This study focuses on the core pathology of sinew wei （痿）， which is mainly characterized by the fai-lure of qi and blood to nourish the sinews. A mechanical-biological response framework is constructed with mitochondria as a key component， explaining the modern interpretation of the disease location of sinew transmitting to qi and blood pathology. Mechanical loading， as a physical stress stimulus applied to the body， manifests primarily as passive loading formed by external forces such as massage， and active loading resulting from voluntary muscle contractions， such as dao yin （导引）. Mechanical loading can regulate mitochondrial function through two pathways， mechanical signal transduction and metabolic demand-driven regulation. Skeletal muscle mitochondrial dysfunction is regarded as the core microscopic basis of qi imbalance in sinew wei， highlighting the intrinsic connection between qi and mitochondrial energy metabolism， as well as between blood and microcirculatory efficiency. Accordingly， distinct regulatory patterns of mechanical loading are identified. Wei associated with qi stagnation may correspond to mitochondrial network fragmentation and can be treated by regulating qi through passive loading， such as tuina， to restore mitochondrial dynamics. In contrast， wei caused by qi deficiency is attributed to insufficient mitochondrial biogenesis and may be treated by tonifying qi through active loading， such as dao yin， to promote mitochondrial biogenesis. This framework reveals the biological differences in mitochondrial regulation induced by distinct mechanical loading modalities and provides a microscopic mechanism-based explanation for the principle of "treating the same disease with different methods" in sinew wei.

Objective To systematically investigate biomechanical characteristics of one-finger Zen push method applied at the Fengchi acupoint under different force conditions,in order to provide precise quantitative data and enhance the treatment efficacy.Methods Ten senior Tuina practitioners were recruited.The German Novel Pliance-X 32 Expert dynamic pressure distribution system was used to record the mechanical parameters during the application of one-finger Zen push at the Fengchi acupoint under three force intensities:light,medium,and heavy,for 3 minutes.Data from the stable 1-minute segment of the mechanical output was selected for data analysis,and key biomechanical parameters such as the maximum force,average force,peak pressure,mean pressure,force-time integral(FTI),pressure-time integral(PTI),and operational frequency were evaluated.Results Under light,medium,and heavy force conditions,the mean maximum force applied by senior Tuina practitioners at the Fengchi acupoint were 6.31,9.45,and 18.27 N,respectively,while the mean force were 3.31,5.64,and 9.05 N,respectively.The mean peak pressures were 26.10,34.80,and 70.00 kPa,while the mean pressures were 11.95,21.00,and 26.15 kPa,respectively.The mean FTIs were 55.65,182.10,and 225.21 N·s,and the mean PTIs were 167.10,489.59,and 795.83 kPa·s,respectively.The mean operational frequencies were 156.00,150.60,and 154.80 times/min,respectively.Conclusions Ten senior Tuina practitioners showed a high degree of consistency between their subjective definitions of light,medium,and heavy force and the objectively measured mechanical parameters.This reflected their precise control over the applied force under different force conditions,verifying the practicality and reproducibility of the one-finger Zen push method in clinical applications.This study provides a reliable basis for quantitative research and development of standardized clinical operation guidelines.

Objective To systematically investigate biomechanical characteristics of one-finger Zen push method applied at the Fengchi acupoint under different force conditions,in order to provide precise quantitative data and enhance the treatment efficacy.Methods Ten senior Tuina practitioners were recruited.The German Novel Pliance-X 32 Expert dynamic pressure distribution system was used to record the mechanical parameters during the application of one-finger Zen push at the Fengchi acupoint under three force intensities:light,medium,and heavy,for 3 minutes.Data from the stable 1-minute segment of the mechanical output was selected for data analysis,and key biomechanical parameters such as the maximum force,average force,peak pressure,mean pressure,force-time integral(FTI),pressure-time integral(PTI),and operational frequency were evaluated.Results Under light,medium,and heavy force conditions,the mean maximum force applied by senior Tuina practitioners at the Fengchi acupoint were 6.31,9.45,and 18.27 N,respectively,while the mean force were 3.31,5.64,and 9.05 N,respectively.The mean peak pressures were 26.10,34.80,and 70.00 kPa,while the mean pressures were 11.95,21.00,and 26.15 kPa,respectively.The mean FTIs were 55.65,182.10,and 225.21 N·s,and the mean PTIs were 167.10,489.59,and 795.83 kPa·s,respectively.The mean operational frequencies were 156.00,150.60,and 154.80 times/min,respectively.Conclusions Ten senior Tuina practitioners showed a high degree of consistency between their subjective definitions of light,medium,and heavy force and the objectively measured mechanical parameters.This reflected their precise control over the applied force under different force conditions,verifying the practicality and reproducibility of the one-finger Zen push method in clinical applications.This study provides a reliable basis for quantitative research and development of standardized clinical operation guidelines.

ObjectiveTo investigate the analgesic effect of Tuina at the "Weizhong （BL 40）" on neuropathic pain in a rat model of chronic constriction injury （CCI） of the sciatic nerve and its potential central spinal mechanisms. MethodsThirty-two Sprague-Dawley rats were randomly divided into four groups （8 rats in each group）， sham-operated group， model group， Tuina group， and blockade group. The CCI model was established in the model group， Tuina group， and the blockade group by ligating the sciatic nerve with catgut， while the sham-operated group underwent only sciatic nerve exposure without ligation. From postoperative day 4 to day 14， rats in the Tuina group and the blockade group received Tuina manipulation at the "Weizhong （BL 40）" using a dynamic pressure distribution measurement system （5 N pressure， 2 Hz frequency， 10 min per session， once daily）. The blockade group also received intraperitoneal injections of the microglial inhibitor minocycline （10 mg/kg） once daily. The sham-operated and the model group underwent the same handling and fixation as the Tuina group without actual Tuina. Mechanical withdrawal threshold （MWT） and paw withdrawal latency （PWL） were measured before surgery and on day 3， 7， 10， and 14 post-surgery. Transmission electron microscopy was used to evaluate sciatic nerve injury and repair， measuring axon diameter and total myelinated fiber diameter to calculate the g-ratio. Western Blotting was performed to detect the protein levels of ionized calcium-binding adapter molecule 1 （Iba-1）， CD206， CD68， interleukin-10 （IL-10）， and β-endorphin （β-EP） precursor pro-opiomelanocortin （POMC） in the ipsilateral spinal dorsal horn. ResultsCompared with the sham-operated group， the model group showed significantly reduced MWT and PWL on day 3， 7， 10， and 14 （P＜0.01）. Compared with the model group， the Tuina group and the blockade group showed increased MWT and PWL on day 10 and 14 （P＜0.05）. Compared with the Tuina group， the blockade group exhibited higher MWT on day 7， 10， and 14， and higher PWL on day 10 （P＜0.05）. Sciatic nerve pathological morphology revealed intact and well-structured myelin in the sham-operated group， while the model group exhibited myelin collapse， distortion， and myelin ovoid formation. The Tuina group displayed partially irregular myelin with occasional myelin collapse， whereas the blockade group exhibited partial myelin irregularities and phospholipid shedding. Compared with the sham-operated group， the model group showed a decreased g-ratio and increased levels of Iba-1 and CD68 in the spinal dorsal horn （P＜0.05 or P＜0.01）. Compared with the model group， the Tuina group and the blockade group exhibited an increased g-ratio and reduced Iba-1 and CD68 levels. Additionally， the Tuina group showed elevated levels of CD206， IL-10， and POMC， whereas the blockade group had decreased CD206 levels （P＜0.05）. ConclusionTuina at "Weizhong （BL 40）" alleviates neuropathic pain in CCI rats， potentially by regulating microglial activation in the spinal cord， inhibiting M1 polarization while promoting M2 polarization， and activating the IL-10/β-EP pathway to exert analgesic effects.

Objective To study the characterization of surface electromyographic signals of upper limb force-generating muscles operated by rolling manipulation of Tuina doctors.Methods Surface electromyographic signals during rolling manipulation were collected from beginners and proficient operators for comparative analysis,and the patterns,similarities,and differences were summarized.Results The iEMG ratio of the ulnar lateral wrist extensor muscle in the proficient group was significantly higher than that in the beginner group(P＜0.05),while that of the middle deltoid fascicle in the beginner group was significantly higher than that in the proficient group(P＜0.05).There was no statistical difference in the iEMG ratios of other muscle groups(P＞0.05).The proficient group mainly used the ulnar wrist extensors,lateral head of triceps brachii,pectoralis major,and ulnar wrist flexors,while the beginner group mainly used the lateral head of triceps brachii,pectoralis major,and radial wrist flexors.Conclusions The proficient group and the beginner group shared common features in the electromyographic signals of the rolling manipulation.The proficient group increased the angle of ulnar deviation by recruiting more ulnar wrist extensors to increase the angle of palmar flexion and the dorsal contact area of the hand,and the proficient group used the middle and posterior deltoid fasciculus muscles less intensively and mastered the'sinking shoulder'principle better.

Objective To study the characterization of surface electromyographic signals of upper limb force-generating muscles operated by rolling manipulation of Tuina doctors.Methods Surface electromyographic signals during rolling manipulation were collected from beginners and proficient operators for comparative analysis,and the patterns,similarities,and differences were summarized.Results The iEMG ratio of the ulnar lateral wrist extensor muscle in the proficient group was significantly higher than that in the beginner group(P＜0.05),while that of the middle deltoid fascicle in the beginner group was significantly higher than that in the proficient group(P＜0.05).There was no statistical difference in the iEMG ratios of other muscle groups(P＞0.05).The proficient group mainly used the ulnar wrist extensors,lateral head of triceps brachii,pectoralis major,and ulnar wrist flexors,while the beginner group mainly used the lateral head of triceps brachii,pectoralis major,and radial wrist flexors.Conclusions The proficient group and the beginner group shared common features in the electromyographic signals of the rolling manipulation.The proficient group increased the angle of ulnar deviation by recruiting more ulnar wrist extensors to increase the angle of palmar flexion and the dorsal contact area of the hand,and the proficient group used the middle and posterior deltoid fasciculus muscles less intensively and mastered the'sinking shoulder'principle better.

Objective To study changes in the kinematics and joint coordination of the shoulder,elbow,and wrist joints during rolling manipulation performed by Tuina doctors.Methods The kinematic data of 10 beginners and 10 proficient Tuina doctors performing rolling manipulation were collected using a Vicon three-dimensional(3D)motion capture system,and the differences in movement patterns of the shoulder,elbow,and wrist joints between the two groups during Tuina rolling manipulation were compared.Results There was no difference in the elbow joint activity angle between the beginner group and proficient group during rolling manipulation(P＞0.05),and the main differences were in the angles of wrist flexion/extension and shoulder adduction/abduction.The proficient group had a smaller shoulder adduction/abduction angle(P＜0.05),and the maximum angle of palmar flexion of the wrist joint in the proficient group was significantly greater than that of the beginner group(P＜0.05).Conclusions The main kinematic characteristics of rolling manipulation are flexion/extension of the wrist and rotation of the elbow and shoulders.Rolling manipulation is mainly the composite movement of forearm rotation and wrist flexion/extension.The essential'sinking shoulder'operation was better mastered by the proficient group.

Objective:To observe the effects of rolling manipulation with different durations on erector spinae muscle tonus and low back pain in patients with lumbar muscle strain and to explore the best duration for rolling manipulation in treating lumbar muscle strain. Methods:A total of 75 patients who met the inclusion criteria were randomized into a 5-minute rolling manipulation group,a 10-minute rolling manipulation group,and a 15-minute rolling manipulation group using the random number table method,with 25 cases in each group.All three groups were treated with the same rolling manipulation,while the treatment time was 5 min,10 min,and 15 min,respectively.The treatment was performed 3 times a week for 2 consecutive weeks.The muscle tonus of bilateral erector spinae and visual analog scale(VAS)score for low back pain were compared among the three groups before and after treatment. Results:A total of 63 patients completed the study.Before treatment and after the last treatment,there were no statistical differences in the muscle tonus of the left erector spinae and right erector spinae among the three groups(P>0.05).After the last treatment,bilateral erector spinae muscle tonus dropped compared with the baseline in all three groups(P<0.01).Before treatment and after the last treatment,there were no significant differences in comparing the low back pain VAS score among the three groups(P>0.05).After the last treatment,the VAS score for low back pain in all three groups decreased(P<0.01). Conclusion:Under the condition that the forward swing force is 50-70 N,the backward swing force is 20-40 N,and the frequency is 138 times/min,the 5-minute rolling manipulation can significantly reduce the muscle tonus of erector spinae and relieve low back pain.

Objective:To observe the effect of Yi Jin Jing(Sinew-transforming Qigong Exercises)intervention on anxiety in asymptomatic patients with Corona Virus Disease 2019(COVID-19)infection during quarantine.Methods:A total of 160 asymptomatic patients with COVID-19 infection were stratified by gender and divided into an observation group and a control group by the stratified randomization method,with 80 cases in each group.The control group was given basic nursing in the cabin,and the observation group was given additional Yi Jin Jing exercises once a day,20 min each time,and trained continuously until 1 d before leaving the cabin.The Hamilton anxiety scale(HAMA)score was compared between the two groups.Results:A total of 154 cases were included for data analysis in this study,including 74 cases in the observation group and 80 cases in the control group.After intervention,the HAMA scores in both groups increased(P<0.05),while the score in the observation group was lower than that in the control group(P<0.05).In the control group,the HAMA score of females after intervention was higher than that of males.The scores of mental anxiety and somatic anxiety in both groups were higher than those before intervention,while the score of mental anxiety in the observation group was significantly lower than that in the control(P<0.05).However,there was no statistical difference in the somatic score between the two groups(P>0.05).Conclusion:Patients with COVID-19 infection will get anxious during quarantine.Yi Jin Jing exercise can effectively reduce the aggravation of anxiety in asymptomatic patients with COVID-19 infection during concentrated quarantine.

The article analyzes chief physician SUN Wuquan's empirical characteristics in treating neck-type cervical spondylosis:disease differentiation combined with pattern differentiation,emphasizing the assessment of tendons and bones,with DING's Tuina(Chinese therapeutic massage)manipulations and static Gongfa(Qigong exercise)as the predominant treatment,inherits the academic features of DING's Tuina school,"paying equal attention to tendons and bones,putting function first";thus provides a reference for treating neck-type cervical spondylosis with Tuina therapy.