用模拟针刺方法刺激天窗穴治疗失眠150例疗效观察

失眠（Insomnia）是指睡眠的始发（Sleep onset）和睡眠的维持（Sleep maintenance）发生障碍。是睡眠质量或数量达不到正常需求的一种主观体验。在社会节奏加快及竞争加剧的今天，针对失眠症发病率高，治疗方法又多依赖于镇静催眠药，使得失眠患者并不乐于接受的状况。笔者采用模拟针刺方法刺激天窗穴法疗该病150例，取得较好的疗效。现报道如下。

击针撞击模拟装置冲击特性研究

为研究击针撞击模拟装置撞击过程中检测单元冲击振动特性,采用多刚体仿真软件对装置进行了刚柔耦合仿真分析,通过将模拟装置安装基座柔性化处理进行仿真,提取了模拟装置工作全过程检测装置的振动特性曲线,得出了适合检测装置检测的时间区间,为工程实践提供了理论依据。

DITTO框架及其对针刺临床研究中模拟针刺设置的启示

如何科学有效地设置安慰对照是针刺临床研究的难题。2020年,英国国立卫生研究所制定了一套由“Deconstruct”“Identify”“Take out”“Think”“Optimize”5个环节构成的标准化方法学框架(DITTO框架)以规范侵入性安慰对照干预的设置。针刺在理论上属于侵入性治疗干预的范畴,在DITTO框架制定时也考虑了经皮穿刺疗法。因此,该框架可以尝试应用在针刺临床研究中,为适宜的模拟针刺对照设置提供参考。本文介绍了DITTO框架的制定过程与主要内容,并通过案例对框架各部分在针刺临床研究应用时需要做出的调整以及可能遇到的问题进行了分析。DITTO框架可以在一定程度上指导和规范针刺临床研究中模拟针刺对照的设计,有利于找到更为适宜的模拟针刺实施方式,从而促进针刺临床研究质量的提升。但由于尚无在中医针刺领域应用的先例,在今后的实际应用中还需要进一步研究,使其能更好地与针刺特点及临床研究的目的相结合。

模拟机下细针经皮肺穿刺(附53例临床分析)

目的 探讨模拟机下细针经皮肺穿刺对肺部周围型病变诊断的价值。方法 对5 3例肺部周围型占位性病变患者在模拟机下应用细针穿刺取材涂片,行细胞学检查。结果 5 3例患者均穿刺成功,获得细胞学资料,总阳性率为90 .5 % (48/ 5 3)。其中4 4例患者涂片找到肿瘤细胞,非癌诊断者4例。出现并发症7例(13.2 % ) ,其中气胸4例(7.5 % ) ,咯血3例(5 .7% ) ,血量少(<5 0 ml) ,常规处理后好转。结论 模拟定位机下细针经皮肺穿刺是一种快速、简便、安全和实用的诊断技术,且并发症少,它减少了开胸探查术,可在有条件的单位开展。

自适应模糊控制的模拟双针气压表驱动系统研究

针对目前应用于列车驾驶仿真平台中的模拟双针气压表控制系统的硬件结构及其控制策略进行了研究;以C8051F410单片机和双电机驱动控制模块BA6239为核心设计开发了表针电机驱动系统,提出了基于PWM控制技术的转速闭环控制策略;系统能够自动计算电机控制模型参数从而得到转速与PWM控制电压的关系,并通过引入自适应模糊PI转速调节器,减小系统及计算误差,提高动态响应精度;测试结果表明,基于自适应模糊控制的模拟双针气压表能够达到真车气压表的动作要求,为构建列车驾驶仿真平台提供了可靠的硬件支持。

模拟双针气压表远端控制和测试平台设计

针对模拟双针气压表显示驱动控制的要求,首先基于C8051F单片机完成了电机驱动控制和数据采集等硬件的设计和实现;并在此基础上完成了基于单片机的下位机模拟双针气压表驱动控制软件以及上位机测试及显示软件的设计;最终实现了对模拟双针气压表的远端控制和性能测试。运行结果表明,该系统工作稳定可靠,软硬件调试良好,为自主研制产品的性能测试提供了良好的平台和必要的手段。

自动注射针:应急医学现场救援的关键技术措施

自动注射针,一种将药物预先灌封好的由弹簧驱动的能自行完成注药过程的"药械一体化"组合产品,能帮助患者在无医护人员的现场自行完成注射药物过程,是应急医学现场实施自救互救的关键技术措施。美国是自动注射针技术的发明者也是该技术不断创新的领跑者。自动注射针载体技术从最初的战场到现在的民用,经历了挤压式半自动注射针、弹簧式单腔全自动注射针和弹簧式双腔全自动注射针等三大发展过程。现行的弹簧式载体装置共有小规格单腔式、大规格单腔式、液-液型双腔式、液-固型双腔式以及针头回缩式等5种基本类型,与之组合的军用药物主要有阿托品、解磷啶、双复磷、安定和吗啡等以及肾上腺素、利多卡因和舒马曲坦等其他急救药物。所有自动注射针品种均配备有相应的培训或训练专用模拟针。针头自动回缩或自动遮藏技术以及注药始末的提示技术,是自动注射针载体技术重要的研发应用趋势。

银质针联合手法松解治疗膝骨性关节炎的疗效观察

目的观察银质针联合中医推拿手法治疗膝骨性关节炎患者的临床疗效。方法60例膝骨性关节炎患者,采用随机数字表法分为对照组和研究组,每组30例。对照组患者采用玻璃酸钠注射液膝关节腔内注射联合局部痛点治疗。研究组采用银质针联合中医推拿手法治疗方法:比较两组患者治疗效果以及视觉模拟评分法(VAS)、奎森功能演算指数(Lequesne)评分。结果研究组治疗总有效率96.7%高于对照组的73.3%,差异具有统计学意义(P<0.05)。研究组患者VAS评分(2.14±0.23)分、Lequesne评分(6.11±1.52)分均低于对照组的(3.64±0.58)、(8.80±1.51)分,差异具有统计学意义(P<0.05)。结论针对膝骨性关节炎患者,使用银质针联合中药外敷方法治疗效果显著,所产生的副作用比较小,膝骨性关节炎患者的依从性以及耐受性好。

Effects of pin angle and preheating on temperature distribution during friction stir welding operation

Friction stir welding （FSW） is applied extensively in industry for joining of nonferrous metals especially aluminum. A three-dimensional model based on finite element analysis was used to study the thermal characteristic of copper C I 1000 during the FSW process. The model incorporates the mechanical reaction of the tool and thermo-mechanieal characteristics of the weld material, while the friction between the material and the probe and the shoulder serves as the heat source. It was observed that the predicted results about the temperature were in good compatibility with the experimental results. Additionally, it was concluded that the numerical method can be simply applied to measuring the temperature of workpiece just beneath the tool. The effects of preheating temperature and pin angle on temperature distribution were also studied numerically. The increase of pin angle enhances the temperature around the weld line, but preheating does not affect temperature distribution along the weld line considerably.

Computer Simulation on Metallic Card Clothing Garnett Wire Teeth's Temperature Field & Structure Field in the Process of Quenching Treatment

The quenching process of garnett wire teeth of metallic card clothing heated by flame was researched by use of 3-D finite element method and the equation of boundary condition was established by making use of a model of artificial neural network. The transient temperature field, phase transformation in the heating process, the quenching microstructures and the hardness distribution on quenched garnett wire teeth of metallic card clothing were simulated. The result shows that the maximum error of the hardness between the simulative value and the actual measuring value is 8.0% on only one testing point and errors are all less than 3.0% on other testing points.

桃小食心虫危害对苹果果实蛋白质含量及防御酶活性的影响

为探明桃小食心虫取食危害对不同品种苹果果实蛋白质含量和防御酶活性的影响,田间条件下采用人工接虫和针刺模拟危害苹果果实,处理12 d后调查果实受害程度并测定蛋白质含量及超氧化物歧化酶(SOD)、过氧化物酶(POD)和过氧化氢酶(CAT)活性,分析了果实蛀孔数与可溶性蛋白质和防御性酶活性的关系。结果表明:人工接虫后,"嘎啦"的蛀孔数显著多于"乔纳金"和"金帅"。桃小食心虫危害后苹果果实蛋白质含量变化不大,均显著低于针刺模拟处理;SOD活性显著高于针刺模拟处理(P<0.05);POD活性都显著增加,"乔纳金"、"金帅"的变化显著大于"嘎啦";CAT活性都与对照相比无显著变化,均高于针刺模拟处理,CAT酶活性与苹果蛀孔数呈显著正相关。桃小食心虫危害可以诱导寄主产生一系列反应,蛋白质含量和应激防御酶活性均发生了变化,其中,防御性酶可能在苹果防御桃小食心虫危害中发挥着重要作用。

Function of shoulder muscles of driver in vehicle steering maneuver

In order to study the function of muscles of driver shoulder during vehicle steering, identification of relations between electromyograph (EMG) activity of 10 shoulder muscles and steering force was performed. The procedure was to perform controlled steering maneuver by right hand in a driving simulator, and based on analyzing the EMG data with steering force in the steering wheel plane, the function was identified. It was found that muscle function depends strongly on both steering rotation and steering torque directions. In clockwise steering, the long head of triceps brachii was the prime mover and an important contributor to clockwise moment, while the sternocostal portion of the pectoralis major, the lateral head of triceps brachii, biceps brachii and teres major were the important stabilizers or fixators. In contrast, in counterclockwise steering, the anterior, middle and posterior deltoid, the clavicular portion of the pectoralis major and infraspinatus were the prime movers and also the important contributors to counterclockwise moment, while the sternocostal portion of the pectoralis major, the lateral head of triceps brachii, biceps brachii and teres major were the important stabilizers or fixators. We conclude that the prime movers are primarily a consequence of steering direction, while the stabilizers or fixators are primarily constant. These results can be used to improve the neuromuscular model and estimate the steering comfort of driver.

Verification on Spray Simulation of a Pintle Injector for Liquid Rocket Engine

The pintle injector used for a liquid rocket engine is a newly re-attracted injection system famous for its wide throttle ability with high efficiency. The pintle injector has many variations with complex inner structures due to its moving parts. In order to study the rotating flow near the injector tip, which was observed from the cold flow experiment using water and air, a numerical simulation was adopted and a verification of the numerical model was later conducted. For the verification process, three types of experimental data including velocity distributions of gas flows, spray angles and liquid distribution were all compared using simulated results. The numerical simulation was performed using a commercial simulation program with the Eulerian multiphase model and axisymmetric two dimensional grids. The maximum and minimum velocities of gas were within the acceptable range of agreement, however, the spray angles experienced up to 25% error when the momentum ratios were increased. The spray density distributions were quantitatively measured and had good agreement. As a result of this study, it was concluded that the simulation method was properly constructed to study specific flow characteristics of the pintle injector despite having the limitations of two dimensional and coarse grids.

Effect of acupuncture plus exercise on pain and motor function in patients with knee osteoarthritis

Objective:To observe the effects of acupuncture combined with isokinetic eccentric exercise on pain and motor function in patients with knee osteoarthritis(KOA).Methods:Sixty-four patients with KOA were randomly divided into an observation group and a control group,with 32 cases in each group.The observation group received acupuncture and isokinetic eccentric exercise,and the control group received isokinetic eccentric exercise and oral intake of meloxicam tablets.Both groups were treated for 4 weeks.Before and after treatment,the visual analog scale(VAS)score,the lysholm knee scale(LKS)score,and the quadriceps peak torque(PT)were evaluated.Results:The total effective rate was 93.8%in the observation group,versus 81.3%in the control group.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS scores of the two groups were lower than those before the treatment;both LKS score and quadriceps PT were higher than those before treatment,and the differences were statistically significant(all P<0.05).The VAS score,LKS score and quadriceps PT(angular velocity was 60%)of the observation group were significantly different from those of the control group(all P<0.05).Conclusion:Acupuncture plus isokinetic eccentric exercise is effective in treating KOA.The combined treatment can reduce the pain of KOA patients,improve joint function,strengthen quadriceps,improve joint stability,and its curative effect is better than isokinetic eccentric exercise plus oral intake of meloxicam tablets.

Warm needling moxibustion plus functional exercises for knee osteoarthritis

Objective： To observe the clinical efficacy of warm needling moxibustion plus functional exercises in treating knee osteoarthritis（KOA）. Methods： Totally 108 eligible KOA patients were intervened by warm needling moxibustion plus functional exercises. The warm needling moxibustion was given 3 times a week, successively for 4 weeks. The visual analogue scale（VAS） was adopted to evaluate the pain intensity of the knee joint. After 4-week treatment, the change of VAS score, range of motion（ROM） of knee, and Lysholm score were observed, and the clinical efficacy was also estimated. Results： After treatment, the VAS score dropped obviously, and the ROM and Lysholm score increased markedly; the total effective rate was 83.3%. Conclusion： Warm needling moxibustion plus functional exercises is effective in treating KOA, as it can relieve the knee joint pain and improve the joint motion.

Treatment of 28 Cases of Post-herpetic Neuralgia by Local Encircled Needling Method

According to the affected area, 28 patients with herpes zoster were treated. Electroacupuncture and local encircled needling method were used for the patient with the affected head and Jiaji （Ex-B 2） on the ,same side of pathological changes was added to puncture for the patient with the affected chest and waist. Visual analogue scale （VAS） was used to assess analgesic effect. The result showed VAS 〈 2 in 19 cases, VAS 〈 5 in 7 cases and VAS 〉 6 in 2 cases.

Observation on instant analgesic effect of Governor Vessel-regulating and collateral-unblocking acupuncture method for primary headache

Objective： To observe the instant analgesic effect of Governor Vessel-regulating and collateral-unblocking acupuncture method in treating primary headache and to inherit and carry forward the academic achievements of Gao＇s acupuncture school in Yanzhao （Hebei Province） area. Methods： Eighty eligible primary headache patients were randomized into an observation group and a control group following their visiting sequence, 40 patients in each group. The observation group was intervened by Yanzhao Gao＇s Governor Vessel-regulating and collateral-unblocking acupuncture, and the control group was intervened by ordinary acupuncture method. The visual analogue scale （VAS） was used to evaluate the headache intensity before and after the first treatment session in the two groups, to compare the instant analgesic effect of the two acupuncture methods. Results： After the first treatment session, the VAS scores dropped significantly in both groups （both P〈0.05）. The change of VAS score after the initial treatment in the observation group was significantly different from that in the control group （P〈0.05）. The percentage of patients with headache completely vanished instantly after the first treatment was markedly higher in the observation group than that in the control group （P〈0.05）. Conclusion： The two acupuncture methods both can produce a significant instant analgesic effect in treating primary headache, while Yanzhao Gao＇s Governor Vessel-regulating and collateral-unblocking acupuncture method is superior to ordinary acupuncture method.

Frequency steps and compositions determine properties of needling sensation during electroacupuncture

OBJECTIVE:To investigate the relationship of electro-parameters and the electroacupuncture sensation(EAS),which is thought to be an important factor for optimal treatment.METHODS:The frequency steps and compositions of three frequently used electrical stimulations were set when the switch of the electroacupuncture apparatus was turned to the second or third grade of the dense-disperse frequency wave(DD2and DD3,respectively) or the second grade of the continuous wave(C2).Three groups of patients according to the three electroacupuncture stimulations were divided again into three sub-groups according to the stimulated acupoints:the face acupoint Quanliao(SI 18),the upper-limb acupoint Quchi(LI 11) and the back acupoint Dachangshu(BL25).The EAS values were measured every 5 min during 30 min electroacupuncture treatments using a visual analogue scale.RESULTS:The frequency compositions of the three electroacupuncture stimulations were 3.3 and 33 Hz,12.5 and 66.7 Hz,and 3.3 and 3.3 Hz;each frequency step was 30,54 and 0 Hz,respectively.In each sub-group of the C2 group,the EAS values from 10 to 30 min were significantly weaker than at 0 min.The sensation fluctuations in the DD2 and DD3 groups were different during the 30 min.CONCLUSION:The greater the frequency step of the electroacupuncture stimulation,the longer the needling sensation lasted.The electroacupuncture stimulations of the DD3 group were unsuitable for the facial acupoint because of its painful and uncomfortable EAS,but more suitable for the back acupoint.