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 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 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 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.

Objective: To explore the clinical efficacy of spine subtle adjusting manipulation for postpartum low back pain (PLBP). Methods: A total of 76 patients with PLBP were randomized into a control group and a treatment group, with 38 cases in each group. The control group was treated with core muscle strengthening exercises, and the treatment group was treated with spine subtle adjusting manipulation. After 3 weeks of treatment, the clinical efficacy was observed, and the visual analog scale (VAS) score and Oswestry disability index (ODI), and the changes of lumbar Cobb angle and pelvic rotation were compared between the two groups. Results: The total effective rate of the treatment group was 92.1％, and that of the control group was 78.9％. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS score and ODI in both groups decreased, and the intra-group differences were all statistically significant (P<0.05). There were no intra-group statistical differences in the lumbar Cobb angle or pelvic rotation in the two groups (P>0.05). After treatment, there were no statistical differences in the lumbar Cobb angle or pelvic rotation between the two groups (P>0.05); the VAS score and ODI in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion: Spine subtle adjusting manipulation can effectively relieve the pain for patients with PLBP, and improve their daily activity function.

Objective To study changes in kinematics and joint coordination of the waist and hips during sit-to-stand and stand-to-sit tasks in patients with lumbar disc herniation (LDH). Methods The Vicon 3D motion capture system was used to collect the kinematics data from 20 healthy controls and 20 LDH subjects, and differences in movement patterns of the lumbar spine and hip joints during sitting and standing tasks were compared between two groups through statistical parametric mapping (SPM). Results During sit-to-stand task, the lumbar spine flexion and extension range and hip joint abduction angle of LDH subjects were significantly limited, and the hip flexion angle increased. SPM analysis showed that for both groups at initial stage of sit-to-stand (10%-13%), there was a statistically significant difference in flexion angle of the lumbar spine, and lumbar flexion angle of LDH subjects was significantly reduced, while hip flexion angle at 2%-14% phase was significantly increased. During stand-to-sit phase (65%-69%), LDH subjects showed increased hip abduction angle. Conclusions LDH subjects have limited lumbar flexion and hip abduction functions during sitting and standing, and they need to be compensated with increased hip flexion activities to complete functional tasks. In clinical evaluation, changes in motor function of the spine and hips should be focused on.

Objective To explore the clinical value of 3-dimensional digital subtraction angiography(3D-DSA)in the diagnosis and therapy of intracranial aneurysms.Methods 2-dimensional digital subtraction angiography (2D-DSA)and 3D-DSA was performed respectively on 1 53 patients,including 1 5 1 cases with spontaneous subarachnoid hemorrhage (SAH),1 case with headache and 1 case with cerebral infarction;Meanwhile,to compare the difference in diagnosis of intracranial aneurysms between 2D-DSA and 3D-DSA.Results 1 12 patients(125 pieces)with intracranial aneurysms were detected on 2D-DSA,its detecting rate was 73.2%(1 12/1 53 );136 patients(1 52 pieces)with intracranial aneurysms were detected on 3D-DSA,its detecting rate was 88.9%(136/1 53)(χ2 =12.254,P <0.05).The displaying rate of 3D-DSA for the relationship between carrying tumor artery and aneurysms and the necks of aneurysms was 100%(1 52/1 52),however,the displaying rate of 2D-DSA for that was 61.6%(77/125)(χ2 =63.993,P <0.05). Conclusion 3D-DSA can improved the diagnostic accurate rate of intracranial aneurysms,it is important in chosing the therapeutic regimen.

Total knee replacement surgery is commonly used in end-stage diseases of the knee. It is important for improving surgical efficacy and patient satisfaction by promoting early rehabilitation of patients and improving knee function.

Objective: To observe the effect of acupuncture and Chinese mina manipulation therapy in treating knee osteoarthritis, and analyze the alteration of musculus quadriceps femoris strength.Methods: A total of 80 patients were randomly assigned to a treatment group receiving acupuncture combined Chinese tuina manipulation therapy (n=40) and a control group receiving Fenbid treatment (n=40), curative effective score, Lequene & Mery assessment tests, and isokinetic evaluation were recorded before and after the treatment course. Results: The total effective rate was 90.0 % in the treatment group and 87.5% in the control group, without a significant difference between the two groups. Lequene & Mery assessment tests had no significant change. Musculus quadriceps femoris isokinetic evaluation improved significantly after the treatment course in the two groups (P＜0.05), and there was a significant difference between the two groups (P＜0.05). Conclusion: Acupuncture combined with tuina manipulation therapy and Fenbid treatment both can reduce knee pain and joint disability in the short term, though no improvement was shown in the severity of the disease.Acupuncture combined with mina manipulation therapy is better than Fenbid in improving the strength, total work and explosive force of the musculus quadriceps femoris.