Technical operation specification for pricking-cupping therapy

Pricking-cupping therapy is a Traditional Chinese Medicine(TCM)nursing technology that can adjust the viscera of the human body,make the meridians smooth,and Yin and Yang balanced mainly by means of relieving heat and detoxification,harmonizing Qi and blood,promoting blood circulation and removing blood stasis,dredging meridians and activating collaterals,reducing swelling and pain,purging heat and calming shock,clearing heat,and opening orifices.Pricking-cupping therapy has a long history and wide application.After thousands of years of development,it has made great progress.They are widely used to treat lumbar disc herniation,herpes zoster,acute arthritis,migraine,and other diseases in China.Through the clinical practice and theoretical exploration of physicians of past dynasties,the therapeutic mechanism and application scope of pricking-cupping therapy have been greatly enriched.Modern TCM practitioners have conducted in-depth researches on the operation norms of the therapy on the basis of the ancients,hoping to grasp the essence of the disease more accurately and make the rational use of the operation technology of the therapy.

CLINICAL RESEARCH OF IMPACTS ON PLASMA ENDOTHELIN AND INTELLIGENCE IN MULTI-INFARCT DEMATIA TREATED WITH CLUSTER PRICKING ON HEAD POINTS

Objective To probe into the impacts on the therapeutic effects and endothelin （ET） in multi-infarct dementia （MID） treated with cluster pricking on head points.Methods 60 cases of MID were randomized into acupuncture group and western medicine group,treated with cluster pricking on head points and huperzien A tablet respectively.Plasma ET lever,HDS,ADL and CNFDS （clinical neurological functional defect scoring） were determined before treatment,and the statistical analysis showed that there were no significant difference （P〉0.05）.Results In 8-week treatment,ET level in both groups were decreased,but it was decreased much more obviously in acupuncture group,indicating significant difference in the statistical comparison （P〈0.05）.The scores of HDS and ADL were all up in acupuncture and western medicine groups,but the significant statistical difference was obtained in the comparison between acupuncture group and western medicine group （P〈0.05）.In acupuncture group,the result of CNFDS was much down comparing with that before the treatment,indicating significant difference （P〈0.05）;but in western medicine group,there was no significant difference in CNFDS before and after treatment （P〉0.05）,suggesting that acupuncture reduces CNFDS of MID patient,neither for western medicine.Conclusion Cluster pricking on head points improves the intelligence of MID patient,reduces ET level and grades up HDS and ADL,moreover,it reduces CNFDS of MID patients and releases the symptoms.

Effectiveness of Histopathological Examination of Ultrasound-guided Puncture Biopsy Samples for Diagnosis of Extrapulmonary Tuberculosis

Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.

Attitudes and Practices of Lumbar Puncture among Students, Interns, and Residents of the Pediatric Department of the Mohammed VI University Hospital Center of Oujda, Morocco

Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and practices of students, interns, and residents about LP, and to assess their feelings about how this procedure is taught. Materials and Methods: We conducted a cross-sectional study of 160 participants, using an anonymous questionnaire, to evaluate the attitudes and practices of students, interns and residents in the pediatrics department concerning lumbar puncture. Results: Half of the participants had never performed LP, usually because of the risk involved or lack of confidence, while 20% had performed it more than 4 times. None of the participants had learned to perform the procedure through simulation sessions, while (42%) had learned it under the supervision of a senior physician and had not been able to perform it successfully the first time. Most participants inform the patient about the procedure before performing it. Only 44% of participants acknowledged that LP can be performed under local anesthetic. The sitting position (60%) was by far the most commonly used. Most LPs were performed for diagnostic purposes. Most participants stated that the pediatric ward and the pediatric emergency department are among the departments that perform LP most frequently, and that they would be interested in taking part in simulated lumbar puncture sessions in children in the future. Conclusion: The results of our study show that LP is perceived by students as a risky procedure that is difficult to perform. Teachers should reconsider how this technical procedure is taught, by integrating simulation on mannequins into student training.

Application of prostate resectoscope in the treatment of massive rectal bleeding after transrectal prostate puncture

BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after the puncture.We hypothesized that using a transrectal resectoscope could help treat massive rectal bleeding after transrectal prostate punctures.AIM To identify a simple and effective treatment for massive rectal bleeding after transrectal prostate punctures.METHODS Patients requiring treatment for massive rectal bleeding after transrectal prostate punctures were included.A SIMAI resectoscope was inserted through the anus.Direct electrocoagulation was performed for superficial bleeding points.Part of the rectal mucosa or surface muscle layer was removed to expose deep bleeding points,followed by electrocoagulation.An electric cutting ring was used to compress and stop the bleeding for jet-like points before electrocoagulation.The fluid color in the drainage tube was monitored postoperatively for continuous bleeding.RESULTS Eight patients were included from 2012 to 2022.None of the patients with massive rectal bleeding after the transrectal prostate punctures improved with conventional conservative and blood transfusion treatments.Two patients had an inferior artery embolism,and digital subtraction angiography was ineffective.All patients received emergency transanal prostate resection,which immediately stopped the bleeding.Four days after the procedure,the patients had recovered and were discharged.CONCLUSION Using a transanal prostate resection instrument is a simple,safe,and effective method for treating massive rectal bleeding after transrectal prostate punctures.

Clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride on mild-to-moderate depression

BACKGROUND Depression is a common,chronic,and recurrent mood disorder that has become a worldwide health hazard.Fluoxetine hydrochloride,a common treatment method,can inhibit 5-hydroxytryptamine(5-HT)recycling in the presynaptic membrane;however,the efficacy of a single drug is inadequate.At present,mildto-moderate depression can be treated with acupuncture of ghost caves,but the clinical curative effect of combined therapy with fluoxetine hydrochloride has not been sufficiently reported.AIM To evaluate the clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride in the treatment of mild-to-moderate depression.METHODS This retrospective study included 160 patients with mild-to-moderate depression who were admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Affiliated to Shanghai University of Traditional Chinese Medicine,between January 2022 and June 2023.Patients were separated into a single-agent group(fluoxetine hydrochloride treatment,n=80)and a coalition group(fluoxetine hydrochloride treatment combined with acupuncture at ghost points,n=80).Pre-treatment symptoms were recorded,and the clinical curative effect and adverse reactions[Asberg Antidepressant Side Effects Scale(SERS)]were assessed.Depression before and after treatment[Hamilton Depression Scale(HAMD)-24],neurotransmitter levels[5-HT,norepinephrine(NE),dopamine(DA)],oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA)],and sleep quality[Pittsburgh Sleep Quality Index(PSQI)]were compared.RESULTS The total efficacy rate was 97.50%in the coalition group and 86.25%in the single-agent group(P<0.05).After 2,4,6,and 8 wk of treatment,the HAMD,self-rating depression scale,and SERS scores of the coalition and single-agent groups decreased compared with pre-treatment,and the decrease was more significant in the coalition group(P<0.05).After 8 wk of treatment,the levels of NE,DA,5-HT,and SOD in the coalition and single-agent groups increased,while the levels of MDA decreased;the increases and decrease in the coalition group were more significant(P<0.05).The PSQI scores of the coalition and single-agent groups decreased,and the decrease was more significant in the coalition group(P<0.05).CONCLUSION Acupuncture at ghost points combined with paroxetine tablets can safely improve depressive symptoms and sleep disorders,regulate neurotransmitter levels,and reduce stress responses in patients with mild-to-moderate depression.

Percutaneous antegrade management of large proximal ureteral stones using non-papillary puncture

Objective:To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy(npPCNL)for the management of large proximal ureteral stones.Methods:We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL.Depending on stone size,in-toto stone removal or lithotripsy using the Lithoclast®Trilogy(EMS Medical,Nyon,Switzerland)was performed.Perioperative parameters including operative time(from start of puncture to the skin suturing),stone extraction time(from the first insertion of the nephroscope to the extraction of all stone fragments),and the stone-free rate were evaluated.Results:Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi.The median age and stone size of treated patients were 58(interquartile range[IQR]:51-69)years and 19.3(IQR:18.0-22.0)mm,respectively.The median operative time and stone extraction time were 25(IQR:21-29)min and 8(IQR:7-10)min,respectively.One case(2.7%)of postoperative bleeding and two cases(5.4%)of prolonged fever were managed conservatively.The stone-free rate at a 1-month follow-up was 94.6%.Conclusion:The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter.Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.

Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety

BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.

Application of the “Three Threes” Method in Clinical Teaching of Internal Jugular Vein Puncture

Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.

A REPORT OF 300 CASES OF MIGRAINE TREATED WITH ACUPUNCTURE PLUS BLOOD-LETTING PUNCTURING AND CUPPING

Acupuncture combined with blood-letting puncturing and cupping Is quite effectivein treatment of migraine.The total effective rate of 300 cases is 95.7％.Combined treatment ofacupuncture and cupping can supplement each other in strengthening the therapeutic effect and is agood way for relieving headache.

CLINICAL OBSERVATION ON SITTING STILL OF QIGONG PLUS PRICKING BLOOD THERAPY FOR TREATMENT OF 21 CASES OF AIDS

In this paper,the author introduced her clinical observation and main points ofoperation on sitting still of Qigong plus blood pricking therapy founded by herself for treatment of 21cases of Aids.Results showed that this therapy had actions in clearing away heat and toxic materials,strengthenign the body resistance to eliminate pathogenic factors and enhancing the immune functionand the ability against diseases of the human body which played important roles in controlling syrup-toms of patients with Aids and prolonging their life span.

OBSERVATION ON TREATMENT OF GOUTY ARTHRITIS BY PRICKING BLOOD PLUS CUPPING

In this study,the changes of clinical symptoms and signs,contents of uric acid inthe blood and urine and RNAase activities were observed to investigate the therapeutic role of prickingblood plus cupping in the treatment of gouty arthritis.It was observed that the effective rate was100％in the pricking blood group and 68.43％in the medicine group.Besides,there was a statisticallysignificant difference in chemical indexes between the two groups.The results indicate that prickingblood may cure the disease by promoting the excretion of uric acid,inhibiting the synthesis of uric acidand regulating the metabolism of pruines in organism.

Puncturing Period on the Performance of Punctured Turbo Codes

Puncturing is the predominant strategy to construct high code rate turbo codes. Puncturing period is a crucial parameter influencing the performance of punctured turbo codes (PTC). Here we developed a new puncturing scheme of turbo codes, with which the puncturing period on the performance of PTC is studied. Consequently, suggestions on selecting the puncturing period are proposed.

APPLICATION OF PUNCTURING THE POINTS OPPOSITE TO THE DISEASED SIDE IN THE TREATMENT OF TRAINING INJURY IN TROOPS——A Report on 2560 Cases

Puncturing points opposite to the diseased side was used to treat injuries in 2560soldiers during their training.The instant effective rate and curative rate of the therapy was up to 96.25％and 38.44％respectively.

Characterisation of Fractures and Fracture Zones in a Carbonate Aquifer Using Electrical Resistivity Tomography and Pricking Probe Methodes

Position, width and fragmentation level of fracture zones and position, sig-nificance and characteristic distance of fractures were aimed to determine in a carbonate aquifer. These are fundamental parameters, e.g. in hydrogeological modelling of aquifers, due to their role in subsurface water movements. The description of small scale fracture systems is however a challenging task. In the test area (Kádárta, Bakony Mts, Hungary), two methods proved to be applicable to get reasonable information about the fractures: Electrical Resistivity Tomography (ERT) and Pricking-Probe (PriP). PriP is a simple mechanical tool which has been successfully applied in archaeological investigations. ERT results demonstrated its applicability in this small scale fracture study. PriP proved to be a good verification tool both for fracture zone mapping and detecting fractures, but in certain areas, it produced different results than the ERT. The applicability of this method has therefore to be tested yet, although its problems most probably origin from human activity which reorganises the near-surface debris distribution. In the test site, both methods displayed fracture zones including a very characteristic one and a number of individual fractures and determined their characteristic distance and significance. Both methods prove to be able to produce hydrogeologically important parameters even individually, but their simultaneous application is recommended to decrease the possible discrepancies.

Treatment of Patients with Vitiligo by Intradermal Pricking of Vitiligenous Skin Using Sharp and Blunt Needle

Background: Vitiligo is a well known autoimmune disease, both cell mediated and humeral reaction are implicated in its etiopathogensis. Pricking of marginal pigmented of vitiligo skin to stimulate normal melanocytes to migrate into vitiligenous area and induce new melanogenesis and this is well known mechanism to induce repigmentation and supported by publications. Objective: To use needling technique by using blunt and sharp needle by doing pricking completely white vitiligo skin in order to stimulate residual melanocytes of basal layer and or the melanocytes of outer root sheath of hair follicles to proliferate and induce active melanogenesis. Patients and Methods: This is an interventional, therapeutic, comparative, study that was done in Department of Dermatology-Baghdad Teaching Hospital, Medical City, Baghdad, Iraq from April 2014-March 2015. Thirty five patient with vitiligo were enrolled in this study, their ages ranged from 5 - 55 (22.28 ± 12.09) years;15 patients treated with sharp needle, 2 males and 13 females and 20 patients treated with blunt needle, 4 males and 16 females. All clinical types of vitiligo including the generalized, localized and segmental were treated. The number of vitiligo patches varied between patients and the treated patches by sharp needle were 22 and by blunted needle were 20 patches. In both groups, needling was done geometrically, softly and rapidly in systemic horizontal rows away from pigmented margin and pigmented spot inside the patches and was not repeated. In Group A needle gauge 18 hold at 45° to skin surface and the distance between each pricking was 5 - 10 mm and similarly was done in Group B by using blunt needle. Each patient was advised to have daily sun light exposure for at least 15 min. Measuring the surface area of the lesions and calculating the reduction rate was done by using transparent with square paper and this was carried out every month till the end of the 4th month period of the treatment. All patients in both groups were evaluated every 2 weeks for the 1st month and then monthly for 3 months and the rate of reduction in surface area was measured. Also to record any side effects and complications. Results: After 2 week, 2 months, and 4 months of treatment, there was 0.5%, 4.31%, and 10% respectively reduction in the surface area of lesions in Group A, while in Group B, there was 7%, 18.42%,and 13.5% respectively reduction in the surface area. Conclusions: Pricking the vitiligo skin by needle, gauge 18 gave success rate 10% and 13.5% at four months after therapy and needling could be repeated once a week to accelerate melanogenesis and until get complete repigmentation.

PUNCTURING THE EMPIRICAL POINT SHENGEN IN TREATMENT OF 101 CASES OF APOPLECTIC HEMIPLEGIA

By needling chiefly an empirical point Shengen with the penetration method, a total effective rate of 96.04% was obtained in 101 cases of apoplectic hemiplegia. In comparison with 38 controls, either the therapeutic effects and courses or other indices observed in the needling group were shown to be encouraging.

Discussion on the Theory of Pricking Blood in Nei Jing from the Perspective of Time

Objective:The purpose of this paper is to explore the influence of time factors recorded in Nei Jing,such as changes of Yin Yang in four seasons,the wax and wane of the moon and the rhythm of Yin Yang in a day,on pricking blood therapy.Methods:The contents of pricking blood according to time in Nei Jing is studied by using the method of literature review.Results:Through the research,this paper concludes that(1)pricking blood according to time takes"the correspondence between nature and man"as the dominant thought,"meridian Qi and Blood"as the regulating object,and"time factor"as the specie operation key,which reflects the influence of time on pricking blood therapy;(2)pricking blood therapy has different speci行c operations according to different time,which can be roughly divided into three situations.One is to prick blood according to the change of seasons,pricking shallowly with expelling less blood in spring and summer and pricking deeply with squeezing more blood out in autumn and winter.The second is pricking blood according to the laws of moon's wax and wane.When the moon is born,the amount of bleeding should be less;when the moon is full,the amount of bleeding should be more;when the moon wanes,pricking blood therapy should not be used.Thirdly,take pricking blood therapy according to circadian rhythm.It is more suitable to use pricking blood therapy in the morning than afternoon.Conclusion:As a characteristic therapy of TCM,pricking blood embodies the idea of"the correspondence between nature and man"in TCM.Adopting different pricking blood rules according to the change of time can improve the clinical therapeutic effect.The thought of pricking according to time plays an important guiding role in the application of pricking blood therapy in clinic.

Clinical Experience of Pricking Therapy

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Pricking cupping bloodletting combined with slide cupping for acne:a case report

Objective:To report a patient with acne by using the combined treatment of pricking cupping bloodletting and slide cupping.Methods:Pricking cupping bloodletting was prescribed at the points of Feishu(BL13)in the bladder meridian of foot-Taiyang and Dazhui(DU14)in governor vessel and slide cupping was prescribed at the points on the back in the bladder meridian of foot-Taiyang.Results:Clinical manifestations revealed that acne and scar were significantly reduced after two courses.Conclusion:Pricking cupping bloodletting combined with slide cupping can successfully relieve acne and promote skin healing,which may provide us a new idea for the non-drug therapy of acne.