Name: clinical efficacy of small needle knife therapy on stage i-ii frozen shoulder
Uploaded: 2023-11-17T12:50:00.000+00:00
Duration: 5 min 52 s
Description: Watch this Scientific Journal Video about Treating Frozen Shoulder with Small Needle Knife Therapy at JoVE.com

感谢（1）国家自然科学基金（81973877）、（2）《上海市进一步加快中医药传承创新发展三年行动计划》（ZY （2021-2023）-0201-01）、（3）浦东新区卫生系统浦东名医师培训计划（PWRzm2020-15）和（4）中医康复服务提升项目（医疗032）的财政支持。

本研究方案已获得上海中医药大学附属龙华医院人体研究伦理委员会批准（批准文号：2023-LHXS-030）。在试验之前，研究中的每位患者都提供了书面知情同意书。选取2022年12月至2023年5月上海中医药大学附属龙华医院康复科I-II.期腰周炎患者76例，符合纳入标准，随机分为对照组和治疗组，每组38例。操作者必须熟悉肩关节的解剖结构和具体的手术方法。
1. 招募患者
<ol><li>使用以下纳入标准将患者纳入本研究：符合肩周炎的诊断标准;I期或II期肩周炎;不分性别，40-65岁;VAS 评分≤ 7;同时没有其他治疗。</li>
	<li>使用以下排除标准不包括本研究的患者：凝血功能障碍患者;血糖控制不稳定的糖尿病患者;孕妇和哺乳期妇女;治疗部位受损或严重感染的患者;对麻醉过敏的患者。</li>
</ol>2. 对照组的练习制度
<ol><li>对照组患者进行如下所述的功能锻炼疗程19.<ol><li>手攀岩：让患者面向墙壁站立，双脚张开，举起双手沿墙向上攀爬。要求患者将手放在最大公差的最高刻度上，并为每位患者记录下来。</li>
		<li>辅助手：在站立姿势下，要求患者将患上肢保持在向后伸展的状态，并用健康的上肢拉动患上肢的手腕，向另一侧进行内旋，然后保持向上拉的状态，直到患者的最大耐受性。</li>
		<li>摆锤摆动：在站立和弯腰姿势下，要求患者支撑每个患者的健康手臂并下降到患侧，进行来回、左右以及圆圈运动。当症状改善时，增加运动范围，并通过握住1-2公斤的物体（如水瓶、哑铃）画圈，以增加伸展运动的强度。</li>
	</ol></li>
	<li>功能锻炼过程：确保对照组患者每天进行功能锻炼，包括爬墙、辅助手和摆动，每天 30 次，持续 4 周。 注意： 功能锻炼必须在公差范围内进行;否则，可能会导致肩部软组织拉伤并导致病情恶化。</li>
	<li>在功能锻炼过程中，遵循从轻到重，从小到大，循序渐进，持续不断的原则。要求患者避免长期肩部工作、提重物或剧烈活动，尽管患者可以在治疗期间进行所有日常活动。</li>
</ol>3. 治疗组的运动方案
<ol><li>对治疗组的患者进行小针刀治疗和功能锻炼。</li>
	<li>术前准备<ol><li>材料准备（图1）：一次性医用塑料杯、医用镊子、吸水棉球、敷料块、40 mm x 40 mm一次性无菌小针刀、记号笔、II型皮肤消毒剂、2%盐酸利多卡因、无菌注射用水、10mL一次性无菌注射器、一次性无菌注射针、橡胶手术手套、不干胶敷料。</li>
		<li>患者信息检查：检查每个患者的基本信息（姓名、年龄、受影响的肩部）。说明小针刀疗法的工艺和优点。确保患者在手术过程中完全理解和放松。</li>
		<li>患者准备：以坐姿完全暴露受影响的肩膀。</li>
		<li>体位（图2）：标记患肩的明显压痛点，如喙突点（肱二头肌短头的附着点）、大结节的小结节（肩胛下肌的附着点）、结节间沟（肱二头肌长头的附着点）、肩峰下滑囊（冈上肌的附着点）、 肱骨大结节（圆小肌附着点）后方 2 厘米20。</li>
		<li>消毒：在II型皮肤消毒剂中准备棉球。常规对皮肤进行 3 次消毒，从标记点周围 15 厘米开始逐渐减小直径。</li>
	</ol></li>
	<li>操作程序（图2）<ol><li>将 5 mL 2% 利多卡因和 5 mL 无菌水加载到 10 mL 注射器中，以制备 10 mL 1% 利多卡因工作溶液。</li>
		<li>将22G针头换成25G针头（使用较细的针头缓解疼痛）。左手戴上无菌手套，右手握住注射器。</li>
		<li>将针头插入标记处，并确保抽吸时没有血液回流。在每个标记点垂直注射 1-2 mL 1% 利多卡因工作溶液。</li>
		<li>小针刀插入（图2）：右手戴上无菌手套握住小针刀。将小针刀垂直垂直插入利多卡因注射部位，深度约为1-3厘米。确保小针刀的刀刃与肌肉纤维平行，以免损伤重要的血管和神经。</li>
		<li>执行纵向切口的3步操作，剥离和释放粘附物7,15。患者会感到局部酸痛和疼痛，操作者会在刀下感到阻力。</li>
		<li>当操作者感觉到刀下有松动感时，拔出针头。</li>
	</ol></li>
	<li>术后护理（图2）<ol><li>用干燥的无菌棉球按压注射部位1分钟。用无菌自粘敷料覆盖操作区域。</li>
		<li>协助患者穿好衣服。 注意： 将医疗废物放入医疗废物垃圾桶中。</li>
		<li>请患者在离开手术室前静坐约15分钟，以免术后不适。建议患者保持自粘敷料干燥，直到 48 小时后取出，以避免出血和感染。</li>
	</ol></li>
	<li>小针刀治疗疗程 21：对治疗组患者进行小针刀治疗，每周一次，共 4 次。对治疗组的患者进行与对照组相同的功能锻炼。</li>
</ol>4. 干预后结果评估
<ol><li>评价指标 22,23,24<ol><li>使用视觉模拟评分 （VAS）、常数和默雷评分 （CMS） 以及超声下 CHL 的厚度来评估结果。 注意：基线测量是在治疗前和治疗后一周进行的。</li>
	</ol></li>
	<li>评估工具<ol><li>使用GJJDC01高精度关节运动电子测量仪器进行肩关节运动测量和便携式彩色超声系统（图3）。</li>
	</ol></li>
	<li>评估工具操作方法（图3）<ol><li>测量肩关节活动度。<ol><li>按 ON 打开电源。要求受试者将肩膀抬高到尽可能大的角度。旋转测量尺，得到测量值。</li>
			<li>将测量仪器刻度设置回 0 并重复测量 2 次。按住 OFF 可关闭电源。</li>
		</ol></li>
		<li>使用超声波测量 CHL 的厚度。<ol><li>按 电源 按钮打开超声波机。按 “患者 ”按钮，单击 “新建患者”，然后输入受试者的姓名。</li>
			<li>要求患者以坐姿完全暴露患肩。被动移动患者的肩关节以定位 CHL。 将超声探头与 CHL 对齐。</li>
			<li>按 冻结 按钮保存超声图像。按卡 尺 按钮测试 CHL 厚度。记录测量结果并将其关闭。</li>
		</ol></li>
	</ol></li>
</ol>5. 统计分析
<ol><li>将连续变量表示为平均值±标准差 （SD）。使用独立样本 t 检验来比较两组之间的差异。所有统计检验均为双侧检验， P<0.05 被认为具有统计学意义。所有分析均使用统计软件进行。</li>
</ol>

小针刀治疗肩周炎的疗效

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H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recent+therapeutic+effect+and+mechanism+of+small+needle+knife+in+the+treatment+of+patients+with+cold-dampness-blocking+frozen+shoulder.">Recent therapeutic effect and mechanism of small needle knife in the treatment of patients with cold-dampness-blocking frozen shoulder.</a> World of Chinese Medicine. 13 (5), 1254-1257 (2018).</li><li>Zhou, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+small+needle+knife+therapy+on+expression+of+IL-1&#946;,+TNF-&#945;,+and+ASIC1+in+local+tissue+of+rabbits+with+frozen+shoulder.">Effect of small needle knife therapy on expression of IL-1&#946;, TNF-&#945;, and ASIC1 in local tissue of rabbits with frozen shoulder.</a> Shanghai J Acupuncture Moxibustion. 40 (6), 762-768 (2021).</li><li>Zhang, Z. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+small+needle+knife+and+local+closure+on+pain+mediators+and+inflammatory+factors+in+patients+with+frozen+shoulder.">Effect of small needle knife and local closure on pain mediators and inflammatory factors in patients with frozen shoulder.</a> Clin Res Chinese Med. 10 (8), 82-84 (2018).</li><li>Bunker, T. D., Reilly, J., Baird, K. S., Hamblen, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Expression+of+growth+factors,+cytokines+and+matrix+metalloproteinases+in+frozen+shoulder.">Expression of growth factors, cytokines and matrix metalloproteinases in frozen shoulder.</a> J Bone Joint Surg Br. 82 (5), 768-773 (2000).</li><li>Millar, N. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Frozen+shoulder.">Frozen shoulder.</a> Nat Rev Dis Primers. 8 (1), 59 (2022).</li><li>Li, H. Y., Chen, S. Y., Zhai, W. T., Chen, J. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Expression+of+TGF-&#946;+and+MMPs+in+capsula+tissue+of+frozen+shoulder+patients.">Expression of TGF-&#946; and MMPs in capsula tissue of frozen shoulder patients.</a> J Shanghai Jiaotong Uni. 29 (11), 1363-1366 (2009).</li><li>Cher, J. Z. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alarmins+in+Frozen+Shoulder:+A+Molecular+Association+Between+Inflammation+and+Pain.">Alarmins in Frozen Shoulder: A Molecular Association Between Inflammation and Pain.</a> Am J Sports Med. 46 (3), 671-678 (2018).</li><li>Wang, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+study+on+the+treatment+of+frozen+shoulder+in+rats+with+&amp;#34;C&amp;#34;+shaped+small+needle+knife.">Experimental study on the treatment of frozen shoulder in rats with &amp;#34;C&amp;#34; shaped small needle knife.</a> Hubei Uni Chinese Med. , (2020).</li><li>Bai, Y., Chen, B., Qin, Y. N., Du, Y. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Thoughts+on+constructing+the+core+outcome+index+set+of+clinical+research+on+frozen+shoulder.">Thoughts on constructing the core outcome index set of clinical research on frozen shoulder.</a> Chinese Med J. 36 (1), 69-73 (2019).</li><li>Buchbinder, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Preliminary+Core+Domain+Set+for+Clinical+Trials+of+Shoulder+Disorders:+A+Report+from+the+OMERACT+2016+Shoulder+Core+Outcome+Set+Special+Interest+Group.">A Preliminary Core Domain Set for Clinical Trials of Shoulder Disorders: A Report from the OMERACT 2016 Shoulder Core Outcome Set Special Interest Group.</a> J Rheumatol. 44 (12), 1880-1883 (2017).</li><li>Fan, Z. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+measurement+of+coracohumeral+ligament+thickness+in+diagnosis+and+evaluation+of+curative+effect+of+frozen+shoulder.">The role of measurement of coracohumeral ligament thickness in diagnosis and evaluation of curative effect of frozen shoulder.</a> Soochow University. , (2018).</li><li>Xiu, Z. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+guidelines+of+small+needle+knife+for+knee+osteoarthritis.">Clinical guidelines of small needle knife for knee osteoarthritis.</a> J Rehabil. 33 (3), 193-201 (2019).</li></ol>

作者报告没有利益冲突。

在这项研究中，我们发现小针刀治疗显着缓解了I-II期肩周炎患者的疼痛症状，改善了肩关节功能，减少了CHL的厚度，并改善了生活质量。小针刀疗法对肩周炎有确切的效果。然而，手术地点是有争议的。由于知识背景不同，可以选择许多手术部位，用小针刀治疗肩周炎。主要手术部位是压痛穴、穴位和特定的解剖部位。因为治疗原理相似，无论选择什么手术部位，都能达到一定的治疗效果，但治...

肩周炎是一种以疼痛和主动和被动肩部运动受限为特征的疾病，对患者的工作和生活造成极大的不便1。全球肩周炎发病率在女性中为2%-5%2,3且高于男性，显示出一定的遗传趋势4。肩周炎患者多为40-60岁5.此外，肩周炎由于恢复周期较长且临床实践中缺乏既定的治疗共识，带来了沉重的社会负担。
肩周炎的主要治疗方法有口服或外用草药、针灸、按摩、功能锻炼等6;然而，由于治疗频率高、耗时较长，患者依从性较差，无法满足患者改善疼痛和功能受限的迫切需求。因此，迫切需要在肩周炎患者的临床管理中寻找更有效的治疗方法。
小针刀疗法是中医药的一种特殊而有效的外疗，近几十年来在中医药领域迅速兴起7。具有见效快、疗效明确、重复性高等优点。而且，操作仪器价格便宜，容易获得，操作过程简单，方法不受环境和条件的限制。小针刀治疗后患者的正常工作和生活不受影响，因为微切口会很快恢复，而不会对身体造成伤害，引起感染或其他副作用8,9,10,11。系统评价表明，小针刀治疗肩周炎的疗效明显优于针灸、按摩和口服中药12,13。现代研究表明，小针刀治疗肩周炎的机理是疏通经络和侧支，促进气血循环，切剥离病变组织，去除粘连，促进组织修复，恢复人体的动态平衡14,15。
这里介绍的方案演示了小针刀在治疗肩周炎中的操作，包括患者管理、材料准备、定位、手术和术后护理。该协议的目的是缓解肩周炎患者的疼痛和功能限制，提高其生活能力。
随着小针刀疗法的发展，其应用已从治疗颈、肩、腰、腿痛等肌肉骨骼疾病扩展到内科、外科、妇科、儿科等疾病，在康复医学领域发挥着越来越重要的作用16。近年来，由于超声引导小针刀可视化疗法的应用，小针刀显示出更加准确、科学和安全的治疗效果，其发展进入了一个新的阶段17,18。

<table><tbody><tr><td>Disposable sterile injection needle</td><td>Shanghai Mishava Medical Industry Co., Ltd</td><td>601900973</td><td>Type specification:0.5 x 38 RWLB</td></tr><tr><td>Disposable sterile small needle-knife</td><td>Wujiang Yunlong Medical equipment Co., Ltd</td><td>PR-4040</td><td>Type specification:40 mm x 40 mm&amp;nbsp;</td></tr><tr><td>Disposable sterile syringe</td><td>Shandong Weigo Group Medical polymer Products Co., Ltd</td><td>601909174</td><td>Type specification:10 mL</td></tr><tr><td>Lidocaine hydrochloride</td><td>Shanghai Hefeng Pharmaceutical Co., Ltd</td><td>6904996104121</td><td>Type specification:5 mL</td></tr><tr><td>Marker pen</td><td>Zebra Trading (Shenzhen) Co., Ltd</td><td>4901681518111</td><td>Type specification:1.0 mm/0.5 mm</td></tr><tr><td>Sterile absorbent cotton ball</td><td>Shanghai Honglong Medical Supplies Equipment Co., Ltd</td><td>601905637</td><td>Type specification:0.3&amp;nbsp; 25 g</td></tr><tr><td>Sterile disposable medical plastic cup</td><td>Shanghai Honglong Medical Supplies Equipment Co., Ltd</td><td>709008633</td><td>Type specification:Waist-shaped disc</td></tr><tr><td>Sterile dressing block</td><td>Ningbo Haishu Shenyuan Medical Materials Co.,&amp;nbsp; Ltd</td><td>601909470</td><td>Type specification:7.5 cm x 7.5 cm x 8 floors</td></tr><tr><td>Sterile medical tweezers</td><td>Shanghai Honglong Medical Supplies Equipment Co.,Ltd</td><td>603917444</td><td>Type specification:Small size</td></tr><tr><td>Sterile rubber surgical gloves</td><td>Guilin Hengbao health protection Co.,&amp;nbsp; Ltd</td><td>6971787071320</td><td>Type specification:6.5</td></tr><tr><td>Sterile self-adhesive dressing</td><td>Shanghai ISO Medical Products Co., Ltd</td><td>601909414</td><td>Type specification:10 cm x 15 cm</td></tr><tr><td>Sterile water for injection</td><td>Shanghai Xinyi Jinzhu Pharmaceutical Co., Ltd</td><td>6938493300953</td><td>Type specification:5 mL</td></tr><tr><td>Type II skin disinfectant</td><td>Shanghai Likang Disinfection high-tech Co., Ltd</td><td>6909157000359</td><td>Type specification:500 mL/ bottle</td></tr><tr><td>Ultrasound</td><td>Suzhou Daer Medical Equipment Co., Ltd</td><td>100018857</td><td>uSmart3300 portable color ultrasound system</td></tr></tbody></table>

clinical efficacy of small needle knife therapy on stage i-ii frozen shoulder

肩周炎是一种由劳损、外伤等原因引起的肩部无菌性炎症性疾病，导致肩关节疼痛和功能受限。这里介绍的方案演示了小针刀治疗肩周炎的操作，包括患者管理、材料准备、定位、操作和术后护理。该协议的目的是缓解肩周炎患者的疼痛和功能限制，提高其生活能力。在我们的研究中，76 名符合纳入标准的 I-II 期肩周炎患者被随机分为对照组和治疗组 （n=38）。对照组患者接受功能性运动，治疗组患者接受小针刀治疗和功能性运动。评估超声下的视觉模拟评分 （VAS）、Constant 和 Murley 评分 （CMS） 以及喙肱韧带 （CHL） 的厚度。小针刀治疗后，治疗组VAS评分（5.11±0.89）显著低于对照组（5.49±0.65;t=-2.065，p<0.05）; 治疗组的CMS评分（64.72±4.78）显著高于对照组（60.97±6.00;t=2.947，p<0.05）; 治疗组（2.38 ± 0.36）的CHL厚度显著降低，而对照组（2.57 ± 0.42;t=-2.117，p<0.05）。 这些结果表明，小针刀显著缓解了疼痛症状，改善了肩部功能，减少了CHL厚度，提高了生活质量，因此在I-II期肩周炎患者中具有显著的治疗效果。

对照组1例患者因疼痛加重而接受其他治疗（关节内类固醇注射），故终止试验，对照组其余37例患者纳入最终统计分析。对于治疗组2例超声检测不到CHL的患者，因此取消了检测，治疗组其余36例患者进入最终统计分析。
基线特征 两组患者在性别、年龄、患侧、病程和分期方面的差异相当（p > 0.05）。对照组男性13例，女性24例，治疗组男性19例，女性17例?...

Watch this Scientific Journal Video about Treating Frozen Shoulder with Small Needle Knife Therapy at JoVE.com

作者聚焦：用小针刀疗法治疗肩周炎 

这里介绍的方案描述了详细的手术方法，并证明了小针刀治疗肩周炎的有效性。

小针刀治疗I-II期肩周炎的临床疗效

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain ...

本研究调查了小针刀对肩周炎患者的治疗效果，以及改善疼痛功能和生活能力的证据。我们的方案解决了肩周炎患者小针刀的详细操作过程。我们的方案具有更快和明确的治疗效果、高可重复性、更广泛的可用性以及患者身体伤害更少的优点。

clinical-efficacy-small-needle-knife-therapy-on-stage-i-ii-frozen

Research

JoVE Journal

Medicine

Clinical Efficacy of Small Needle Knife Therapy on Stage I-II Frozen Shoulder

1.2K 次观看.  Shanghai University of Traditional Chinese Medicine. 本研究调查了小针刀对肩周炎患者的治疗效果，以及改善疼痛功能和生活能力的证据。我们的方案解决了肩周炎患者小针刀的详细操作过程。我们的方案具有更快和明确的治疗效果、高可重复性、更广泛的可用性以及患者身体伤害更少的优点。

视频: 作者聚焦：用小针刀疗法治疗肩周炎 

Reverse Total Shoulder Arthroplasty

Reverse total shoulder arthroplasty was initially approved for use in rotator cuff arthropathy and well as chronic pseudoparalysis without arthritis in patients who were not appropriate for tendon transfer reconstructions. Traditional surgical options for these patients were limited and functional results were sub-optimal and at times catastrophic. The use of reverse shoulder arthroplasty has been found to effectively restore these patients function and relieve symptoms associated with their disease. The procedure can be done through two approaches, the deltopectoral or the superolateral. Complication rates associated with the use of the prosthesis have ranged from 8-60% with more recent reports trending lower as experienced is gained. Salvage options for a failed reverse shoulder prosthesis are limited and often have significant associated disability. Indications for the use of this prosthesis continue to be evaluated including its use for revision arthroplasty, proximal humeral fracture and tumor. Careful patient selection is essential because of the significant risks associated with the procedure.

Reverse total shoulder arthroplasty is indicated for the treatment of conditions that cannot be treated with conventional arthroplasty or other procedures. These primarily include degenerative and incapacitating conditions with irreparable rotator cuff and loss of the normal biomechanical coupling of the shoulder.

反向共肩关节置换术

Reverse total shoulder arthroplasty was initially approved for use in rotator cuff arthropathy and well as chronic pseudoparalysis without arthritis in ...

科研

医学

Cytotoxic Efficacy of Photodynamic Therapy in Osteosarcoma Cells In Vitro

In recent years, there has been the difficulty in finding more effective therapies against cancer with less systemic side effects. Therefore Photodynamic Therapy is a novel approach for a more tumor selective treatment.
Photodynamic Therapy (PDT) that makes use of a nontoxic photosensitizer (PS), which, upon activation with light of a specific wavelength in the presence of oxygen, generates oxygen radicals that elicit a cytotoxic response1. Despite its approval almost twenty years ago by the FDA, PDT is nowadays only used to treat a limited number of cancer types (skin, bladder) and nononcological diseases (psoriasis, actinic keratosis)2.
The major advantage of the use of PDT is the ability to perform a local treatment, which prevents systemic side effects. Moreover, it allows the treatment of tumors at delicate sites (e.g. around nerves or blood vessels). Here, an intraoperative application of PDT is considered in osteosarcoma (OS), a tumor of the bone, to target primary tumor satellites left behind in tumor surrounding tissue after surgical tumor resection. The treatment aims at decreasing the number of recurrences and at reducing the risk for (postoperative) metastasis.
In the present study, we present in vitro PDT procedures to establish the optimal PDT settings for effective treatment of widely used OS cell lines that are used to reproduce the human disease in well established intratibial OS mouse models. The uptake of the PS mTHPC was examined with a spectrophotometer and phototoxicity was provoked with laser light excitation of mTHPC at 652 nm to induce cell death assessed with a WST-1 assay and by the counting of surviving cells. The established techniques enable us to define the optimal PDT settings for future studies in animal models. They are an easy and quick tool for the evaluation of the efficacy of PDT in vitro before an application in vivo.

Cytotoxic Efficacy of Photodynamic Therapy in Osteosarcoma Cells In Vitro

The protocol reported here allows the evaluation of the efficacy of photodynamic therapy (PDT) in cell lines and the optimization of the PDT settings before applying the therapy in animal models.

光动力疗法治疗骨肉瘤细胞的细胞毒功效<em&gt;体外</em

In recent years, there has been the difficulty in finding more effective therapies against cancer with less systemic side effects. Therefore Photodynamic ...

Preparation and Respirometric Assessment of Mitochondria Isolated from Skeletal Muscle Tissue Obtained by Percutaneous Needle Biopsy

Respirometric profiling of isolated mitochondria is commonly used to investigate electron transport chain function. We describe a method for obtaining samples of human Vastus lateralis, isolating mitochondria from minimal amounts of skeletal muscle tissue, and plate based respirometric profiling using an extracellular flux (XF) analyzer. Comparison of respirometric profiles obtained using 1.0, 2.5 and 5.0 &#956;g of mitochondria indicate that 1.0 &#956;g is sufficient to measure respiration and that 5.0 &#956;g provides most consistent results based on comparison of standard errors. Western blot analysis of isolated mitochondria for mitochondrial marker COX IV and non-mitochondrial tissue marker GAPDH indicate that there is limited non-mitochondrial contamination using this protocol. The ability to study mitochondrial respirometry in as little as 20 mg of muscle tissue allows users to utilize individual biopsies for multiple study endpoints in clinical research projects.

Methods for biopsy of Vastus lateralis, preparation of purified mitochondria, and respirometric profiling are described. The use of small muscle volume makes this technique suitable for clinical research applications.

线粒体的制备及透气性评估，从骨骼肌组织通过穿刺活检获得的分离

Respirometric profiling of isolated mitochondria is commonly used to investigate electron transport chain function. We describe a method for obtaining ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

Here, we present a protocol for a study comparing the efficacy, safety, and delivery of olive-oil-based 3CB and soybean-oil-based CoB formulations in adults requiring parenteral nutrition. The results revealed that olive-oil-based 3CBs is non-inferior and well tolerated compared to soybean formulations.

一项临床试验，评估基于橄榄油的三腔袋的亲子营养的安全性、有效性和交付

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Radiation therapy is a frequently used modality for the treatment of solid cancers. Although the mechanisms of cell kill are similar for all forms of radiation, the in vivo properties of photon and proton beams differ greatly and maybe exploited to optimize clinical outcomes. In particular, proton particles lose energy in a predictable manner as they pass through the body. This property is used clinically to control the depth at which the proton beam is terminated, and to limit radiation dose beyond the target region. This strategy can allow for substantial reductions in radiation dose to normal tissues located just beyond a tumor target. However, the degradation of proton energy in the body remains highly sensitive to tissue density. As a consequence, any changes in tissue density during the course of treatment may significantly alter proton dosimetry. Such changes may occur through alterations in body weight, respiration, or bowel filling/gas, and may result in unfavorable dose deposition. In this manuscript, we provide a detailed method for the delivery of proton therapy using both passive scatter and pencil beam scanning techniques for prostate cancer. Although the described procedure directly pertains to prostate cancer patients, the method may be adapted and applied for the treatment of virtually all solid tumors. Our aim is to equip readers with a better understanding of proton therapy delivery and outcomes in order to facilitate the appropriate integration of this modality during cancer therapy.

The fundamentals of radiation planning and delivery for proton therapy using prostate cancer as a model are presented. The application of these principles to other selected disease sites highlights how proton radiotherapy may enhance clinical outcomes for cancer patients.

质子治疗在实体肿瘤恶性肿瘤选择中的临床应用

Radiation therapy is a frequently used modality for the treatment of solid cancers. Although the mechanisms of cell kill are similar for all forms of ...

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many areas of biomedical research due to its cost-effectiveness and its translation to humans. This protocol describes a method to create a preclinical free skin flap model in rats with ischemia-reperfusion injury. The described 3 cm x 6 cm rat free skin flap model is easily obtained after the placement of several vascular ligatures and the section of the vascular pedicle. Then, 8 h after the ischemic insult and completion of the microsurgical anastomosis, the free skin flap develops the tissue damage. These ischemia-reperfusion injury-related damages can be studied in this model, making it a suitable model for evaluating therapeutic agents to address this pathophysiological process. Furthermore, two main monitoring techniques are described in the protocol for the assessment of this animal model: transit-time ultrasound technology and laser speckle contrast analysis.

Here, we describe a pre-clinical animal model for studying the pathophysiology of ischemia-reperfusion injury in reconstructive microsurgery. This free skin flap model based on the superficial caudal epigastric vessels in the rat may also allow for the evaluation of different therapies and compounds to counteract ischemia-reperfusion injury-related damage.

重建显微外科缺血再灌注损伤研究的临床前大鼠模型

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many ...

Large Animal Model for Evaluating the Efficacy of the Gene Therapy in Ischemic Heart

Coronary artery disease is one of the significant causes of mortality and morbidity worldwide. Despite the progression of current therapeutics, a considerable proportion of coronary artery disease patients remain symptomatic. Gene therapy-mediated therapeutic angiogenesis offers a novel therapeutic method for improving myocardial perfusion and relieving symptoms. Gene therapy with different angiogenic factors has been studied in few clinical trials. Due to the novelty of the method, the progress of myocardial gene therapy is a continuous path from bench to bedside. Therefore, large animal models are needed for evaluating the safety and efficacy. The more the large animal model identifies the original disease and the endpoints used in clinics, the more predictable outcomes are from clinical trials. Here, we introduce a large animal model for evaluating the efficacy of the gene therapy in the ischemic porcine heart. We use clinically relevant imaging methods such as ultrasound imaging and 15H2O-PET. For targeting the gene transfers into the desired area, electroanatomical mapping is used. The aim of this method is: (1) to mimic chronic coronary artery disease, (2) to induce therapeutic angiogenesis at hypoxic areas of the heart, and (3) to evaluate the safety and efficacy of the gene therapy by using relevant endpoints.

Myocardial gene therapy for ischemic heart disease holds great promise for future therapeutics. Here, we introduce a large animal model for evaluating the efficacy of gene therapy in the ischemic heart.

用于评估基因治疗缺血性心脏疗效的大型动物模型

Coronary artery disease is one of the significant causes of mortality and morbidity worldwide. Despite the progression of current therapeutics, a ...

FSN 疗法治疗膝骨关节炎疼痛

Fu's Subcutaneous Needling for Knee Osteoarthritis Pain

Fu's subcutaneous needling (FSN) is a new acupuncture and dry needling technique based on traditional Chinese medicine. It rapidly produces long-lasting effects in soft tissue injuries, particularly in painful musculoskeletal conditions, by providing stimulation primarily in the subcutaneous area. Osteoarthritis (OA) is the most common joint disease in adults worldwide and is often accompanied by a painful syndrome of structural changes in the peripheral joints of the knee. However, the etiology of OA pain is not fully understood, though myofascial trigger points (MTrPs) are commonly found in the lower limb muscles (so-called "tightened muscles") of patients with knee OA. 
FSN has been used in many fields for the treatment of acute pain problems and can relieve muscle contraction from MTrPs, thereby improving the local circulation. This study recruited patients with pain from knee OA into an FSN group or a transcutaneous electrical nerve stimulation (TENS) group with three treatment sessions and a follow-up over the course of 2 weeks. The results showed that FSN was effective in treating soft tissue pain around the knee with OA. This study aimed to establish and visualize three key technical indicators during FSN therapy, including the FSN needle insertion point and layer; the frequency and duration of the swaying movement; and the manipulation of the reperfusion approach. These findings have great potential for future applications in myofascial pain treatment, especially for pain management. Following this protocol could enhance FSN skills.

作者聚焦： Fu 的皮下针刺治疗膝骨关节炎疼痛  

We present a protocol for using Fu's subcutaneous needling for knee osteoarthritis pain, which combines swaying movement and reperfusion approach techniques. This protocol has great potential for future applications in myofascial pain treatment and could enhance Fu's subcutaneous needling (FSN) manipulation skills.

傅氏皮下针刺治疗膝关节骨关节炎疼痛

Fu's subcutaneous needling (FSN) is a new acupuncture and dry needling technique based on traditional Chinese medicine. It rapidly produces long-lasting ...

小针刀治疗I-II期肩周炎的临床疗效

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反向共肩关节置换术

光动力疗法治疗骨肉瘤细胞的细胞毒功效

线粒体的制备及透气性评估，从骨骼肌组织通过穿刺活检获得的分离

一项临床试验，评估基于橄榄油的三腔袋的亲子营养的安全性、有效性和交付

质子治疗在实体肿瘤恶性肿瘤选择中的临床应用

重建显微外科缺血再灌注损伤研究的临床前大鼠模型

用于评估基因治疗缺血性心脏疗效的大型动物模型

傅氏皮下针刺治疗膝关节骨关节炎疼痛

傅氏皮下针刺治疗膝关节骨关节炎疼痛

傅氏皮下针刺治疗膝关节骨关节炎疼痛