{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:33:20Z","timestamp":1792100000114,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although the general functionality and structures of acupoints have been studied, there has been little insight into their underlying morphology and physical characteristics. We describe the microanatomical structures surrounding acupoints, the electron microscopic appearance of the needles, and the physical effects of acupuncture needling on the fascia. We injected heparinized blood solution through thin needles at seven known and commonly used \u201csweat acupoints\u201d in eight fresh, unembalmed, cryopreserved human cadavers to mark the needle positions, and later, during histological examination, to identify them. After the solution was injected, samples were dissected and prepared for histological examination. We examined 350 cross\u2010sections of five different paraffin wax sections from each acupoint microscopically. Acupuncture needles were photographed and superimposed on the cross\u2010sectioned tissues at similar magnifications. Needles were also examined under a scanning electron microscope to judge the roughness or smoothness of their surfaces. A greater conglomeration of nerve endings surrounded the acupoints than in tissues more than 1\u20133\u2009cm distant from them. Nerve endings and blood vessels were in close contact with a complex network of membranes formed by interlacing collagen fibers, and were always enclosed within those collagen membranes. Nerve endings were found within hypodermis, muscles, or both. Scanning electron microscopy demonstrated the three\u2010dimensional shapes and sizes of the needles, and the degree of roughness or smoothness of their polished external surfaces. We demonstrate a delicate arrangement of nerve endings and blood vessels enclosed within complex collagen membrane networks at acupoints within the hypodermis and muscle. This arrangement could explain why needling is an essential step in the acupuncture process that provides favorable outcomes in clinical practice.<\/jats:p>","DOI":"10.1002\/ca.23845","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T07:04:01Z","timestamp":1643871841000},"page":"392-403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Microscopy of structures surrounding typical acupoints used in clinical practice and electron microscopic evaluation of acupuncture needles"],"prefix":"10.1002","volume":"35","author":[{"given":"Vanessa","family":"Intriago","sequence":"first","affiliation":[{"name":"Department of Clinical Medical Sciences CEU\u2010San\u2010Pablo University School of Medicine  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9078-1020","authenticated-orcid":false,"given":"Miguel A.","family":"Reina","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences CEU\u2010San\u2010Pablo University School of Medicine  Madrid Spain"},{"name":"Department of Anesthesiology Madrid\u2010Montepr\u00edncipe University Hospital  Madrid Spain"},{"name":"Acute and Perioperative Pain Medicine, Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida USA"},{"name":"Facultad de CC de la Salud Universidad Francisco de Vitoria  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-1214","authenticated-orcid":false,"given":"Andr\u00e9 P.","family":"Boezaart","sequence":"additional","affiliation":[{"name":"Acute and Perioperative Pain Medicine, Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida USA"},{"name":"Lumina Health Pain Medicine Collaborative  Surrey UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-1047","authenticated-orcid":false,"given":"Richard Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Anatomical Sciences St. George's University  St. George's West Indies"},{"name":"Department of Structural and Cellular Biology Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Neurosurgery and Ochsner Neuroscience Institute Ochsner Health System  New Orleans Louisiana USA"},{"name":"Department of Neurology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana V.","family":"Monta\u00f1a","sequence":"additional","affiliation":[{"name":"Facultad de CC de la Salud Universidad Francisco de Vitoria  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"P\u00e9rez\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Pathology Madrid\u2010Montepr\u00edncipe University Hospital  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Sanroman\u2010Junquera","sequence":"additional","affiliation":[{"name":"Department of Signal Theory and Communications, Telematics, and Computing Systems Rey Juan Carlos University  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bem.20403"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0011907"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6882-5-10"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-32048-3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-13-0971-7_1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-5275-1_1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.b.33006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-3357-6_3"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194022"},{"key":"e_1_2_7_11_1","first-page":"43","volume-title":"Acupuncture. 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