温针药灸与电针治疗单纯性肥胖的临床研究

目的：进一步提高针刺治疗肥胖症的疗效。方法：将单纯性肥胖患者分成虚实两型给予不同治疗及临床观察研究。将虚证型者随机分为温针药灸组与针刺组并进行疗效对比；将实证型患者随机分为电针组与针刺组并进行疗效对比。结果：虚证型中，两组的总有效率相比，差异有显著性意义（P＜0．05）；实证型中，两组的总有效率相比，差异亦有显著性意义（P＜0．05）。结论：将单纯性肥胖分虚实两型辨证施以温针药灸法和电针法治疗，疗效确切。     

现代中国针灸学的三大突破性进展

实验针灸学、全息针灸学、针刀学是3个自成体系的新学派，它们都是近年来在针灸学的基础上发展建立起来的，在理论上都保持鲜明的自我特征，又主动融入大量现代科学的成分和方法，理论上越来越清晰，具有可持续发展的潜力；实践的精确性也有所提高，各自都已形成比较成熟的手段与方法，具有可操作性及可重复性。笔者认为这3个学派及其衍化的子系统将构筑真正意义上的现代针灸学的主要框架，逐步与现代科学相接轨，为我们研究针灸学提供了丰富的思路和可行的方法，对整个针灸学的创新和发展有示范推动作用。     

Needle track recurrence after biopsy of non-metastatic Wilms tumour

A 2-year-old girl presented with a left-sided Wilms tumour. She was randomised to have a needle biopsy and preoperative chemotherapy according to the United Kingdom Children's Cancer Study Group (UKCCSG) protocol, a trial of preoperative chemotherapy in biopsy-proven Wilms tumour versus immediate nephrectomy (UK 9101). A nephrectomy was performed 6 weeks later. Six months later she presented with an abdominal wall recurrence at the needle biopsy site, which was resected. The value of needle biopsy in localised Wilms tumour is debated.     

骨肿瘤的针吸细胞学诊断

骨肿瘤诊断中，常用的针吸取材切片诊断因所获标本较小，不足供切片和诊断需要而造成漏诊及误诊。采用针吸标本做涂片供细胞学诊断，可弥补此类不足。用此法对可触及骨肿物及Ｘ线表现为骨质改变的病例１５５例行巴氏涂片诊断和分类的探讨，其中１２例无组织学结果或失去随访而资料不全，对１４３例资料完整有随访的病例进行了与组织学对照分析的研究。良性及恶性骨病损１４３例中，细胞学定性与分类符合者１１９例，总符合率８３．２％，恶性肿瘤９８例中９６例为细胞学所定性，细胞学敏感度高达９８％，对误诊及漏诊的原因进行了分析，结果表明，细胞学可以作为骨肿瘤的简便快速而准确的筛选和诊断方法之一。     

Seeding of osteosarcoma in the biopsy tract of a patient with multifocal osteosarcoma

We report a case of multifocal osteosarcoma in a 7-year-old boy who developed iatrogenic seeding of tumor along the biopsy tract. The results of the plain radiograph, CT, and histopathological correlation are presented.     

Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies

The aim of this study was to analyze and compare the costs of low-field (0.23 T) MRI- and CT-guided bone biopsies. The cost comparison consisted of 18 MRI-guided and 12 CT-guided bone biopsies performed during a 1-year period. The costs and activities of these two methods were analyzed by using activity-based cost accounting (ABC). The costs of MRI-guided bone biopsy (1205 Euro) were 2.55-fold compared with those of the CT-guided bone biopsy (472 Euro). The higher costs of the biopsy procedure in MRI were due to the higher material (5.57-fold) and personnel (2.73-fold) costs. The MRI-guided bone biopsies proved to be considerably more expensive than CT-guided bone biopsies. This was due to the higher material costs, especially the highly priced MRI compatible instrumentation and the longer procedure time. The MRI guidance in performing bone biopsies should be justified on the basis of the better accuracy and the lack of radiation. Evaluations of cost-effectiveness concerning MRI-guided bone biopsy are needed.     

Frameless image guidance improves accuracy in three-dimensional interstitial brachytherapy needle placement

PURPOSE: The aim of this work was to adapt a computer-assisted real-time three-dimensional (3D) navigation system for interstitial brachytherapy procedures. METHODS AND MATERIALS: The 3-D navigation system Surgical Planning and Orientation Computer System (SPOCS; Aesculap, Tuttlingen, Germany) was adapted for use in interstitial brachytherapy. A special needle holder with mounted infrared-emitting diodes (IRED) for 3D navigation-based needle implantation was developed. Measurements were made on a series of different phantoms to study the feasibility and the overall accuracy and precision of the navigation system with regard to single-needle application and volume implants (multiple-needle implantations). In all, 250 single implants and 20 volume implants were performed. Accuracy was measured as the target registration error (TRE) between the preoperatively defined and the achieved target position. RESULTS: Analyses of the 250 different targets showed a mean TRE for single-needle applications of 1.1 mm (SD +/- 0.4 mm), 0.9 mm (SD +/- 0.3 mm), and 0.7 mm (SD +/- 0.3 mm) in the x, y, and z direction, respectively. The maximal deviation was 2.3 mm. The corresponding TRE in the x, y, and z direction for volume implants was 1.6 mm (SD +/- 0.4 mm), 1.9 mm (SD +/- 0.6 mm), and 1.0 mm (SD +/- 0.4 mm), respectively. The maximum deviation was 2.9 mm. CONCLUSIONS: The adaptation of a commercially available surgical planning and navigation system to interstitial brachytherapy is feasible. It enables virtual planning and improved accuracy in 3D interstitial needle implantation.     

Effects of acupuncture on skin and muscle blood flow in healthy subjects

In 14 healthy female subjects, the effects of needle stimulation (acupuncture) on skin and muscle blood flow were investigated using a non-invasive custom-designed probe and photoplethysmography (PPG). In randomised order, 2–7 days apart, three modes of needle stimulation were performed on the anterior aspect of the tibia: superficial insertion (SF), insertion into the anterior tibial muscle (Mu), and insertion into the muscle including manipulation of the needle in order to elicit a distinct sensation of distension, heaviness or numbness (DeQi). Before intervention, the subjects rested for 30 min. After the intervention, the needle was left in situ for 20 min. Blood flow recordings were performed intermittently from 10 min prior to the intervention to the end of the trial. In a fourth session, serving as control, corresponding measurements were performed without any needle stimulation. Area under curve was calculated for 5-min periods prior to and after stimulation, respectively, and for the remaining 15-min period after stimulation. Compared to the control situation, muscle blood flow increased following both Mu and DeQi for 20 min, with the latter being more pronounced for the initial 5 min. Skin blood flow increased for 5 min following DeQi. However, no increase was found following SF. The DeQi stimulation was preceded by higher visual analogue scale ratings of anxiety prior to stimulation, which might have influenced skin blood flow to some extent. The results indicate that the intensity of the needling is of importance, the DeQi stimulation resulting in the most pronounced increase in both skin and muscle blood flow.     

针刺开"四关"加百会穴温针灸治疗原发性高血压的临床研究

目的：观察针刺开“四关”加百会穴温针灸治疗原发性高血压(EH)的临床疗效。方法：将60例EH患者随机分为针灸组,针刺合谷、太冲、百会;西药组,常规服用卡托普利片,每组各30例,治疗1个月。结果：降压疗效针灸组总有效率(80．0％)略高于西药组(73．3％),但差异无显著性意义(P＞0．05)。症状疗效针灸组显效率较西药组高(53．3％、40．0％),无效率较西药组低(16．7％、33．3％),总有效率优于西药组(83．3％、66．7％),差异均有显著性意义(P＜0．05)。结论：针刺开“四关”加百会穴温针灸治疗EH有效,尤其对改善头痛、防晕、心悸等症状效果良好。