| Background:Impact injuries are one of the most common acute skeletal muscle injury(ASMI)types in clinical practice.The pathogenesis of skeletal muscle impact injury(SMII)has not yet been clearly elucidated due to differences in the environment,the size and direction of the force,and limb state during impact injury.E specially in the event of fracture or neurovascular injury,skeletal muscle injury is often neglected or placed in a secondary position.Incomplete repair after skeletal muscle injury,such as fibrosis and chronic inflammation,often leads to limb pain and dysfunction.Sequelae such as incomplete functional recovery have become major challenges and challenges in the clinic.The study of the pathogenesis of skeletal muscle impact injury needs to be based on a good impact injury model.A large number of experimental models have been established to suit different research purposes.However,the experimental models for simulating,describing,and evaluating SMII systems are still inadequate.In particular,studies related to mechanical impact reactions to the pathogenesis of impact injuries themselves are still lacking..Chinese medicine has a long history and rich practical experience in the treatment of bruises(SMII),and has established a perfect disciplinary system.For ASMI,the traditional Chinese medicine for orthopedic trauma uses Qi and blood as the core repairing feature of the pathogenesis,and often uses the treatment strategy of the three phases of syndrome differentiation;with the principle of "reconciling Qi and Blood","different treatment of tendon injury based on Qi and blood are essential".However,in the ASMI model with different degrees of injury,and the differences in the inflammatory response,proliferative repair,and alternative remodeling shown by the body,it is required that the syndrome differentiation of Chinese medicines reveals Qi in this context.The interpretation of theoretical doctrines and the guiding role of clinical decision-making;Providing discourse perspectives for the therapeutic strategies and modernization of Chinese medicine,that is,providing the modernity of traditional Chinese medicine for the cognition and treatment of skeletal muscle injury,rather than,which has been suspended compared with the development of modern technology.Objective:To explore the modern discourse system of Qi theory and provide a new perspective for the diagnosis and treatment of diseases by Chinese medicine.To establish a stable and effective SMII model system,the relationship between the impact response,mechanical conduction and tissue damage of the external forces on rat gastrocnemius muscles(GM),and the histopathological features and fibrosis progression during repair of different degrees of injury of the GM were analyzing.Using the description and evaluation of the impact injury model system(IIMS),in the pathogenesis of "Qi",the converging points of integrative Chinese and western medicine treatment of skeletal muscle injury at the level of cognition and diagnosis were discussed;which make the injury model system provides theoretical and practical basis for further experimental research.Method:Theoretical discussion:Starting from the cognitive model of "Qi" and using the method of analytic philosophical referential and phenomenological intentional reduction,combining "Qi" as the Chinese character's own characteristics,exploring the form and content of the "Qi" words;and from this perspective,attempts to modernize the interpretation of Qi's related theories.Experimental study:1.Measure and compare the anatomic relationship between rat gastrocnemius and tibia,and then explore the geometrical dynamic characteristics of the rat's lower leg;According to the anatomical kinetic characteristics of the rat's lower leg,carry out the design of wood support shield and impact injury,and the technical improvements to the SMII modeling system.2.According to the impact energy of different parameters,to determine whether the impact energy and impact response(including:peak force,maximum velocity,pulse width,displacement,impulse,and absorbed energy,etc.)are related to the severity and how to correlate,to determine the stability of the SMII modeling system and mechanical properties of the impact response.3.Rat GM model was used to investigate whether the impact energy,mechanical characteristics and severity of gastrocnemius muscle injury induced by different parameters of injury energy(1.18J:G1kg24cm,2.35J:G0.5kg48cm,G1kg24cm,G2kg12cm,4.71J:G1kg48cm)related with each other and how there is relationship;and the difference in impact response of gastrocnemius muscles in ex vivo and in vivo conditions also have be explored.4.Through the observation of the functional recovery of the injured rat limb,the histomorphological change of muscle fiber damage,and the degree of fibrosis at different time points(1,3,7,14,35,and 56 days after the impact injury),In combination with the mechanical characteristics of impact injuries,the effects of different severity of gastrocnemius impact injury models on the time course of tissue repair,muscle fiber regeneration,and functional recovery was explored.Results:Theoretical discussion:Through the analysis of the affair of the "Qi" word referent,this paper expounds the cognitive model of "xiang-fact-truth" corresponding to"word-meaning-referent" under the traditional thinking of Qi,in which the grasp of "Qi" as state of affairs of spatiotemporal sequence(SASTS)is mainly manifested as the organization form of phenomenon flow and spatial experiential flow,and thus form objects,such as basic state of affairs and complex state of affairs.Experimental studies:1.the target area of experimental GM is located in the weak region of rat tibial geometry and mechanical conduction;and there are multiple muscular and bony dynamic triangle structures,as buffer space in rat calf for skeletal muscle trauma;accordingly,this study improved the Drop-mass technique(DMT)and designed an impact injury modeling system that includes a wood-supported shield.2 The wooden platform was used as the test object,and the differences and correlations of various variables in different degrees of impact responses were analyzed.It was confirmed that the peak impact force determined the impact interval(P<0.05),the pulse width was negatively correlated with the impact strength(P<0.05),and the impulse was the most effective indicator(P<0.05),and the energy absorbed was the most effective indicator of the damage of the impact of the test(P<0.05).At the same time,the strength of the impact response follows the law of conservation of energy and momentum,and has its own characteristics;compared to the increase in speed,the mass of the impact weight has a greater impact on the impact results.3.with the increase of encephalic injury caused by GM injury,the stronger the impact response,the more severe the degree of skeletal muscle injury(P<0.05).According to the injury of the membranous structure of the endomysium,perimysium,epimysium and deep fascia,combined with the distribution characteristics of the force transmission and the morphological observation of the injury,the GM injury can be classified into three levels of different degrees of injury(moderate injury).The model shows three types of subtypes according to the condition of muscle fiber breakage.The distribution of mechanical conduction(squeeze area,shear area,and distraction area)corresponds to the characteristics of damage subarea(core area,alternating area,and marginal area).In the impact modeling system,comparing ex vivo,the GM was more rigid,and the impact reaction was slightly stronger in vivo(P<0.05),but there was no difference in tissue damage between the two groups(P>0.05).4 With the increase of the injury degree of the GM impact injury model,the recovery of limb motor function became worse(P<0.05),histopathological changes,and the degree of fibrosis in the different time intervals after injury became worse too(P<0.05).The relationship between microstructure damage and impact response,mechanical conduction characteristics,and anatomical observations was explained.The division index description of SM? showed different time-series differences during injury repair(P<0.05),indicating that the "secondary repair" reaction in the core area of severe injury model was the pathology leading to incomplete functional recovery.At the same time,the pathological repair outcome of the severe injury model showed fibrosis,fat replacement,atrophy and other types.Conclusion:1.The conceptual reference of "Qi" with the connotation of SASTS makes the term related to "Qi" present a hierarchical extension system from the same perspective,and provides a new approach for the research and application of TCM theory.2.Based on DMT,the improved IIMS shows the stability of the mechanical properties of the impact response;impact energy parameters of the different make the decisions of the uniqueness of the impact response.3.The model of GM impact injury that was replicated by the IIMS was stable,accurate and mature,and effectively eliminated bone factors.At the same time,the increase of muscle tension and stiffness can effectively reduce the impact reaction and have a certain protective effect.4.Combining the distribution and partitioning of external force transmission is more conducive to the description and assessment of the degree of skeletal muscle injury,and provides different levels of model characterization for the IIMS,such as muscle breakage,muscle bundle breakage,muscle fiber breakage,Collagen fibers tear,elastic deformation and microstructure damage.These provide a theoretical basis and experimental basis for the in-depth study of skeletal muscle injury.5.This experiment found the "secondary impact" and its characteristics in the impact modeling system,and provided the theoretical basis and practical model for the related various damages with secondary impact.At the same time,this experiment also discovered the characteristics of "secondary repair" and chronic inflammation lesion area shown by the severe injury model,providing experimental basis for clinical research.6.Through the time-series evaluation of the movement function of the GM after impact injury,the time-series description of histopathology,and the sequential judgment of the degree of collagen fibers,the entity's grasp of the time-series events in the relevant category is presented.The "Qi" chronology epistemic theory has been applied and verified in practice,and it provides a reference point and an effective scientific approach for the integration of the basic theory of Chinese medicine into modern research.This experiment provides new understanding approaches and interpretation perspectives for treating "injury" with "Qi";combined with repair differences of various degrees of damage,it attempts to explain the richness of "blockage of Qi-ji",which provides the theoretical and experimental basis for the subdivision after skeletal muscle injury and Syndrome differentiation and treatment.Finally,through the analysis of the affair's allegation of "Qi",this paper probes into the discourse interpretation and cognitive style of ASMI's repair process in the theory of "Qi" in Chinese medicine. |
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