This work was supported by Budget Project of Shanghai Municipal Education Commission (Grant Number 2021LK099) and the National Natural Science Foundation of China (Grant Number 82174506).

All procedures in the protocol were conducted on commercially available human simulation materials (see Table of Materials) rather than on humans, so no ethical issues were involved in this study. Informed consent was also obtained from all volunteers who participated in the study. The participants in this experiment were 20 students from the College of Acumox and Tuina at Shanghai University of Traditional Chinese Medicine. These students had completed coursework on the acupuncture lifting and thrusting technique as part of the &#34;Science of Acupuncture and Moxibustion&#34;27curriculum. Additionally, they had nearly a year of practical experience in human needling through lessons and hands-on practice. The details of the equipment and software used are listed in the Table of Materials.
1. Fabrication of the control cannula
<ol>
	<li>Prepare the cannula, the needle sleeve, and the adjustable stopper using 3D printing technology.</li>
	<li>Use white resin as the material for 3D printing to ensure a minimum precision of 0.1 mm, which prevents issues with structures not fitting together due to errors. This material is also more cost-effective and allows easier adjustment of the structure.</li>
</ol>
2. Videography
<ol>
	<li>Camera settings
	<ol>
		<li>Place two tripods in front of the operator&#39;s desk at an appropriate height and connect the two motion cameras. Set the angle between the two motion cameras to 60&#176;-120&#176; (Figure 2A).</li>
		<li>Adjust the camera settings as follows: resolution 1280 &#215; 720 pixels, format MP4, full manual mode (M), aperture F1.2, shutter speed 1/1000s, ISO 6400, auto white balance, and optical zoom 0 mm.</li>
	</ol>
	</li>
	<li>Calibration settings
	<ol>
		<li>Place a 3D calibration stand measuring 15 cm &#215; 15 cm &#215; 15 cm on the table (Figure 2B). Ensure it is within the coverage of the two motion cameras.</li>
	</ol>
	</li>
	<li>Tracking marker placement
	<ol>
		<li>Prepare a passive infrared reflective sphere with a diameter of 6.5 mm. Attach it to the fingernail cap of the participant&#39;s right thumb to measure the movement trajectory.</li>
	</ol>
	</li>
	<li>Experimental operation 
	NOTE: The twenty participants were instructed to perform lifting and thrusting manipulations on the human simulation material, including the following techniques: even lifting and thrusting, heavy thrusting with light lifting, and light thrusting with heavy lifting. Each participant completed the three types of manipulations on the human simulation material, both with and without a cannula set to an amplitude of 15 mm. They then repeated the three manipulations using cannulas with amplitudes of 5 mm, 10 mm, and 15 mm. A 30 min interval was provided between each manipulation session to ensure consistency among the participants. Each manipulation was repeated 10 times.
	<ol>
		<li>Perform lifting and thrusting manipulations without cannula
		<ol>
			<li>Even lifting and thrusting: Insert the needle to a depth of 20 mm. Lift the needle up and down at a uniform rate with an amplitude of 15 mm at a frequency of 60 times per minute.</li>
			<li>Heavy thrusting with light lifting: Insert the needle to a depth of 20 mm. Quickly insert the needle to a certain depth, then slowly withdraw it to the superficial layer with an amplitude of 15 mm at a frequency of 60 times per minute.</li>
			<li>Light thrusting with heavy lifting: Insert the needle to a depth of 20 mm. Slowly insert the needle to a certain depth, then rapidly withdraw it to a shallow layer with an amplitude of 15 mm at a frequency of 60 times per minute.</li>
		</ol>
		</li>
		<li>Perform lifting and thrusting manipulations with cannula 
		NOTE: Fabricate three cannulas that are compatible with the needle size. Adjust their amplitudes to 5 mm, 10 mm, and 15 mm by sliding the adjustable stoppers to the appropriate length.
		<ol>
			<li>Manipulate with the cannula with an amplitude of 5 mm
			<ol>
				<li>Even lifting and thrusting: Fix a needle in a needle sleeve. Place the needle sleeve in a cannula with an amplitude of 5 mm. Insert the needle to a depth of 20 mm and lift the cannula up and down at a uniform rate at a frequency of 60 times per minute.</li>
				<li>Heavy thrusting with light lifting: Use the same cannula. Insert the needle to a depth of 20 mm. Quickly insert the needle to the limited depth, then slowly withdraw it to the superficial layer at a frequency of 60 times per minute.</li>
				<li>Light thrusting with heavy lifting: Use the same cannula. Insert the needle to a depth of 20 mm. Slowly insert the needle to the limited depth, then rapidly withdraw it to the superficial layer at a frequency of 60 times per minute.</li>
			</ol>
			</li>
			<li>Manipulate with the cannula with an amplitude of 10 mm
			<ol>
				<li>Even lifting and thrusting: Fix a needle in a needle sleeve. Place the needle sleeve in a cannula with an amplitude of 10 mm. Insert the needle to a depth of 20 mm and lift the cannula up and down at a uniform rate at a frequency of 60 times per minute.</li>
				<li>Heavy thrusting with light lifting: Use the same cannula. Insert the needle to a depth of 20 mm. Quickly insert the needle to the limited depth, then slowly withdraw it to the superficial layer at a frequency of 60 times per minute.</li>
				<li>Light thrusting with heavy lifting: Use the same cannula. Insert the needle to a depth of 20 mm. Slowly insert the needle to the limited depth, then rapidly withdraw it to the superficial layer at a frequency of 60 times per minute.</li>
			</ol>
			</li>
			<li>Manipulate with the cannula with an amplitude of 15 mm
			<ol>
				<li>Even lifting and thrusting: Fix a needle in a needle sleeve. Place the needle sleeve in a cannula with an amplitude of 15 mm. Insert the needle to a depth of 20 mm and lift the cannula up and down at a uniform rate at a frequency of 60 times per minute.</li>
				<li>Heavy thrusting with light lifting: Use the same cannula. Insert the needle to a depth of 20 mm. Quickly insert the needle to the limited depth, then slowly withdraw it to the superficial layer at a frequency of 60 times per minute.</li>
				<li>Light thrusting with heavy lifting: Use the same cannula. Insert the needle to a depth of 20 mm. Slowly insert the needle to the limited depth, then rapidly withdraw it to the superficial layer at a frequency of 60 times per minute.</li>
			</ol>
			</li>
		</ol>
		</li>
	</ol>
	</li>
</ol>
3. Project configuration of the motion capture and analysis software and video analysis
<ol>
	<li>Video export and renaming 
	NOTE: Transfer all video files from the camera to the designated storage disk on the computer. Rename the 3D calibration video files from cameras 1 and 2 to &#34;1.mp4&#34; and &#34;2.mp4,&#34; respectively.
	<ol>
		<li>Video storage
		<ol>
			<li>Save the operation videos to the computer-designated storage disk. Name them using the participants&#39; full initials in the format &#34;xxx-1&#34; and &#34;xxx-2.&#34;</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>Reality motion system project configuration (motion capture and analysis software)
	<ol>
		<li>New project: Start the motion capture and analysis software and select New Project. Set the project name in the project tab, then click on Create and Save to store the project on the specified storage disk.</li>
		<li>Specification: Select Specification &#62; Points &#62; Thumb Tip, drag the tracking point from the predefined point box to the used point box, and click on the Close button to continue.</li>
		<li>Adding camera groups: Right-click on the Cameras &#62; Add Camera Group to add a new camera group.</li>
		<li>Select tracking file: Click on the Select File button in the Tracking box.</li>
		<li>Importing operation video: Click on Open Existing File and select the operation video xxx-1 in the popup window. Click on Apply to complete the video import.</li>
		<li>Import calibration video: Click on Select File in the 3D Calibration box to import the corresponding calibration video &#34;1.mp4.&#34;</li>
		<li>Importing other videos: Following the same steps as in step 3.2.5, import the operation video &#34;xxx-2&#34; and its corresponding calibration video &#34;2.mp4.&#34;</li>
	</ol>
	</li>
	<li>Video analysis
	<ol>
		<li>Opening a camera group: Open the camera group, then right-click on 1.mp4 &#62; Properties.</li>
		<li>Perform 3D calibration: Click on the 3D Calibration button in the 3D Calibration box, enter a description, and add 20 points by clicking on the Add Points button 20 times.</li>
		<li>Setting point parameters: Set the name and corresponding X, Y, Z values for each point, then click on Apply according to the calibration parameters.</li>
		<li>Finish calibration: After configuring all the points, click on each endpoint of the calibration video to complete the 3D calibration.</li>
		<li>Calibrate other cameras: Follow steps 3.3.1-3.3.4 to complete the 3D calibration of the other camera.</li>
		<li>Setting up 3D tracking: Right-click on Camera Group &#62; 3D Tracking, select all cameras, and click on the OK button to open the 3D tracking window.</li>
		<li>Apply mode matching tracking: Set Use Pattern Matching Tracking for both cameras. Manually click on the Thumb Tip point in the first frame.</li>
		<li>Start auto tracking: Click on the Auto Search button to begin automatic 3D tracking frame by frame.</li>
		<li>Complete other video tracking: Follow steps 3.3.6-3.3.8 to complete motion tracking for the other videos. 
		NOTE: If the tracking points are lost during auto 3D tracking, select the row where points are lost, right-click, and select Discard Points From Here. Then, click on the points and the Auto Search button again.</li>
	</ol>
	</li>
	<li>Data export
	<ol>
		<li>Creating 3D calculations: Right-click on Camera Group &#62; New 3D Calculation, select All Cameras, and check Update Data Continuously and Store Data Explicitly in the &#34;Create 3D Data&#34; window. Update data and explicitly store data in a file. Click on the OK button to proceed.</li>
		<li>Export settings: Right-click the folder Containing All the Data &#62; Export.</li>
		<li>Exporting data files: Click on the Export button to export a data file with a customized name (*.txt). Export the other data files in the same way.</li>
	</ol>
	</li>
</ol>
4. Data analysis
<ol>
	<li>Summarization of data
	<ol>
		<li>Measure the spatial dispersion by recording the maximum value of the moving range on the X-, Y-, and Z-axes of the passive infrared reflective sphere on the participants&#39; thumbnail cap (Figure 2C).</li>
		<li>Calculate the standard deviation and take the mean value. Store the data in Microsoft Office Excel files and calculate the mean &#177; standard deviation for graphing.</li>
	</ol>
	</li>
	<li>Analysis of data
	<ol>
		<li>Assess the differences between conditions with and without the cannula by conducting independent samples t-tests (for data consistent with normal distribution) or rank sum tests (for data not consistent with normal distribution).</li>
		<li>Then, perform a two-factor, three-level analysis of variance to evaluate the stability of different lifting and inserting amplitudes. Set the alpha level at p &#60; 0.05 and use the Statistical Package for data analysis to carry out all statistical analyses.</li>
	</ol>
	</li>
</ol>

Control Cannula Improves Precision and Stability in Acupuncture Manipulation

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This study innovatively designed a cannula to improve the stability and safety of acupuncture lifting and inserting manipulations and conducted experiments to evaluate its effectiveness. The researchers used 3D modeling for the structural design and white resin as the material for 3D printing. Compared to manufacturing a metal mold, 3D printing technology offers the advantages of lower cost and easier structural adjustments. Additionally, since the disposable needle is positioned sideways in the groove of the needle slee...

Needling manipulation is performed after the needle is inserted into the patient&#39;s skin to either induce a needle sensation known as &#34;DeQi&#34; (which refers to the sensation of meridian qi induction at the acupuncture point) or to adjust the direction and intensity of the needle sensation. As an essential part of acupuncture, different needling techniques produce varying effects1. Needling manipulation is a critical factor that affects the effectiveness of acupuncture treatment2,3. Research has shown that the signals activated by the lifting-thrusting technique are stronger than those induced by other needling methods4.
The therapeutic effect of acupuncture is closely related to the intensity of stimulation5,6,7, which, in turn, depends on the type of needling manipulation used. As a result, the quantitative-effect relationship of acupuncture manipulation is a key area of experimental research8,9,10. Standardization and reproducibility are crucial to ensuring the scientific validity of acupuncture research11. Both the lifting-thrusting and twisting methods require specific frequency and amplitude of operation12,13, and the selection of acupoints is also important for treating diseases14. However, manual acupuncture relies on human operators, making it difficult to maintain consistent frequency and amplitude during needle manipulation15. Additionally, precautions must be taken to avoid complications such as pneumothorax by carefully controlling the depth and direction of needle insertion in certain areas of the body16,17.
Thus, one of the most urgent challenges in the scientific study of acupuncture manipulation is the development of controllers to improve the stability of needling techniques, which is vital for ensuring the safety and standardization of acupuncture practices18.
Lifting-thrusting is one of the most commonly used basic acupuncture techniques. It involves lifting the needle up and thrusting it down after inserting it into the acupoint at a specific depth. The upward movement is called lifting, while the downward movement is known as thrusting. This process is repeated to achieve the desired clinical effect, with the level of stimulation depending on the amplitude and frequency of the lifting and thrusting motions19,20,21,22. Currently, the amplitude of the lifting and thrusting technique is mainly controlled by the practitioner, and its effectiveness is often evaluated based on the sensation of &#34;De Qi&#34; (the feeling of meridian qi induction at the acupuncture point)23,24,25. However, there is no established standard to evaluate the stability and safety of this technique, and the depth of needle insertion is entirely dependent on the practitioner&#39;s skill.
To promote standardization in acupuncture, several new techniques have been developed to replace traditional manual acupuncture, including pulsed electro-acupuncture, ultrasonic acupuncture, microwave acupuncture, laser acupuncture, and extracorporeal shock wave acupuncture26. While these methods help to some extent in standardizing the effects of acupuncture, they cannot fully replace traditional manual acupuncture in clinical practice. Therefore, standardizing the manipulation of manual acupuncture remains essential.
To address the aforementioned issues, this study designed an acupuncture needle cannula that improves the safety and stability of the lifting and thrusting technique. The control cannula used in the study was manufactured using 3D printing technology (see Table of Materials), and the overall structure consists of three components: the cannula, the needle sleeve, and the adjustable stopper, along with disposable acupuncture needles (Figure 1). The cannula, needle sleeve, and adjustable stopper were all produced through 3D printing technology (see Supplementary File 1, Supplementary File 2, and Supplementary File 3).
The cannula offers several advantages: first, the amplitude is controlled by the stopper, which significantly reduces the burden on practitioners; second, the separation of the needle and cannula prevents contamination during acupuncture; and third, the adjustable scale allows for precise control of the needle&#39;s depth and amplitude, enabling free adjustment as needed. The results of this study provide a safe auxiliary tool for experimental research on acupuncture manipulation, which is crucial for advancing the standardization of acupuncture techniques.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Blender</td>
			<td>Blender Institute B.V.</td>
			<td>Blender 4.2.2 LTS</td>
			<td>Blender is the free and open source 3D creation suite. It supports the entirety of the 3D pipeline&#8212;modeling, rigging, animation, simulation, rendering, compositing and motion tracking, even video editing and game creation. Advanced users employ Blender&#39;s API for Python scripting to customize the application and write specialized tools; often these are included in Blender&#39;s future releases. Blender is well suited to individuals and small studios who benefit from its unified pipeline and responsive development process.</td>
		</tr>
		<tr>
			<td>Human simulation materials</td>
			<td>Dongguan Jiangzhao silicon industry Co., LTD</td>
			<td>Acupuncture exercise skin model</td>
			<td>Portable acupuncture practice skin model, simulated skin, with a ductile layer, can better simulate the feeling of acupuncture.</td>
		</tr>
		<tr>
			<td>IBM SPSS Statistics</td>
			<td>IBM</td>
			<td>R26.0.0.0</td>
			<td>The IBM SPSS Statistics software provides advanced statistical analysis for users of all experience levels. Offering a comprehensive suite of capabilities, it delivers flexibility and usability beyond traditional statistical software.</td>
		</tr>
		<tr>
			<td>Prism 9</td>
			<td>GraphPad Software, LLC.</td>
			<td>GraphPad Prism 9.5.0 (525)</td>
			<td>Prism is a software to draw graphs.</td>
		</tr>
		<tr>
			<td>Simi Reality Motion Systems</td>
			<td>Simi Reality Motion Systems GmbH</td>
			<td>Simi Motion 2D/3D</td>
			<td>Simi Motion provides an&#160;extensive platform for motion capture and 2D/3D movement analysis.</td>
		</tr>
	</tbody>
</table>

a mechanical construction to enhance the stability and safety of lifting and thrusting manipulation of acupuncture

The therapeutic effectiveness of acupuncture relies on both safety and stability, making these factors essential in acupuncture manipulation research. However, manual manipulation introduces unavoidable inaccuracies, which can impact the reliability of research findings. To address this challenge, a unique lifting and thrusting manipulation control cannula was designed in this study, offering flexible adjustment of movement amplitude. The cannula was created using 3D printing technology, and its effectiveness in maintaining stability was verified by recording the acupuncture needle's movement range with optical sensor technology. The study's results show that the control cannula significantly enhances the stability of acupuncture manipulation, reducing human error. This innovation suggests that the cannula could serve as a valuable auxiliary tool for ensuring both the precision and safety of acupuncture-related experimental research. Its adoption could also contribute to the standardization of acupuncture practices, ensuring more consistent and accurate research outcomes, which is essential for future advancements in acupuncture research and clinical applications.

Effect of the cannula on the stability of the lifting and thrusting manipulation 
Graphs were generated based on the data from one operator, as shown in Figure 3, Figure 4, and Figure 5. The horizontal axis in each figure represents time, and the vertical axis represents the position of the tracking point on the operator&#39;s thumb tip, recording the motion trail of this point. Two lines of different colors il...

Author Spotlight: Development of a Standardized Acupuncture Tool Inspired by Advanced Techniques for Improved Safety and Precision

This protocol designs a cannula that can be used to control the range of motion for the lifting and thrusting manipulation in acupuncture, thereby improving stability and safety. It can thus serve both the clinical application and scientific research of acupuncture treatment.

A Mechanical Construction to Enhance the Stability and Safety of Lifting and Thrusting Manipulation of Acupuncture

The therapeutic effectiveness of acupuncture relies on both safety and stability, making these factors essential in acupuncture manipulation research. ...

a-mechanical-construction-to-enhance-stability-safety-lifting

Research

JoVE Journal

Medicine

188 Views.  Shanghai University of Traditional Chinese Medicine. This protocol designs a cannula that can be used to control the range of motion for the lifting and thrusting manipulation in acupuncture, thereby improving stability and safety. It can thus serve both the clinical application and scientific research of acupuncture treatment.

Video: Author Spotlight: Development of a Standardized Acupuncture Tool Inspired by Advanced Techniques for Improved Safety and Precision

Quantitative Visualization and Detection of Skin Cancer Using Dynamic Thermal Imaging

In 2010 approximately 68,720 melanomas will be diagnosed in the US alone, with around 8,650 resulting in death 1. To date, the only effective treatment for melanoma remains surgical excision, therefore, the key to extended survival is early detection 2,3. Considering the large numbers of patients diagnosed every year and the limitations in accessing specialized care quickly, the development of objective in vivo diagnostic instruments to aid the diagnosis is essential. New techniques to detect skin cancer, especially non-invasive diagnostic tools, are being explored in numerous laboratories. Along with the surgical methods, techniques such as digital photography, dermoscopy, multispectral imaging systems (MelaFind), laser-based systems (confocal scanning laser microscopy, laser doppler perfusion imaging, optical coherence tomography), ultrasound, magnetic resonance imaging, are being tested. Each technique offers unique advantages and disadvantages, many of which pose a compromise between effectiveness and accuracy versus ease of use and cost considerations. Details about these techniques and comparisons are available in the literature 4.
Infrared (IR) imaging was shown to be a useful method to diagnose the signs of certain diseases by measuring the local skin temperature. There is a large body of evidence showing that disease or deviation from normal functioning are accompanied by changes of the temperature of the body, which again affect the temperature of the skin 5,6. Accurate data about the temperature of the human body and skin can provide a wealth of information on the processes responsible for heat generation and thermoregulation, in particular the deviation from normal conditions, often caused by disease. However, IR imaging has not been widely recognized in medicine due to the premature use of the technology 7,8 several decades ago, when temperature measurement accuracy and the spatial resolution were inadequate and sophisticated image processing tools were unavailable. This situation changed dramatically in the late 1990s-2000s. Advances in IR instrumentation, implementation of digital image processing algorithms and dynamic IR imaging, which enables scientists to analyze not only the spatial, but also the temporal thermal behavior of the skin 9, allowed breakthroughs in the field.
In our research, we explore the feasibility of IR imaging, combined with theoretical and experimental studies, as a cost effective, non-invasive, in vivo optical measurement technique for tumor detection, with emphasis on the screening and early detection of melanoma 10-13. In this study, we show data obtained in a patient study in which patients that possess a pigmented lesion with a clinical indication for biopsy are selected for imaging. We compared the difference in thermal responses between healthy and malignant tissue and compared our data with biopsy results. We concluded that the increased metabolic activity of the melanoma lesion can be detected by dynamic infrared imaging.

We demonstrated that malignant pigmented lesions with increased metabolic activity generate quantifiable amounts of heat and the measurement of the transient thermal response of the skin to a cooling excitation allows quantitative identification of melanoma and other skin cancers (vs. non-proliferative nevi) at an early stage of the disease.

In 2010 approximately 68,720 melanomas will be diagnosed in the US alone, with around 8,650 resulting in death 1. To date, the only effective treatment ...

The Measurement and Treatment of Suppression in Amblyopia

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%1-3, the majority of cases being monocular2. Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation.
Although amblyopia is initially caused by abnormal visual input in infancy, once established, the visual deficit often remains when normal visual input has been restored using surgery and/or refractive correction. This is because amblyopia is the result of abnormal visual cortex development rather than a problem with the amblyopic eye itself4,5 . Amblyopia is characterized by both monocular and binocular deficits6,7 which include impaired visual acuity and poor or absent stereopsis respectively. The visual dysfunction in amblyopia is often associated with a strong suppression of the inputs from the amblyopic eye under binocular viewing conditions8. Recent work has indicated that suppression may play a central role in both the monocular and binocular deficits associated with amblyopia9,10 .
Current clinical tests for suppression tend to verify the presence or absence of suppression rather than giving a quantitative measurement of the degree of suppression. Here we describe a technique for measuring amblyopic suppression with a compact, portable device11,12 . The device consists of a laptop computer connected to a pair of virtual reality goggles. The novelty of the technique lies in the way we present visual stimuli to measure suppression. Stimuli are shown to the amblyopic eye at high contrast while the contrast of the stimuli shown to the non-amblyopic eye are varied. Patients perform a simple signal/noise task that allows for a precise measurement of the strength of excitatory binocular interactions. The contrast offset at which neither eye has a performance advantage is a measure of the "balance point" and is a direct measure of suppression. This technique has been validated psychophysically both in control13,14 and patient6,9,11 populations.
In addition to measuring suppression this technique also forms the basis of a novel form of treatment to decrease suppression over time and improve binocular and often monocular function in adult patients with amblyopia12,15,16 . This new treatment approach can be deployed either on the goggle system described above or on a specially modified iPod touch device15.

Amblyopia is a developmental disorder of the visual cortex that is often accompanied by strong suppression of one eye. We present a new technique for measuring and treating interocular suppression in patients with amblyopia that can be deployed using virtual reality goggles or a portable iPod Touch device.

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

Construction of Vapor Chambers Used to Expose Mice to Alcohol During the Equivalent of all Three Trimesters of Human Development

Exposure to alcohol during development can result in a constellation of morphological and behavioral abnormalities that are collectively known as Fetal Alcohol Spectrum Disorders (FASDs). At the most severe end of the spectrum is Fetal Alcohol Syndrome (FAS), characterized by growth retardation, craniofacial dysmorphology, and neurobehavioral deficits. Studies with animal models, including rodents, have elucidated many molecular and cellular mechanisms involved in the pathophysiology of FASDs. Ethanol administration to pregnant rodents has been used to model human exposure during the first and second trimesters of pregnancy. Third trimester ethanol consumption in humans has been modeled using neonatal rodents. However, few rodent studies have characterized the effect of ethanol exposure during the equivalent to all three trimesters of human pregnancy, a pattern of exposure that is common in pregnant women. Here, we show how to build vapor chambers from readily obtainable materials that can each accommodate up to six standard mouse cages. We describe a vapor chamber paradigm that can be used to model exposure to ethanol, with minimal handling, during all three trimesters. Our studies demonstrate that pregnant dams developed significant metabolic tolerance to ethanol. However, neonatal mice did not develop metabolic tolerance and the number of fetuses, fetus weight, placenta weight, number of pups/litter, number of dead pups/litter, and pup weight were not significantly affected by ethanol exposure. An important advantage of this paradigm is its applicability to studies with genetically-modified mice. Additionally, this paradigm minimizes handling of animals, a major confound in fetal alcohol research.

We demonstrate the construction of alcohol vapor chambers using readily available materials that simultaneously house 6 mouse cages. We further describe their use in a mouse model of fetal alcohol exposure equivalent to all 3&#160;trimesters of human pregnancy. This paradigm exposes animals during gestation and postnatal days 1-12.

Exposure to alcohol during development can result in a constellation of morphological and behavioral abnormalities that are collectively known as Fetal ...

Modeling and Simulations of Olfactory Drug Delivery with Passive and Active Controls of Nasally Inhaled Pharmaceutical Aerosols

There are many advantages of direct nose-to-brain drug delivery in the treatment of neurological disorders. However, its application is limited by the extremely low delivery efficiency (&#60; 1%) to the olfactory mucosa that directly connects the brain. It is crucial to develop novel techniques to deliver neurological medications more effectively to the olfactory region. The objective of this study is to develop a numerical platform to simulate and improve intranasal olfactory drug delivery. A coupled image-CFD method was presented that synthetized the image-based model development, quality meshing, fluid simulation, and magnetic particle tracking. With this method, performances of three intranasal delivery protocols were numerically assessed and compared. Influences of breathing maneuvers, magnet layout, magnetic field strength, drug release position, and particle size on the olfactory dosage were also numerically studied.
From the simulations, we found that clinically significant olfactory dosage (up to 45%) were feasible using the combination of magnet layout and selective drug release. A 64 -fold higher delivery of dosage was predicted in the case with magnetophoretic guidance compared to the case without it. However, precise guidance of nasally inhaled aerosols to the olfactory region remains challenging due to the unstable nature of magnetophoresis, as well as the high sensitivity of olfactory dosage to patient-, device-, and particle-related factors.

This manuscript reviews the modeling and simulations of different protocols to deliver medications to the olfactory region in image-based nasal airway models. Multiple software modules are used to develop the anatomically accurate nose model, generate computational mesh, simulate nasal airflows, and predict particle deposition at the olfactory region.

There are many advantages of direct nose-to-brain drug delivery in the treatment of neurological disorders. However, its application is limited by the ...

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.

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

Acupuncture in a Rat Model of Asthma

A high platform can fix rats without restriction and completely expose the acupoints on the back during acupuncture manipulation. This article describes methods for the fabrication of the high platform, establishes a rat model of asthma and measures changes in respiratory function using a noninvasive and real-time whole-body plethysmography (WBP) system.

A high platform can fix rats without restriction and completely expose the acupoints on the back during acupuncture manipulation. This article describes ...

Direct Drug Delivery to Kidney via the Renal Artery

There is a need for directed injections to enable increased and specific renal exposure for efficient evaluation of drug targets in the renal research field. Accumulation of drugs in certain organs may give rise to adverse and unwanted effects, depending on the nature of injectate. To minimize spillover and/or accumulation in other tissues, the herein described method directs the formulation into the renal artery bloodstream by inserting a catheter in the infra renal aorta, just below where it branches into the renal artery, resulting in the kidney as first reached organ and distributing of formulation throughout the kidney.
This manuscript provides a detailed description of the method, as well as its challenges and difficulties. It guides the experimenter to become skillful with this type of microsurgery that requires accuracy under sterile conditions. Speed is crucial for minimizing the ischemia and practicing the procedure will increase the chance of successful injections without adverse effects. By modulating the time between injection and reperfusion as well as the injected volume, the risk of spillover to other organs is mitigated. 
Note that this technique is suitable for single dosing strategies.

This manuscript describes a method for targeted delivery to a single kidney via a catheter placed in the infrarenal abdominal aorta in the mouse.

There is a need for directed injections to enable increased and specific renal exposure for efficient evaluation of drug targets in the renal research ...

Three-Dimensional Finger Motion Tracking during Needling: A Solution for the Kinematic Analysis of Acupuncture Manipulation

Three-dimensional (3D) motion tracking has been used in many fields, such as the researches of sport and medical skills. This experiment aimed to use 3D motion tracking technology to measure the kinematic parameters of the joints of fingers during acupuncture manipulation (AM) and establish three technical indicators "amplitude, velocity and time". This method can reflect the operation characteristics of AM and provide quantitative parameters along three axes of multiple finger joints. The current evidence shows that the method has great potential for future applications such as the study of the dose-effect relationship of acupuncture, teaching, and learning of AM, and the measurement and preservation of famous acupuncturists' AM.

This experimental method describes a solution for the kinematic analysis of acupuncture manipulation with three-dimensional finger motion tracking technology.

Three-dimensional (3D) motion tracking has been used in many fields, such as the researches of sport and medical skills. This experiment aimed to use 3D ...

A Modified Technique for Arteriovenous Fistula Construction in Rabbits

Juxta-anastomotic stenosis is a challenging problem that often causes non-maturation and decreases the patency of an arteriovenous fistula (AVF). Injury to the veins and arteries during the operation and hemodynamic changes can lead to intimal hyperplasia, leading to juxta-anastomotic stenosis. To reduce injury to the veins and arteries during the operation, this study proposes a new modified no-touch technique (MNTT) for AVF construction that can decrease the rate of juxta-anastomotic stenosis and improve the AVF patency. To unravel the hemodynamic changes and mechanisms of the MNTT, this study presented an AVF procedure using this technique. Although this procedure is technically challenging, 94.4% procedural success was achieved after adequate training. Ultimately, 13 out of 34 rabbits had a functional AVF 4 weeks after the surgery, leading to a 38.2% AVF patency rate. However, at 4 weeks, the survival rate was 86.1%. Ultrasonography showed active blood flow through AVF anastomosis. Furthermore, the spiral laminar flow was observed in the vein and artery near the anastomosis, suggesting that this technique may improve the hemodynamics of the AVF. On histological observation, significant venous intimal hyperplasia was observed at the AVF anastomosis, whereas no significant intimal hyperplasia was observed at the proximal external jugular vein (EJV) of the anastomosis. This technique will improve the understanding of the mechanisms underlying the use of MNTT for AVF construction and provide technical support for the further optimization of the surgical approach in AVF construction.

The present protocol proposes the creation of an arteriovenous fistula in rabbits using a modified no-touch technique. The technique involves the side-to-side anastomosis of the common carotid artery and external jugular vein without the dissection of the perivenous tissues or cutting off the artery.

Juxta-anastomotic stenosis is a challenging problem that often causes non-maturation and decreases the patency of an arteriovenous fistula (AVF). Injury ...

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia

A systematic review and meta-analysis were conducted to evaluate the clinical effectiveness and safety of Shugan Jieyu capsules for treating insomnia by searching seven databases up to February 21, 2022. The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the studies was assessed using the risk of bias assessment tool. This article describes in detail how to retrieve and screen the literature. The detailed steps for conducting the meta-analysis are also included in the protocol. Fourteen studies were found to be eligible, including 1,283 insomnia patients (644 with and 639 without Shugan Jieyu capsules at baseline). The meta-analysis showed a better total clinical effectiveness (odds ratio [OR]: 5.71, 95% confidence interval [CI]: 3.56 to 9.15) and a lower Pittsburgh Sleep Quality Index (PSQI) score (mean difference [MD]: &#8722;2.95, 95% CI: &#8722;4.97 to &#8722;0.93) with combined Shugan Jieyu capsules and Western medicine compared to Western medicine alone. The secondary outcomes showed that the Shugan Jieyu capsule group had significantly reduced adverse reactions and improvements in sleep duration, night awakening, nightmares with excessive dreaming, daytime sleepiness, and low energy. Further multicenter randomized trials must be encouraged to provide more concrete evidence on whether Shugan Jieyu capsules are beneficial in routine clinical practice.

The presented protocol describes an investigation strategy and systematic review to evaluate the clinical effectiveness and safety of Shugan Jieyu capsules for treating insomnia.

A systematic review and meta-analysis were conducted to evaluate the clinical effectiveness and safety of Shugan Jieyu capsules for treating insomnia by ...