| Objective: The use of sodium deoxycholate for Fat-FAT-DISSOLVING has been an effective means of treating local fat accumulation.However,adverse reactions like numbness,swelling,pain and subcutaneous induration often occur at a higher incidence and last a long time,which affects the satisfaction of the patients.The study is designed to observe the lipolysis effects and adverse reactions of Sodium Deoxycholate in combination with Triamcinolone Acetonide as injection lipolysis treatment and preliminarily explore the feasibility of alleviating the adverse reactions after lypolysis.Method: Twenty-eight healthy New Zealand laboratorial rabbits were divided into 4 groups by random number table with 7 rabbits in each group: SD group(Sodium Deoxycholate),TA group(Triamcinolone Acetonide),SD+TA group(Sodium Deoxycholate + Triamcinolone Acetonide),and Blank group(Sterile Water for Injection)group.The experiment adopted the methods of self control,group control and blank control.The self control took the spine as the center line,then,the left side of the spine was regarded as the experimental side(injection of corresponding drugs)and the right side was considered as the control side(injection of the same amount of normal saline as that in experimental side).The respective drug for each group was injected into the adipose tissue at medial inferior border of New Zealand white rabbits' bilateral scapula.A total of two injections(day 0 and day 14)shall be given,and each treatment cycle was 2 weeks and the experimental observation lasted for 28 days.Day 0,1,3,7,14,and 28 were chosen as time points for gross and histopathological observations;Day 0,1,3,28 were chosen as time points for the analysis of related blood biological indicators;Day 0,14,28 were chosen as time points for ultrasound observation.At last,the thickness,elasticity and hardness of adipose tissue in the injection site in each treatment group and the blank control group were compared.SPSS23.0 statistical software was used for statistical analysis of data.The measurement data are first tested for normality and the data conforming to the normal distribution are represented by x ±s.T-test was used to compare two groups and one-way variance Ftest was used to compare the multiple groups.The difference of was statistically significant(P<0.05).Result: No changes in living habits or eating habits,and no behavior changes such as restlessness and listless were observed in any animals of each treatment group during the experiment.No skin ecchymosis or ulceration was observed in any animals of each treatment group.In the SD group: a slight edema was observed in local injection site of the experimental side,which naturally faded after lasting for two days.On Day 7-14,the softness of subcutaneous tissue decreased persistently and appeared significant fibrotic changes;on day 28,the relatively well-defined nodules of moderate hardness were palpable at injection site.In the SD + TA group: there was no visible swelling in the injection site.The subcutaneous tissue in the injection site was soft on Day 7-14.On Day 28,the relatively well-defined nodules of moderate hardness were palpable at injection site.In the TA group and the Blank group,no changes in skin color were observed after injection;and there were no visible local swelling of the injection site,no significant changes in subcutaneous tissue hardness or no palpable induration.About the thickness of adipose tissue: on Day 28,the average thickness of the fat layer on the experimental sides in SD group and SD+TA group was respectively reduced from 6.2±0.5mm and 6.3±0.3mm before the injection to 3.3±0.4mm and 3.5±0.3mm after the injection,so the thickness of adipose tissue significantly became thin compared with their control side(P<0.01),but there was no obvious difference in terms of the degree of decline(t=0.525,P=0.827);In the TA group and the Blank group,there was no significant changes in the fat layer in the experimental side after injection(P>0.05).About elasticity of adipose tissue(hardness): on Day 28,the mark of the elasticity(hardness)of fat layer in the experimental side of SD group and SD+TA group increased at varying degrees compared with that before injection(P<0.01).The mark of the elasticity(hardness)of fat layer in the experimental side of SD group rose from 1.0 to 4.0 and the mark of the elasticity(hardness)of fat layer in the experimental side of SD+TA group was raised from 1.0 to 3.3,so these two groups increased significantly compared with their own control side(P<0.01),but more significant in SD group(t=3.592,P < 0.05);The mark of the elasticity(hardness)of fat layer in the experimental side of TA group slightly rose compared with that before injection,from 1.0 to 1.3 and no statistical significance was found in the result(P>0.05);The mark of the elasticity(hardness)of fat layer in the experimental side of Blank group did not change after injection,remaining 1.0.About histopathology: In SD group: on Day 1-3,microscopy showed necrosis of fat cells and bursting of cell membranes in a small area,which fused with each other and formed several irregular vacuoles.Large amount of inflammatory cells infiltrated in the injection site and some fat cells in the inflammatory reaction margin shrunk and deformed,and lost their original morphology.On Day 3-7,the normal tissue structure of the fat layer in the injection area was obviously destroyed,and a large range of fat cells were necrotic,lost and fused to form huge vacuoles.On Day 14,there was significant fibrosis signs in the injection site.Meanwhile,the interval between the fat layer fibers was thickened and the infiltration degree of inflammatory cells in the injection site were alleviated.On Day 28,the interval between the fat layer fibers continued thickening,necrotic adipose tissue was replaced by collagen fibers and the proliferated fibrous tissue was filled in the remaining adipose tissue.In the SD+TA group,the microscopic changes was similar to that of the SD group.The fat cells ruptured and were necrotic and fused into vacuoles,but the degree of inflammatory cell infiltration at the earlier stage and fibrous tissue proliferation at the late stage were all significantly weaker than that in SD group.In TA group,Microscopic examination showed a small number of fat cells in the injection site shrunk,but there was no fat cells necrosis or loss,and no obvious changes in morphology of original normal tissue.On Day 28,the morphology of most adipose tissue cells in the injection site returned to normal,and a very small amount of fibrous tissue proliferation was observed.In BLANK group,Microscopic examination showed adipose tissue structure was normal and there was no obvious change.Blood and biological indexes measurement: On Day 1,3,7 and 28,blood samples were collected from the marginal ear veins to measure blood routine and serum biochemical indexes in each group(alanine aminotransferase,glutamic oxaloacetic transaminase,total bilirubin,direct bilirubin,indirect bilirubin,lactate dehydrogenase,creatine kinase,total cholesterol,triglyceride,blood glucose,C-reactive protein)and there was no significant difference in the results(P>0.05).Conclusion: Sodium deoxycholate subcutaneous injection can cause the necrosis of adipose tissue cells,produce obvious inflammatory response in local position and significantly increase fiber content in subcutaneous tissue.Triamcinolone acetonide can obviously decline the degree of fibrosis caused by sodium deoxycholate by inhibiting inflammation,but it did not have a significant impact on lypolysis. |
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