上理解。通过在Needle法的推导过程中引入“假想层”的概念,使Needle法的整个推导过程清楚明了、容易理解,改进后的Needle法依然保持了它原来的各种优点。最后用两个设计实例说明了这种改进的有效性。

应用Cable-needle钢缆环扎治疗粉碎性髌骨骨折

目的探讨Cable-needle钢缆环扎治疗粉碎性髌骨骨折的临床疗效。方法回顾分析2010年1月至2012年3月我科收治的25例病例,均为粉碎性髌骨骨折,男18例,女7例;年龄15～65岁,平均39岁。采用Cable-needle钢缆进行治疗。结果全部病例随访3～25个月,平均10个月。手术切口一期愈合,未发生感染,骨折全部愈合,无Cable-needle钢缆松动并发症,仅1例髌骨骨折术后3个月Cable-needle钢缆卡扣处钢缆残端外露,突破皮肤,给予取出钢缆闭合皮肤破口,顺利愈合。参照bostman髌骨骨折疗效评分标准进行评分,优23例,良2例,优良率100%。结论Cable-needle钢缆环扎治疗粉碎性髌骨骨折,骨折固定牢固,操作简便,对于粉碎性髌骨骨折是一种较好的选择。

Needle-Tunneling法膜系自动设计

综述了Ｎｅｅｄｌｅ和Ｔｕｎｎｅｌｉｎｇ 法膜系自动设计的基本原理，举出它们的应用实例，并且指出一个优秀的光学膜系自动设计程序应该包括Ｎｅｅｄｌｅ 法、Ｔｕｎｎｅｌｉｎｇ 法和传统的优化方法。它们的结合和交叉使用，使我们有可能从单层膜开始设计任意光学性能的多层膜。