The relationship between body mass index, thickness of subcutaneous fat, and the gluteus muscle as the intramuscular injection site

An intramuscular injection (IMI) is an injection given directly into the central area of a specific muscle. Certain medicines need to be administered by the gluteal route for these to be effective. The aim of this study was to determine the influence of body mass index (BMI), subcutaneous fat, and muscular thickness of the dorsogluteal IMI site among healthy Japanese women. There were 39 healthy female subjects who volunteered and met the criteria. Their ages ranged from 40s to 60s (50.82 ± 6.04). With the data collected using the B-mode ultrasound images of the dorsogluteal site, it was found that the distance from the epidermis to the under-fascia (DEUF) of the gluteus maximus was dissimilar between the subject’s right and left buttocks. It was found that the distance from the epidermis to the iliac bone (DEI) was significantly more on the right than on the left buttocks. In the case of an adult Japanese woman with a BMI of 21 or more, the DEUF of the gluteus medius was found to be about 30 mm, and the DEI was approximately 50 mm or more. Based on these findings, it is recommended that a needle length of 38 mm (1.5 inches) can be safely used to administer IMIs to the gluteus medius muscle to effectively and efficiently deliver medications through the IMI route.

Paraspinal Intramuscular Schwannoma: Case Presentation and Literature Review of a Rare Pathology

Background: A pure intramuscular paraspinal schwannoma is extremely rare, with only few case reports in the literature. Due to low frequency, lack of specific clinical signs and symptoms and difficult radiological assessment, the pre-surgical workup leads to a broad differential diagnosis. The aim of the work carried out was therefore to search for evidence of common clinical and radiological signs of the intramuscular paraspinal schwannoma, useful in the diagnostic work-up, and to highlight possible standards of treatment. Methods: Starting from the analysis of our case, we have extended a search to similar cases on the databases PubMed and Google Scholar. The outcome of the analysis gathered, up to August 2021, six relevant papers. Result: We treated a 69-year-old female with a thoracic intramuscular paraspinal mass. The pre-operative MRI had identified two typical signs of schwannoma (“split-fat” sign and the “entry-exit” sign). Intraoperative nerve isolation was performed and complete surgical excision was achieved. At the pathological analysis, we could confirm a rare OMS grade I “ancient schwannoma”. The analysis of the literature data showed a homogeneous picture of radiological presentation of the pathology. Moreover, surgical treatment was always the treatment of choice. Conclusions: The proposed assessment and treatment were consistent with the standard collected in the literature. Typical radiological signs were also found in the other cases collected. Radical surgery is the preferred treatment.

Change of Subcutaneous Tissue Mass at the Deltoid and Thigh Areas in Japanese Infants Followed from 2 to 15 Months

We previously investigated the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone based on measurements taken from the ultrasonic echograms of Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months. The appropriate needle length for intramuscular injection was 16 mm (5/8 inch) in Japanese infants at any age and site. In the present study, we examined these lengths in 21 infants with physical growth from 2 to 15 months. Average height increased from 58.5 to 73.6 cm and average body weight from 5835 to 9226 g until 15 months. The circumference of the thigh increased from 22.3 cm at 2 months to a maximum of 25.9 cm at 6 months, while that of the deltoid area was 15.2 cm at 2 months and 15.9 cm at 6 months. Subcutaneous mass (length from the skin surface to the muscle fascia) at the thigh increased between 3 and 4 months and decreased at 12 - 15 months and showed good relationship to the circumference of the thigh. Subcutaneous mass at the center of the deltoid area showed the same size until 6 months. Muscle mass (lengths from the muscle fascia to the bone) at thigh and deltoid areas remained the same until 6 months. Ultrasonic echogram is an effective tool for evaluating subcutaneous and muscle mass in young infants.

藏鸡FTO基因表达的时空特性及与肌内脂肪含量的相关分析

旨在获得藏鸡FTO基因序列,并分析其生物学特性,阐明其组织及时序表达规律,同时揭示该基因在不同发育阶段肌肉组织中的表达水平与肌内脂肪含量的关系。选取1~210日龄健康藏鸡为试验材料,采集心、肝、脾、肺、肾、胸肌、腿肌和皮下脂肪组织样品,提取组织总RNA,利用RT-PCR方法克隆FTO基因序列,同时利用实时荧光定量PCR检测其在各组织及不同发育阶段的mRNA表达丰度,并将其表达量与肌内脂肪含量进行相关分析。结果表明,获得藏鸡FTO的基因序列长1 585bp(GenBank登陆号:KY366175),其中CDS为1 524bp,5′UTR 35bp和3′UTR 26bp,编码507个氨基酸,具有一个N端结构域和一个C端结构域。藏鸡与原鸡FTO氨基酸相比发生了6个氨基酸突变。FTO基因在藏鸡的各个组织中广泛表达,在脾组织中的表达水平极显著高于其他组织(P<0.01),在脂肪组织和肺组织也存在较高水平的表达。时序表达谱显示,FTO基因在藏鸡胸肌和腿肌具有不同的表达模式,在胸肌中的表达水平随生长日龄的增加呈逐渐下降的趋势,而在腿肌中的表达水平随生长日龄的增加呈先上升后下降的趋势。藏鸡在不同发育阶段,不同肌肉组织中FTO基因表达水平与IMF含量具有不同程度的相关性,其中FTO基因表达水平与藏鸡胸肌IMF含量呈负相关,并且在母鸡中的相关性达到显著水平(P<0.05)。而公鸡FTO基因表达水平与腿肌IMF含量呈正相关(在119~210日龄阶段r=0.601,P<0.05),母鸡则相反。研究结果提示,FTO基因可能在藏鸡生长发育过程中对肌内脂肪沉积起重要调控作用,本试验结果将为藏鸡FTO基因的结构和功能的进一步研究奠定基础。

改良Z-Track肌内注射法在体外受精-胚胎移植病人黄体酮注射中的应用

[目的]探讨改良Z-Track肌内注射法在体外受精-胚胎移植(IVF-ET)病人黄体酮注射中的应用效果。[方法]采用前瞻性随机对照研究方法,将纳入研究的122例IVF-ET病人按照随机数字表法分为观察组和对照组各61例。对照组采用常规肌内注射法,观察组根据病人不同体质指数,采用改良Z-Track肌内注射法。比较两组给药7 d内注射部位不良反应发生情况。[结果]观察组局部硬结发生率显著低于对照组,组间比较差异有统计学意义(χ 2=6.917, P <0.05);观察组疼痛程度显著低于对照组,组间比较差异有统计学意义( Z =6.622, P <0.05)。[结论]根据病人不同体质指数,采用改良Z-Track肌内注射法进行黄体酮臀部肌内注射,可有效减少局部不良反应,确保用药安全。

HPLC-MS/MS法同时测定家兔血浆中5种皂苷成分及药动学研究

目的:建立快速、灵敏的基于固相萃取技术的高效液相色谱-串联质谱(HPLC-MS/MS)方法,同时测定兔血浆中人参皂苷Rg1、人参皂苷Rb1、人参皂苷Rd、人参皂苷Re和三七皂苷R1的浓度,并研究家兔肌内注射血塞通注射液后的药动学特征。方法:采用色谱柱CAPCELL CORE C18柱(150 mm×2.1 mm,2.7μm),以水-乙腈为流动相,梯度洗脱,流速:0.3ml·min^(-1)。采用多重反应监测(MRM)的扫描方式,离子源为ESI源,选择离子对m/z 823.5+→643.4+(人参皂苷Rg1)、m/z 1131.6+→789.4+(人参皂苷Rb1)、m/z 969.4+→789.5+(人参皂苷Rd)、m/z 969.4+→789.5+(人参皂苷Re)和m/z 955.6+→775.4+(三七皂苷R1)用于定量检测,进样量为1.0μl。家兔血浆样本通过固相萃取法(SPE)处理后进样。结果:5种皂苷质量浓度分别在9.43~603.40 ng·ml^(-1)(人参皂苷Rg1)、10.00~640.04 ng·ml^(-1)(人参皂苷Rb1)、4.91~157.32 ng·ml^(-1)(人参皂苷Rd)、4.84~81.89 ng·ml^(-1)(人参皂苷Re)及4.64~148.70 ng·ml^(-1)(三七皂苷R1)范围内线性良好,日内和日间精密度均小于7.80%,各成分提取回收率介于81.75%~106.83%之间,基质效应介于86.57%~97.40%之间。Rg1主要药动学数半衰期(T1/2)=(2.61±1.05)h,药时曲线下面积(AUC0→∞)=(117.41±17.43)μg·ml^(-1)·h,平均滞留时间(MRT0→∞)=(3.48±0.76) h;Rb1主要药动学参数:T1/2=(18.04±6.77) h,AUC0→∞=(2393.82±594.47)μg·ml^(-1)·h,MRT0→∞=(25.28±8.98) h;Rd主要药动学参数:T1/2=(54.52±23.33) h,AUC0→∞=(1 373.61±398.35)μg·ml^(-1)·h,MRT0→∞=(76.64±32.98) h;Re主要药动学参数:T1/2=(2.28±1.24) h,AUC0→∞=(27.27±4.94)μg·ml^(-1)·h,MRT0→∞=(3.47±0.63) h;R1主要药动学参数:T1/2=(2.61±1.05) h,AUC0→∞=(47.14±6.16)μg·ml^(-1)·h,MRT0→∞=(3.55±0.67) h。结论:该方法适用于测定家兔血浆中人参皂苷Rg1、人参皂苷Rb1、人参皂苷Rd、人参皂苷Re、三七皂苷R1的浓度,并提供药动学参数。药动学参数显示5种皂苷成分在家兔体内呈现两种不同的药动学特征。