ABSTRACT
Objective:To compare the accuracy of the needle tip reaching the target tissue between two subcutaneous injection techniques under ultrasound imaging in order to provide a basis for clinical injection to make a safe and reasonable decision.Methods:This was a parallel controlled non-inferiority comparative study. A total of 68 patients who received subcutaneous injections in the outpatient injection room of Nanjing Drum Tower Hospital Affiliated to Nanjing University from June 2021 to September 2022 were selected as the research subjects, and they were divided intothe A and B group according to the random number table method, there were 34 cases in each group. Group A received pinched skin injections, and group B received taut skin injections. Unify the injection site, injection needle length, and needle insertion angle. The accuracy rate of the needle tip reaching the target tissue, namely the subcutaneous fat layer, was compared between the two groups by ultrasound imaging, and the pain scores and the imaging performance during the injection process were observed.Results:The accuracy of the needle tip reaching the subcutaneous fat layer in the group A was 97.1%(33/34), which compared with the 100.0%(34/34) in the group B, there was no significant difference ( χ2 = 0.53, P>0.05). There was no significant difference about the distribution of pain scores between the two groups ( χ2 = 0.67, P>0.05). There were no significant differences about age, subcutaneous fat thickness and the distance from the needle tip to the myofascial in patients with different pain scores ( F = 1.20, 0.44, H = 0.64, all P>0.05). Conclusions:Under certain conditions, pinching the skin and tightening the skin have the same accuracy and safety when the needle tip reaches the subcutaneous fat layer of the target tissue, and the choice should be made according to the clinical situation. Imaging observations have enlightening significance for the practice of subcutaneous injection.
ABSTRACT
The "superficial fascia" is often interpreted as "tendon-membrane like structure" in acupuncture field and it is speculated that acupuncture stimulation-induced structural alteration of the superficial fascia may contribute to the alleviation of many medical conditions. The fact is that the superficial fascia mainly consists of subcutaneous adipose tissue and fibrotic network (which function in storing, supporting and buffering external pressure and are not responsible for producing "Deqi" or "needling sensations"), and has no typical tendon or membrane structure in hypodermis. In the present paper, the author tries to clarify its incorrect translation, misinterpretation, and misunderstanding in acupuncture and propose that the target of acupuncture stimulation is probably not only the subcutaneous soft tissue per se, but also the contents in subcutaneous soft tissue network as the nerves, blood vessels, lymph-vessels, cutaneous accessory structures, mast cells, multiple movable cells, related receptors, etc.
ABSTRACT
Los lipomas son tumores benignos compuestos por células grasas. Ellos son los tumores mesenquimales más comunes. Se encuentran en el tejido subcutáneo y menos frecuente en órganos internos. Usualmente presentan poca dificultad de diagnóstico y morbilidad. Los lipomas típicamente se desarrollan como masas elásticas discretas en el tejido subcutáneo y tejidos blandos profundos en el adulto. Muchos signos cutáneos y algunos síndromes son anatómicamente muy complejos y pueden estar asociados con un lipoma subyacente. Recientemente un número de nuevas entidades y variantes han sido descriptas. Su reconocimiento es importante para evitar el diagnósitco fallido y terapias inapropiadas. Lipoma condroide, miolipoma y lipoma pleomórfico de células ahusadas puramente cutáneo, son neoplasias biológicamente benignas que pueden simular sarcomas morfológicamente. El advenimiento de las investigaciones moleculares y citogenéticas de las neoplasias lipomatosas tienden a contribuir más al entendimiento de la biología de aquéllas y guiar a la modificación de los esquemas de clasificación convencional.
Lipomas are benign tumors componed of mature fat cells. They are the most common benign mesenchymal tumor. Lipomas are found in the subcutaneous tissues and, less commonly, in internal organs. They usually present with little difficulty in diagnosis or morbidity. Lipomas typically develop as discrete rubbery masses in the subcutaneous tissues of the trunk and proximal extremity. Are the most common neoplasms of subcutaneous and deep soft tissues in adults. Most cutaneous signatures and someone syndromes are anatomically more complex and can associated with an underlying lipoma. In recent years a number of "new" entities and variants have been described. Their recognition is important to avoid diagnostic pitfalls and inappropriare therapy. Chondroid lipoma, myolipoma, and purely cutaneous spindle-cell/pleomorphic lipoma are biologically benign neoplasms which may mimic sarcomas morphologically. The advent of cytogenetic and molecular investigations of lipomatous neoplasms has contributed to a better understanding of the biology of these neoplasms and led to a modification of conventional classification schemes.