This study aimed to analyze the efficacy and safety of microneedling (MN), both alone and in combination with other treatments, to refine the approach for treating acne scars using MN. We systematically searched Pubmed, Cochrane Library, Embase, and Web of Science for randomized controlled trials examining MN or its combinations in patients with acne scars. All statistical analyses were performed using Stata 18 software. A total of 24 studies involving 1546 participants were included. The analysis revealed that MN combined with chemical peels (CP) exhibited the best results in terms of degree of improvement, patient satisfaction, and treatment efficacy compared to other treatments examined, including MN alone, MN with hyaluronic acid (HA), MN with botulinum toxin‑A (TA), MN with platelet-rich plasma (PRP), PRP alone, CP, and laser therapy. The results for MN combined with additional treatments were obviously better than for MN alone. Side effects such as erythema, pain, and post-inflammatory hyperpigmentation showed no significant differences across all treatments assessed.

To explore the efficacy and safety of fractional micro-needling radiofrequency (FMRF) in the treatment of enlarged pores on the cheek in a Chinese cohort. Patients with enlarged facial pores who underwent FMRF between January 2020 and December 2022 were included in this study. Blinded clinical assessments were performed by two independent dermatologists using a six-grade photographic enlarged pore scale and a quartile grading scale. Patients were asked to rate the degree of pain related to treatment on a visual analog scale (VAS), with scores ranging from 0 (no pain) to 10 (worst pain ever). A paired t-test was used to analyze the six-grade photographic enlarged pore scores. A total of 22 patients received three consecutive sessions of FMRF treatment, with intervals of 1-3 months, and underwent follow-up as scheduled. The mean six-grade photographic enlarged score was 3.55 ± 0.96 at baseline, while the score decreased significantly to 2.59 ± 0.59 after three treatment sessions (P < 0.05). The improvement score of the patients, assessed by two independent dermatologists, was 2.31 ± 0.71, according to the quartile grading scale. The mean VAS score was 6.42 ± 1.44. FMRF is effective and safe for the treatment of enlarged facial pores after three sessions.

BACKGROUND: Striae distensae (SD), linear scars of derma, caused by disproportionate skin stretching, which indicates a cosmetic problem and even endangers individuals\' psychosocial health. Microneedling, representing a relatively new procedural therapy, has shown brightening but diverse results in the remedy of SD. Our study systematically investigates and further evaluates the efficacy of microneedling for SD.
METHODS: This study was conducted following the PRISMA guidelines. According to the preplanned search strategy, four electronic databases were comprehensively searched for eligible clinical controlled studies. Standardized mean difference (SMD) and odd ratio (OR) with 95% confidence intervals were calculated for continuous data and dichotomous data, respectively.
RESULTS: According to the predetermined criteria, eleven eligible articles of six RCTs and five non-RCTs were included. Concerning clinical improvement, a significant difference was observed in the microneedle radiofrequency treatment subgroup (SMD: 0.57, 95% CI 0.20-0.94, P = 0.003). The pooled result of the second subgroup revealed that microneedling and lasers producing almost comparable effectiveness for treating SD with no significant difference (P = 0.35). The analysis result of the third subgroup of microneedling versus non-laser therapy indicated significant difference at the 5% significance level (SMD:1.01, 95% CI 0.51-1.51, P < 0.0001). With regard to patient satisfaction, the pooled estimate concluded that participants\' satisfaction with therapeutic effect between MRF and laser group was comparable (P = 0.26), whereas microneedling exhibited significant superiority than both laser (P = 0.04) and non-laser treatments (SMD: 0.95, 95% CI 0.52-1.38, P < 0.0001). Occurrence of post-inflammatory hyperpigmentation (PIH) was not obvious in microneedling therapy compared to other treatments, and a statistically difference was observed (P = 0.0003). Microneedling treatment caused significant pain compared with laser therapy (P < 0.00001).
CONCLUSIONS: This systematic review and meta-analysis has provided initial evidence of the efficacy and safety of microneedling technology for SD.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

OBJECTIVE: To investigate the effects of the elongated needling at the points of hand and foot yang meridians and the Governor Vessel combined with the routine acupuncture therapy on pain, balance function and muscle strength of the patients with post-stroke hemiplegia and central post-stroke pain (CPSP), and to investigate whether its therapeutic mechanism is related to antioxidant damage.
METHODS: Ninety-four patients with post-stroke hemiplegia and CPSP admitted from March 2020 to September 2021 were divided into a trial group (47 cases, 1 cases dropped out) and a control group (47 cases 3 cases dropped out). In the control group, the rehabilitation exercise combined with routine acupuncture therapy was used, and in the trial group, on the base of the treatment as the control group, the elongated needling at the points of hand and foot yang meridians and the Governor Vessel was supplemented. In the two groups, the treatment was given once daily, and 1 course of treatment was composed of 14 days, a total of 6 courses were required in the trial. Separately, before treatment, and 1, 2 and 3 months after treatment, between two groups, the score of visual analogue scale (VAS) and that of Berg balance scale (BBS), as well as muscle strength were compared；the neural function was evaluated using the national institutes of health stroke scale (NIHSS) and the serum contents of nitricoxide synthase (NOS), superoxide dismutase (SOD) and malondialdehyde (MDA) were detected by ELISA in the patients.
RESULTS: Compared with those before treatment, VAS score and NIHSS score were all decreased (P<0.05) in the trial and the control group after 1 month, 2 months and 3 months of treatment, and BBS score was increased (P<0.05)；and the case proportion of muscle strength grade 4 and 5 was higher (P<0.05) in the trial group. In the control group, the proportion of grade 4 increased after treatment for 2 months (P<0.05), and that of grade 4 and 5 increased after treatment for 3 months (P<0.05). The serum contents of NOS and SOD were increased (P<0.05), and MDA was decreased (P<0.05) after 3 months of treatment in the two groups. In comparison with the control group at the same time point, VAS score and NIHSS score were lower (P<0.05), BBS score higher (P<0.05) and the muscle strength grade was improved (P<0.05, P<0.01) after 1, 2 and 3 months of treatment, respectively；and the serum contents of NOS and SOD increased (P<0.05), and MDA decreased (P<0.05) after 3 months of treatment in the trial group.
CONCLUSIONS: The elongated needling at the points of hand and foot yang meridians and the Governor Vessel, combined with the routine acupuncture therapy alleviates CPSP, improves balance and muscle strength and promotes the recovery of neural function in the patients with post-stroke hemiplegia, the mechanism may be related to antioxidant damage.
目的: 观察手足阳经、督脉穴芒针透刺联合体针治疗对中风后偏瘫伴中枢性疼痛（CPSP）患者疼痛、平衡功能、肌力的影响，并探讨其作用机制是否与抗氧化损伤有关。方法: 选取2020年3月至2021年9月收治的94例中风后偏瘫伴CPSP患者，分为研究组（47例，脱落3例）和对照组（47例，脱落1例）。对照组采取康复锻炼联合常规体针治疗，研究组在对照组基础上采取手足阳经、督脉穴芒针透刺治疗，两组均每日治疗1次，14 d为1个疗程，共6个疗程。比较两组患者治疗前和治疗1、2、3个月后的疼痛视觉模拟量尺（VAS）评分、伯格平衡功能评分和肌力，采用神经功能缺损评分（NIHSS）评价患者的神经功能，ELISA法检测患者血清一氧化氮合酶（NOS）、超氧化物歧化酶（SOD）、丙二醛（MDA）含量。结果: 与治疗前比较，治疗1、2、3个月研究组和对照组VAS评分、NIHSS均降低（P<0.05），伯格平衡功能评分升高（P<0.05），研究组的肌力分级4~5级的比例显著升高（P<0.05）；治疗2个月，对照组患者的肌力4级的比例显著升高（P<0.05），治疗3个月，对照组患者的肌力4、5级的比例显著升高（P<0.05）；两组患者治疗3个月后的血清NOS、SOD含量均显著升高（P<0.05），血清MDA含量均显著降低（P<0.05）。与同时点对照组比较，治疗1、2、3个月研究组患者VAS、NIHSS评分均降低（P<0.05），伯格平衡功能评分升高（P<0.05），肌力分级更优（P<0.05，P<0.01）；治疗3个月后的血清NOS、SOD含量升高（P<0.05），MDA含量降低（P<0.05）。结论: 手足阳经、督脉穴芒针透刺联合体针治疗能减轻CPSP，改善偏瘫患者的平衡功能，提高肌力，促进神经功能恢复，其机制可能与抗氧化损伤有关。.

OBJECTIVE: To observe the clinical efficacy of the parallel needling technique for peripheral facial paralysis with qi deficiency and blood stasis.
METHODS: Sixty-two patients with peripheral facial paralysis of qi deficiency and blood stasis were randomly assigned to a parallel needling group and a conventional acupuncture group, with 31 patients in each group. The conventional acupuncture group received needling at Yangbai (GB 14), Quanliao (SI 18), Jiache (ST 6), Dicang (ST 4), Yifeng (TE 17) on the affected side, Hegu (LI 4) on the healthy side, and bilateral Zusanli (ST 36), Sanyinjiao (SP 6), Xuehai (SP 10) and Qihai (CV 6) etc. The parallel needling group, in addition to the conventional acupuncture points, received parallel needling at three additional groups of acupoints, i.e. forehead wrinkle group, mid-face group, and corner of the mouth group. Both groups retained needles for 30 min, with one session every other day and a total of three sessions per week, lasting for four weeks. The House-Brackmann (H-B) facial nerve function grading, physical function (FDIP) and social function (FDIS) scores of facial disability index (FDI), TCM syndrome score before and after treatment were compared between the two groups, and the clinical efficacy was assessed.
RESULTS: Compared with before treatment, after treatment, both groups showed improvements in H-B facial nerve function grading (P<0.05), FDIP total scores and sub-item scores were increased (P<0.05), FDIS total scores, sub-item scores, and TCM syndrome scores were decreased (P<0.05). After treatment, the parallel needling group showed the higher FDIP total score and eating sub-item score and lower FDIS total score and insomnia sub-item score compared with those in the conventional acupuncture group (P<0.05). The total effective rate was 90.3% (28/31) in the parallel needling group and 87.1% (27/31) in the conventional acupuncture group, with no statistically significant difference between the two groups (P>0.05).
CONCLUSIONS: The parallel needling technique combined with conventional acupuncture, is as effective as conventional acupuncture alone in treating facial paralysis with qi deficiency and blood stasis. However, the parallel needling technique combined with conventional acupuncture shows advantages in the improvement of food intake and sleep quality.
目的: 观察平行对刺法治疗气虚血瘀型周围性面瘫的临床疗效。方法: 将62例气虚血瘀型周围性面瘫患者随机分为平行对刺组和常规针刺组，每组31例。常规针刺组穴取患侧阳白、颧髎、颊车、地仓、翳风，健侧合谷，双侧足三里、三阴交、血海及气海等；平行对刺组在常规针刺组基础上，增加3组平行对刺组穴，分别为额纹组、面中组、口角组。两组均留针30 min，隔日1次，每周3次，共治疗4周。比较两组患者治疗前后House-Brackmann（H-B）面神经功能分级、面部残疾指数（FDI）量表中的躯体功能（FDIP）和社会生活功能（FDIS）评分、中医证候积分，并评定两组临床疗效。结果: 与治疗前比较，两组患者治疗后H-B面神经功能分级改善（P<0.05），FDIP总分及各分项评分升高（P<0.05），FDIS总分及各分项评分、中医证候积分均降低（P<0.05）；治疗后，平行对刺组FDIP总分及进食评分高于常规针刺组（P<0.05）、FDIS总分及失眠程度评分低于常规针刺组（P<0.05）。平行对刺组总有效率为90.3%（28/31），常规针刺组总有效率为87.1%（27/31），两组比较差异无统计学意义（P>0.05）。结论: 平行对刺法结合常规针刺和常规针刺法治疗气虚血瘀型周围性面瘫疗效相当，但平行对刺法结合常规针刺在改善进食、失眠程度方面有优势。.

OBJECTIVE: The aim of this clinical study was to explore the effects of thumb-tack needling combined with sporting (TTNS) therapy on the improvement of pain and joint function in older adult patients with knee osteoarthritis (KOA).
METHODS: A total of 120 older adult patients with KOA were randomly assigned to receive TTNS therapy or medicine treatment (Med group) only for 1 month. The patients were followed up for 3 months and clinical efficacies were evaluated using a visual analog scale to assess pain, the Lequesne scoring system to assess motor function, and the Western Ontario and McMaster University Osteoarthritis Index to assess KOA severity. Blood was collected to measure the levels of interleukin-6 and tumor necrotic factor-alpha using enzyme-linked immunosorbent assay.
RESULTS: The data suggested that TTNS therapy resulted in a significantly higher clinical efficacy (P = 0.012). Visual analog scale score, Lequesne index, and Western Ontario and McMaster University Osteoarthritis Index of the TTNS group at the time of post-treatment (1 month) and post-follow-up (3 months) were also lower compared with the Med group. Patients in the TTNS group also showed lower levels of serum tumor necrotic factor-alpha and interleukin-6.
CONCLUSIONS: TTNS therapy is more efficacious than pharmacological treatment in improving the clinical outcomes of patients with KOA, which suggests its clinical utility in the management of KOA. Geriatr Gerontol Int 2024; 24: 415-420.

This paper systematically reviews the historical evolution of the \"Zhibian (BL 54) through Shuidao (ST 28)\" needling technique by examining the history of the Mang needle, controversies and positioning of the Zhibian (BL 54), and the formation and essentials of the needling technique. Furthermore, the advantageous disease spectrum of this needling technique is summarized, and speculates on potential advantageous disease spectrum from the neural mechanisms of obtaining qi and achieving efficacy. Lastly, this paper discusses the inadequacies in the research on \" Zhibian (BL 54) through Shuidao (ST 28)\" needling technique, aiming to provide a comprehensive understanding and reference for further research on this technique.
从芒针的历史沿革、秩边穴的争议和定位、操作方法的形成及要领3个方面对“秩边透水道”针法的源流进行梳理，对该针法现有的优势病谱归类，并从得气和起效的神经机制入手推测该针法潜在的优势病谱，阐述“秩边透水道”针法研究的不足，以期为该针法的全方位认识及进一步研究提供参考。.

The paper introduces professor YIN Kejing\'s clinical experience in treatment of cyclomastopathy. In pathogenesis, cyclomastopathy is relevant with dysfunction of the thoroughfare vessel and the conception vessel, the stagnation of blood and phlegm and the stagnation of liver qi. The principle of treatment prefers to unblocking the circulation of qi and blood and adjusting the balance between yin and yang. In diagnosis, the unique meridian palpation is adopted. Regarding the treatment of cyclomastopathy, the accompanied needling at Tianchi (PC 1) is recommended in combination with the external application of herbal medicines, presenting the specific characteristics of traditional Chinese medicine.
总结殷克敬教授治疗乳腺增生症的临床经验。殷克敬教授认为乳腺增生症的病机主要为冲任失调、血瘀痰凝、肝郁气滞，治疗应以开宣气血、调整阴阳为原则，独创经络别通诊断法，提出傍刺天池穴配合中药外敷治疗乳腺增生症，特色鲜明。.

OBJECTIVE: To compare the clinical effect of fast needling (without needle retaining), needle retaining acupuncture combined with occupational therapy and simple occupational therapy for hand dysfunction of spastic cerebral palsy in children.
METHODS: A total of 75 children with spastic cerebral palsy were randomly divided into an occupational therapy group (25 cases), a fast needling group (25 cases, 1 case dropped out) and a needle retaining group (25 cases, 1 case dropped out). The patients in the occupational therapy group were only treated with occupational therapy for 20 min each time. The patients in the fast needling group were treated with acupuncture (without needle retaining) combined with occupational therapy, and the needle retaining group was treated with acupuncture (needle retaining) combined with occupational therapy, and acupuncture was taken at Hegu (LI 4), Houxi (SI 3), Yuji (LU 10), Waiguan (SJ 5), Jianyu (LI 15) and so on. The needles were retained for 30 min in patients of the needle retaining group. All the above treatments were performed once a day, 5 times a week for 12 weeks. The scores of fine motor function measure (FMFM) and Peabody developmental motor scale 2 (PDMS-2) were observed in patients of the three groups before and after treatment, and the safety of the fast needling group and the needle retaining group was compared.
RESULTS: After treatment, the scores of FMFM and PDMS-2 in patients of the three groups were higher than those before treatment (P<0.01), and the scores of FMFM and PDMS-2 in the fast needling group and the needle retaining group were higher than those in the occupational therapy group (P<0.05, P<0.01). The incidence of acupuncture abnormalities in the fast needling group was 0.3% (5/1 440), which was lower than 1.4% (20/1 440) in the needle retaining group (P<0.05).
CONCLUSIONS: Acupuncture combined with occupational therapy has better clinical effect than occupational therapy alone in improving hand dysfunction in children with spastic cerebral palsy, and there is no statistical difference in effect between fast needling acupuncture and needle retaining acupuncture, but fast needling has better safety than needle retaining acupuncture.
目的: 比较快针、留针结合作业疗法与单纯作业疗法治疗痉挛型脑瘫患儿手功能障碍的临床疗效。方法: 将75例痉挛型脑瘫患儿随机分为快针组（25例，脱落1例）、留针组（25例，脱落1例）和作业疗法组（25例）。作业疗法组只进行作业疗法治疗，每次20 min。快针组予针刺（不留针）结合作业疗法，留针组予针刺（留针）结合作业疗法，针刺取双侧合谷、后溪、鱼际、外关、肩髃等，留针组留针30 min。以上治疗均每日1次，每周5次，共治疗12周。观察各组患儿治疗前后精细运动评定量表（FMFM）评分、Peabody运动发育量表（第2版）（PDMS-2）评分，比较快针组与留针组针刺安全性。结果: 治疗后，各组患儿FMFM、PDMS-2评分较治疗前升高（P<0.01），快针组和留针组FMFM、PDMS-2评分均高于作业疗法组（P<0.05，P<0.01）。快针组针刺异常情况发生率为0.3%（5/1 440），低于留针组的1.4%（20/1 440，P<0.05）。结论: 针刺结合作业疗法改善痉挛型脑瘫患儿手功能障碍的临床疗效优于单纯作业疗法，且快针与留针疗效无差异，但快针的安全性较留针更好。.

BACKGROUND: The application of photodynamic therapy (PDT) is pivotal in the management of diverse dermatologic conditions. Microneedling (MN) is a minimally invasive tool that is capable of inducing transient pores on the skin to facilitate transdermal drug delivery. Several studies have reported augmentation of PDT combined with MN. This systematic review analyzes the current studies on the efficacy and safety of MN-assisted PDT for skin diseases.
METHODS: The literature search using the PRISMA standard was completed through PubMed, Embase, Web of Science and CENTRAL from the establishment of the databases to November 2023. Two independent researchers finished the procedure.
RESULTS: A total of 12 articles and 413 subjects met our study criteria. This systematic review suggests that MN-assisted PDT can decrease the incubation time required for the photosensitizer and reduce skin lesions of actinic keratosis (AK) . The common side effect is pain and no serious adverse events were reported.
CONCLUSIONS: MN is an effective method to increase the transdermal delivery rate of photosensitizers. For different photosensitizers and disease, MN may show different clinical effects.