We acknowledge the financial support from the National Training Program for Clinical Excellence in Chinese Medicine (National Chinese Medicine Human Education Letter [2022] No. 1), &#34;100 Talent Plan&#34; Project of the Hospital of Chengdu University of Traditional Chinese Medicine (Hospital office [2021] 42) and Sichuan Provincial Administration of Traditional Chinese Medicine Scientific and Technological Research Program (2021MS093, 2021MS539, 2023MS608).

The clinical study protocol was reviewed and approved by the Clinical Research Approval Committee of the Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine (Record No. KY2022014).
1. Preparations before operation
<ol>
	<li>Items preparation:
	<ol>
		<li>Prepare items such as Rheum officinale Baill, normal saline, Iodine volts swab, medical tape, medical gauze, medical bending plate, hand disinfectant, and medical rubber glove (Table of Materials).</li>
		<li>Use an ultra-micro pulverizer to make 100 g of Rheum officinale Baill into powder in advance and seal it in a plastic bag for later use.</li>
		<li>Before treatment, please take 15&#160;g of Rheum officinale Baill powder and use 15 mL of normal saline to make a paste of medicinal powder. Place the paste on a curved plate.</li>
	</ol>
	</li>
	<li>Patient preparation:
	<ol>
		<li>Advise the patient to empty the bladder in advance. Let the patient lie on his/her back, bend the knees, relax, and fully expose the abdomen.</li>
	</ol>
	</li>
	<li>Operator preparation:
	<ol>
		<li>Close doors and windows, pay attention to protect the patient&#39;s privacy and prevent the patient from catching a cold.</li>
		<li>Select Shenque point (RN8) and bilateral Tianshu points (ST25) on the patient&#39;s abdomen10, and evaluate the local skin of the patient&#39;s points to ensure that the skin around the selected points is free of lesions or damage while keeping the local points clean and dry (Figure 1 and Figure 2). 
		&#8203;NOTE: The Shenque acupoint (RN8) is in the umbilical region, central umbilical cord. The Tianshu point (ST25) is located in the abdomen, 2 finger-cun each around the navel (finger-cun means the proportional unit of the thumb, 2 finger-cun equals ~6.67 cm)15.</li>
	</ol>
	</li>
</ol>
2. Operating steps
<ol>
	<li>Disinfect the hands, then press the Shenque point (RN8) and bilateral Tianshu points (ST25) of the patient&#39;s abdomen with the thumb fingertip. Press each acupuncture point 50 times, and make sure to rotate the thumb in a clockwise direction while pressing (Figure 3).
	<ol>
		<li>Change the intensity of pressing the acupoints from weak to strong. Press at ~1 s/time and at a frequency of 30-60 times/min until the patient feels a slight feeling of soreness. If the patient does not tolerate it during the procedure, stop the operation immediately.</li>
	</ol>
	</li>
	<li>Rub the palms of both hands until they are warm, then massage the patient&#39;s abdomen 50 times clockwise with the palms (Figure 4). Gradually massage from the navel to the outer circle and then from the outer circle back to the navel. 
	NOTE: The scope of the circle is centered on the navel, with 2 finger-cun as the radius, i.e., the radius is equal to ~6.67 cm.
	<ol>
		<li>Ensure the massage action is gentle and the force is not too heavy. Ensure the frequency of massage is from slow to fast, stable and moderate, about 30-50 times/min. It is best to feel slightly warm in the abdomen. If the patient develops intolerance during the procedure, stop the operation immediately.</li>
	</ol>
	</li>
	<li>Wear medical rubber gloves and use iodine volts swabs to disinfect the patient&#39;s local acupoints. Take about 3/4 of the prepared medicine from the medical bent plate, roughly divide it into 3 equal parts, make them into a shape similar to a ring (diameter x thickness of about 3 cm x 0.5 cm) and apply them to medical gauze separately.</li>
	<li>Fix the medical gauze containing the medicine to the Shenque point (RN8) and Tianshu points (ST25) in the patient&#39;s abdomen with medical tape, respectively. Remove it 6 h later.</li>
	<li>Require the patient to wear clean and breathable clothes after the acupoint application operation.
	<ol>
		<li>Ask the patient to avoid strenuous exercise to prevent the drug from falling off and flowing. Promptly remove the drug residues from the patient&#39;s local skin and assist the patient in getting dressed.</li>
		<li>Inform the patient not to scratch if the local skin is itching, burning, or painful, and remove the drug in time. Keep the local skin clean with normal saline.</li>
	</ol>
	</li>
</ol>

There are no competing financial interests in this article.

The elderly population is at high risk of COPD. Older people experience varying degrees of gastrointestinal decline, while hypoxia and reduced activities in COPD patients increase the risk of constipation. In addition, COPD patients are prone to negative psychological emotions such as nervousness, anxiety, depression, depression, and restlessness, which can cause increased pelvic floor muscle tone, resulting in paradoxical movements between rectal and canals during defecation and inhibition of intestinal peristalsis3,23. COPD belongs to the category of &#34;lung distension&#34; in TCM. Lung manifests in Qi and governs in breath, as well as disperse and descent of lung Qi24. The lung corresponds to the large intestine, according to the theory of TCM. The lung transmits body fluid and moistens the large intestine through the function of spreading and descending so that the conduction function of the large intestine is normal. COPD is due to the dysfunction of the circulation and descending function of the lung, causing abnormal stool or obstruction and constipation25.
The significance of some therapeutic measures such as increased fluid intake, physical activity, fiber-rich diet, and nutritional supplements recommended to relieve constipation is still questionable26. Medication results in some side effects. Highly permeable drugs such as glycerin and lactulose may cause bloating, abdominal pain and even bleeding hemorrhoids, so they are not recommended for daily use27. Biofeedback therapy requires multiple clinic visits, so it is only available at a few specialized centers28. Since the above treatments have limitations and cannot meet the treatment needs of patients, alternative therapies such as acupoint application and acupoint massage are becoming increasingly popular29,30. In the treatment of chronic constipation, acupoint stimulation therapy is beginning to show some advantages9. Acupoint application combined with acupoint massage can avoid the liver first-pass effect and gastrointestinal irritation. Some studies have proved that acupoint application combined with acupoint massage is effective and safe in the treatment of chronic constipation31. Acupoint application combined with acupoint massage can significantly improve the efficacy of constipation in COPD patients. Previous clinical studies have shown that the effective rate of acupoint application combined with acupoint massage in the treatment of constipation in COPD patients is more than 90%, while the effective rate of treatment that only ensures sufficient water and appropriate food fiber intake is less than 80%21,22. Acupressure combined with acupressure is considered an ideal alternative therapy for patients with chronic constipation.
The key to the whole operation is to make the patient&#39;s local acupuncture acupoint warm and sore to fully open up the flow of qi during acupressure massage time, according to the midnight-noon ebb-flow acupuncture theory of TCM, select the time period from 5 am to 7 am when qi and blood flow to the large intestine meridian for treatment32.
Studies have reported that a small number of people will have local skin erythema, papules, blisters, and other adverse reactions after receiving acupoint application, which can spontaneously subside after removing the acupoint application33. Operators can reduce the occurrence of adverse reactions by understanding allergies, adjusting diet plans, and shortening treatment time. If adverse reactions occur, promptly clean up local skin residues and closely monitor vital signs34.
Shenque Acupoint (RN8) and Tianshu Acupoint (ST25) are effective acupuncture acupoints commonly used to treat constipation35. The ganglion corresponding to the Tianshu acupoint (ST25) is consistent with the distribution of ganglia and sacral plexus in the large intestine. Stimulation of the Tianshu acupoint (ST25) can promote and enhance gastrointestinal peristalsis to effectively improve constipation36. Studies have shown that ST25&#39;s pathway in regulating constipation is closely related to inflammation and adipocytokines or leptin37. Studies have also shown that stimulation of Tianshu acupoint (ST25) can improve intestinal motility in constipated rats, which may be related to its upregulation of the immune activity of the colonic muscular plexus vasoactive intestinal peptide and substance P38. At the same time, stimulation of bilateral Tianshu Acupoint (ST25) can improve slow transit constipation-induced changes in colonic smooth muscle structure to treat constipation39. Studies have shown that stimulating Shenque Acupoint (RN8) can improve water content in fecal matter and the rate of intestinal transport in rats with functional constipation, possibly by regulating the expression of the aquaporin-3 (AQP3) and Nuclear factor-kappaB (NF-&#954;B) signaling pathways40. Shennong&#39;s Herbal Classic of Materia Medica recorded that Rheum officinale Baill had the effect of cleaning the stomach and intestines, pushing Chen Zhixin, and improving the water valley.
At present, acupoint stimulation therapy is widely used in digestive system diseases such as constipation, diarrhea, and functional dyspepsia, with definite curative and minor side effects41. Gastrointestinal symptoms are considered to be one of the most common adverse events of chemotherapy42. Some studies have shown that almost 80% of cancer patients experience nausea, about 70% of cancer patients experience constipation, and over 50% of cancer patients experience vomiting and diarrhea during chemotherapy43. In the future, we can combine acupoint application and acupoint massage with chemotherapy for cancer patients to reduce the gastrointestinal side effects of chemotherapy. Hopefully, it will improve the treatment and quality of life of cancer patients.
Finally, the demonstration of the operation of acupoint application combined with acupoint massage for treating constipation in COPD in this study has some limitations. The sample size of this study is small and data from only one patient is presented here. In the future, a large sample size will be included to demonstrate the effectiveness of acupoint application combined with acupoint massage, with the aim of guiding the treatment of constipation in COPD patients to provide a clinical basis.

Chronic respiratory diseases are the third leading cause of death in the world, and COPD is the leading cause of death from chronic respiratory diseases, placing a heavy burden on both individuals and society1. China has the largest number of patients with COPD in the world: about 99 million, with a prevalence rate of 8.6%2. Constipation is a common complication in COPD patients and is associated with high levels of polypharmacy3. There is evidence that more than 39% of COPD patients experience constipation, and constipation was positively correlated with the severity of dyspnea, timing of exacerbations, and complications of COPD4.&#160;It is highly suspected that constipation is associated with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). AECOPD accelerates the disease progression in COPD patients and is the leading cause of death in COPD patients5. Therefore, it is time to pay attention to the treatment of constipation in patients with COPD.
The majority of patients manage their constipation by themselves, mainly using dietary adjustments and laxatives. Studies have shown that osmotic laxatives are often the drug of choice for people with constipation6. However, the use of medications is sometimes not effective in improving constipation symptoms. It is associated with adverse reactions or poor tolerance. Up to 50% of patients with constipation are not fully satisfied with the results of their current treatments7,8. Therefore, it is necessary to find alternative therapies with good efficacy and high security. In the treatment of chronic constipation, acupoint stimulation therapy is beginning to show some advantages9. With the guidance of the concept of holism, syndrome differentiation, and treatment, as well as meridian acupoint theory in TCM, both acupoint application and acupoint massage are used to treat diseases by stimulating specific acupuncture points on the body surface10,11. Acupoint application can make the drug directly absorbed by the local skin. It achieves the effect of channeling meridians and harmonizing qi and blood by stimulating the acupuncture points, thereby improving the symptoms of constipation10. Acupoint massage stimulates the sacral nerve, regulating defecation by increasing the interstitial cell number and controlling rhythmic contractions or peristalsis through activating bowel movements12. Numerous pharmacological and clinical studies have confirmed the clear efficacy of herbs such as Rheum officinale Baill in the treatment of constipation13,14. A demonstration of acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease is presented in this article.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Chinese herbal decoction piece rhubarb</td>
			<td>Sichuan Guoqiang Chinese Medicine Decoction Pieces Co., Ltd</td>
			<td>21120104</td>
			<td></td>
		</tr>
		<tr>
			<td>Gauze swab</td>
			<td>Shandong Angyang Medical Technology Co., Ltd</td>
			<td>2022060201</td>
			<td></td>
		</tr>
		<tr>
			<td>Hand disinfectant</td>
			<td>Gamma Disinfection Products (Foshan) Co., Ltd. Sichuan Branch</td>
			<td>CNSQV3180322A</td>
			<td></td>
		</tr>
		<tr>
			<td>Iodine volts swab</td>
			<td>Zhejiang Baigar Health Technology Co., Ltd</td>
			<td>20220301</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical adhesive tape</td>
			<td>Minnesota Mining Manufacturing Medical Equipment (Shanghai) Co., Ltd</td>
			<td>2105NF8</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical bending plate</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd. Surgical Instrument Factory</td>
			<td>181001</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical rubber glove</td>
			<td>Shanghai Kebang Medical Latex Equipment Co., Ltd</td>
			<td>2112019S</td>
			<td></td>
		</tr>
		<tr>
			<td>Normal saline</td>
			<td>Sichuan Kelun Pharmaceutical Co., Ltd</td>
			<td>N22061906</td>
			<td></td>
		</tr>
	</tbody>
</table>

acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. Constipation that reduces the quality of life and triggers the risk of diseases is a common concomitant symptom in patients with COPD. Currently, western medical treatment does not achieve the desired results for patients. A high recurrence rate accompanies it, whereas traditional Chinese medicine (TCM) has a long history and rich experience in treating chronic diseases. Both acupoint application and acupoint massage are characteristic therapies of TCM, with minor side effects, high safety, simple operation, and outstanding advantages. They are effective in treating constipation for patients with COPD and are considered an ideal alternative therapy for patients with chronic constipation. The purpose of this article is to introduce the method of acupoint application combined with acupoint massage for the treatment of constipation in patients with COPD, including the selection of points, items, treatment time, and operation procedure.

Patients with COPD are diagnosed and treated according to &#34;The Global Initiative for Chronic Obstructive Lung Disease&#34;, published in 202316. The diagnostic criteria for constipation referred to the &#34;Clinical Practice Guideline on the Evaluation and Management of Chronic Constipation for Chinese Adults&#34; issued by the Chinese Society of Colorectal Surgery, Chinese Society of Surgery, Chinese Medical Association in 202217. Efficacy was assessed based on the Patient Assessment of Constipation Symptoms (PAC-SYM) form completed before and after the patient&#39;s treatment18. A patient with constipation who met the requirements in the Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, was selected, and only acupoint application combined with acupoint massage was used to treat constipation after obtaining the patient&#39;s consent. The patient was treated once daily during the 5-7 am time frame each morning for a 1-week course of treatment. PAC-SYM scores were also completed before the start of treatment and after the completion of treatment.
Based on the PAC-SYM score completed by the patient, the pre-treatment and post-treatment score results were 18 and 6, respectively (Table 1). The results showed that acupoint application combined with acupoint massage could significantly improve constipation symptoms. Previous studies have confirmed that both acupoint application and acupoint massage could treat constipation with minor side effects, high security, obvious curative effect, and outstanding advantages19,20. Acupoint application combined with acupoint massage improved the efficacy of constipation in COPD patients, and previous clinical studies have shown that acupoint application combined with acupoint massage was more than 90% effective in the treatment of constipation in COPD patients21,22. Overall, acupoint application combined with acupoint massage is effective and safe in treating constipation in patients with chronic obstructive pulmonary disease.
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/64900/64900fig01.jpg" /> 
Figure 1: Location map of abdominal Shenque acupoint (RN8). The Shenque acupoint (RN8) is in the umbilical region, the central umbilical cord. <a href="https://www.jove.com/files/ftp_upload/64900/64900fig01large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/64900/64900fig02.jpg" /> 
Figure 2: Location map of bilateral Tianshu acupoint (ST25). The Tianshu acupoint (ST25) is located in the abdomen, 2 finger-cun each around the navel (finger-cun means the proportional unit of the thumb, 2 finger-cun equals approximately 6.67 cm). <a href="https://www.jove.com/files/ftp_upload/64900/64900fig02large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/64900/64900fig03.jpg" /> 
Figure 3: Finger press manipulation diagram. The operator presses the patient&#39;s acupoint with the thumb, rotating the thumb clockwise while pressing. <a href="https://www.jove.com/files/ftp_upload/64900/64900fig03large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/64900/64900fig04.jpg" /> 
Figure 4: Palm massage manipulation diagram. Rub the palms of both hands until warm, then massage the patient&#39;s abdominal acupoints in a clockwise direction with the palm of the hands. <a href="https://www.jove.com/files/ftp_upload/64900/64900fig04large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
Table 1: Patient assessment of constipation symptoms (PAC-SYM) <a href="https://www.jove.com/files/ftp_upload/64900/Table 1.xlsx" target="_blank">Please click here to download this Table.</a>

Watch this Scientific Journal Video about Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease at JoVE.com

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. ...

acupoint-application-combined-with-acupoint-massage-for-treating

Nanyang Technological University

Research

JoVE Journal

Medicine

1.6K Views.  Hospital of Chengdu University of Traditional Chinese Medicine. Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).

Video: Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

The degree of vascular dysfunction and contributing physiological mechanisms can be assessed in patients with chronic kidney disease by measuring brachial artery flow-mediated dilation, aortic pulse-wave velocity, and vascular endothelial cell protein expression.

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and lung parenchymal destruction. It has a very high incidence in aging populations. The current conventional therapies for COPD focus mainly on symptom-modifying drugs; thus, the development of new therapies is urgently needed. Qualified animal models of COPD could help to characterize the underlying mechanisms and can be used for new drug screening. Current COPD models, such as lipopolysaccharide (LPS) or the porcine pancreatic elastase (PPE)-induced emphysema model, generate COPD-like lesions in the lungs and airways but do not otherwise resemble the pathogenesis of human COPD. A cigarette smoke (CS)-induced model remains one of the most popular because it not only simulates COPD-like lesions in the respiratory system, but it is also based on one of the main hazardous materials that causes COPD in humans. However, the time-consuming and labor-intensive aspects of the CS-induced model dramatically limit its application in new drug screening. In this study, we successfully generated a new COPD model by exposing mice to high levels of ozone. This model demonstrated the following: 1) decreased forced expiratory volume 25, 50, and 75/forced vital capacity (FEV25/FVC, FEV50/FVC, and FEV75/FVC), indicating the deterioration of lung function; 2) enlarged lung alveoli, with lung parenchymal destruction; 3) reduced fatigue time and distance; and 4) increased inflammation. Taken together, these data demonstrate that the ozone exposure (OE) model is a reliable animal model that is similar to humans because ozone overexposure is one of the etiological factors of COPD. Additionally, it only took 6 - 8 weeks, based on our previous work, to create an OE model, whereas it requires 3 - 12 months to induce the cigarette smoke model, indicating that the OE model might be a good choice for COPD research.

This study describes the successful generation of a new chronic obstructive pulmonary disease (COPD) animal model by repeatedly exposing mice to high concentrations of ozone.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and lung parenchymal destruction. It has a very high ...

Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery

Acupoint needle-embedding combined with ironing therapy is a non-drug treatment method to release postoperative pain after anal surgery. The practice is guided by traditional Chinese medicine (TCM) syndrome differentiation theory and employs acupoint stimulation and heat to alleviate pain. Although prior research has shown that these are dependable methods for pain relief, the combined effect of the two techniques has not been described. In our research, we found that compared to using diclofenac sodium enteric-coated capsules alone, adding acupoint needle-embedding combined with ironing therapy was more effective for reducing pain levels at different stages after hemorrhoid surgery. Although this technique is efficient and commonly used in clinics, due to its invasive practice, acupoint needle embedding still carries risks relating to hospital-acquired infections and broken needles. Ironing therapy, on the other hand, can result in burns and connective tissue injuries. Therefore, there is an urgent need to develop a standardized protocol for medical staff. Our protocol refines the traditional techniques and provides detailed instructions on patient preparation, operation techniques, and postoperative care to ensure the therapy is carried out safely and efficiently. By standardizing this therapy, this technique is expected to become an important complementary therapy for postoperative pain relief&#160;in hemorrhoids, which will significantly improve patients &#39;life quality after anal surgery.

The high incidence of pain after anal surgery is due to the physiological structure and pathological status of the anus. At present, the use of painkillers cannot provide satisfactory pain relief, which makes complementary therapy important. This paper proposes acupoint needle-embedding combined with ironing therapy to relieve postoperative pain.

Acupoint needle-embedding combined with ironing therapy is a non-drug treatment method to release postoperative pain after anal surgery. The practice is ...

Acupuncture Stimulation of Ears to Alleviate Sleeping Disorders in COPD Patients

Auricular Acupuncture as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Sleep Disorders

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by persistent and irreversible airflow limitation and chronic respiratory symptoms. It has a wide spectrum of complications, and sleep disorders, as part of it, are common in severe cases, especially in elderly patients. Long-term lack of sleep may lead to the aggravation of the original disease, reducing patients' quality of life. Benzodiazepines are mainly used for symptomatic treatment of COPD combined with sleep disorders. However, such drugs have the side effect of respiratory central inhibition and could probably aggravate hypoxia symptoms. Auricular acupuncture is a special method of treating physical and psychosomatic dysfunctions by stimulating specific points in the ear. This article explains the specific methods of clinical operation of auricular acupuncture in detail, including assessment of patient eligibility, medical devices used, acupuncture points, course of treatment, post-treatment care, responses to emergencies, etc. The Pittsburgh sleep quality index (PSQI) and chronic obstructive pulmonary disease assessment scale (CAT) were used as the observational index of this method. So far, clinical reports have proved that auricular acupuncture has a definite curative effect in the treatment of COPD combined with sleep disorders, and its advantages of simple operation, few adverse reactions are worthy of further study and promotion, which provide a reference for the clinical treatment of such diseases.

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders 

This protocol introduces an effective method to improve the sleep condition of patients with chronic obstructive pulmonary disease and alleviate cough symptoms by using auricular acupuncture techniques to percutaneously stimulate specific acupoints in the patients' ears.

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by persistent and irreversible airflow limitation and chronic ...

Warm Acupuncture and Moxibustion to Relieve COPD with Abdominal Distension

A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute exacerbations, and quality of life in patients with COPD. Warm acupuncture and moxibustion have been shown to be effective in relieving symptoms in patients with COPD combined with abdominal distention. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. The standardized practice of warm acupuncture and moxibustion is very important for the treatment of COPD combined with abdominal distension. The specific steps include selecting the appropriate acupoints for needling through syndrome differentiation treatment and selecting moxa sticks of appropriate length for moxibustion for about 30 min after the De-qi. The course of treatment lasts for one week. The following indicators are specifically assessed: the score of the COPD Assessment Test (CAT) and the abdominal distension visual analog scale (VAS). This article will clearly illustrate how to standardize the manipulation of warm acupuncture and moxibustion to relieve COPD combined with abdominal distention.

Author Spotlight: An Effective Traditional Chinese Medicinal Treatment for Chronic Obstructive Pulmonary Disease with Abdominal Distension 

Here, we present a protocol to properly manipulate warm acupuncture and moxibustion for treating chronic obstructive pulmonary disease (COPD) with abdominal distension.

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute ...

Establishment of the KOA Model in Rabbits Using the Modified Videman Method

Application of Acupotomy in a Knee Osteoarthritis Model in Rabbit

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of people with KOA. Among several pathogenic factors, the biomechanical imbalance of the knee joint is one of the main causes of KOA. Acupotomology believes that restoring the mechanical balance of the knee joint is the key to treating KOA. Clinical studies have shown that acupotomy can effectively reduce pain and improve knee mobility by reducing adhesion, contracture of soft tissues, and stress concentration points in muscles and tendons around the knee joint. 
In this protocol, we used the modified Videman method to establish a KOA model by immobilizing the left hindlimb in a straight position. We have outlined the method of operation and the precautions related to acupotomy in detail and evaluated the efficacy of acupotomy in conjunction with the theory of "Modulating Muscles and Tendons to Treat Bone Disorders" through the detection of the mechanical properties of quadriceps femoris and tendon, as well as cartilage mechanics and morphology. The results show that acupotomy has a protective effect on cartilage by adjusting the mechanical properties of the soft tissues around the knee joint, improving the cartilage stress environment, and delaying cartilage degeneration.

Author Spotlight: Investigating the Mechanism of Action of Acupotomy in Treating Knee Osteoarthritis

In this protocol, a knee osteoarthritis model was prepared using the modified Videman method, and the operation procedures and precautions of acupotomy are detailed. The effectiveness of acupotomy has been demonstrated by testing the mechanical properties of quadriceps femoris and tendon and the mechanical and morphological properties of cartilage.

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of ...

Enhancing Melasma Treatment with Tranexamic Acid and Microneedling Therapy

Roller Microneedle Combined with Tranexamic Acid Solution in Treating Melasma

Melasma, a common, acquired facial pigmentation skin disorder, presents a straightforward clinical diagnosis but poses challenges in terms of effective management. The precise underlying causes of melasma remain elusive, and the current therapeutic approaches predominantly encompass pharmaceutical and laser interventions, with limited efficacy. Transdermal administration stands as a prevalent treatment method for melasma, often facilitated by the application of microneedles. Among these, tranexamic acid emerges as a frequently employed therapeutic agent. A subset of microneedles, known as roller microneedles, plays a significant role in this approach by delicately puncturing the epidermis with multiple fine needles, synergizing with drug delivery. This methodology not only enhances drug absorption but also augments treatment efficacy while minimizing tissue trauma. These attributes forecast promising avenues for the treatment of melasma. This article primarily introduces the combination of roller microneedle and tranexamic acid solution in the treatment of melasma and demonstrates the efficacy of roller microneedle and tranexamic acid solution in the treatment of melasma through clinical cases.

Author Spotlight: Non-Surgical Treatment of Melasma&#8211; Microneedling with Tranexamic Acid

This article presents a protocol to conduct the treatment of melasma by using roller microneedles in combination with tranexamic acid solution and evaluate the efficacy.

Melasma, a common, acquired facial pigmentation skin disorder, presents a straightforward clinical diagnosis but poses challenges in terms of effective ...

Acupoint Catgut Embedding for Chronic Pelvic Pain Management

Acupoint Catgut Embedding for Treatment of Chronic Pelvic Pain Due to the Sequelae of Pelvic Inflammatory Disease

Chronic pelvic pain caused by the sequelae of inflammatory pelvic disease is a common clinical condition of pelvic pain in women. At present, the main challenges in its treatment are the limited effectiveness of pain relief and the frequent recurrence of symptoms, which significantly impact patients' quality of life and impose a considerable psychological burden on them. It is a clinically challenging disease. After summarizing years of treatment experience, the author's team discovered that acupoint catgut embedding demonstrated notable clinical efficacy in managing chronic pelvic pain stemming from pelvic inflammatory disease sequelae. Compared to existing Western medicine treatment methods, acupoint catgut embedding offers advantages such as a good analgesic effect, lower recurrence rate, economic benefits, and a relatively straightforward procedure. This article provides a comprehensive guide on embedding absorbable catgut into patients' acupoints for the treatment of chronic pelvic pain in females resulting from the sequelae of pelvic inflammatory disease.

Author Spotlight: Enhancing Women's Chronic Pelvic Pain Management Through Acupoint Catgut Embedding

This article outlines acupoint catgut embedding therapy for chronic pelvic pain caused by the sequelae of pelvic inflammatory diseases.

Chronic pelvic pain caused by the sequelae of inflammatory pelvic disease is a common clinical condition of pelvic pain in women. At present, the main ...

Traditional Chinese Medicine Ear Point Therapy for Wheezing in COPD Patients

Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Due to the restriction of expiratory airflow, it is characterized by emphysematous destruction of the lungs. Shortness of breath is one of the main clinical symptoms. Auricular acupressure is a clinical therapy characteristic of Chinese medicine that treats the disease by compressing ear points. Usually, the seeds of Vaccaria segetalis are used to stimulate ear points, which has the effect of regulating qi and alleviating wheezing. In this paper, we propose this characteristic therapy of traditional Chinese medicine (TCM) for the clinical symptoms of wheezing of lung and kidney qi deficiency type in stable COPD patients. Ear points are selected as the treatment protocol for Lung (CO14), Spleen (CO13), Kidney (CO10), Shen Men (TF4), and Ping Chuan (AT1.2.4i) points. The protocol describes a case study using auricular acupressure for a patient with chronic obstructive pulmonary disease to relieve wheezing symptoms.

Author Spotlight: Efficacy of Auricular Pressure Bean Therapy in Reducing Wheezing Symptoms

This protocol describes an effective therapy using auricular acupressure to relieve wheezing symptoms in stable chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Due to the restriction of expiratory airflow, it is characterized by ...

Advancements in Pulmonary Lesion Biopsy Through Robotic Bronchoscopy

Robotic-assisted Bronchoscopy Combined with Multimodal Imaging for Targeted Lung Cryobiopsies

Robotic-assisted bronchoscopy (RAB) allows for targeted bronchoscopic biopsy in the lung. A robotic-assisted bronchoscope is navigated through the airways under direct vision after establishing a pathway to a target lesion based on mapping performed on a 3-dimensional (3D) lung and airway reconstruction obtained from a pre-procedure thin-slice computed tomography chest. RAB has maneuverability to distal airways throughout the lung, precise catheter tip articulation, and stability with the robotic arm. Adjunct imaging tools such as fluoroscopy, radial endobronchial ultrasound (r-EBUS), and cone beam computed tomography (CBCT) can be used with RAB. Studies using shape-sensing robotic-assisted bronchoscopy (ssRAB) have shown favorable diagnostic outcomes and safety profiles in both malignant and non-malignant processes for the biopsy of peripheral pulmonary lesions (PPLs). A 1.1 mm cryoprobe combined with ssRAB has been shown to be safe and effective for the diagnosis of PPLs compared to a traditional bronchoscopy with forceps biopsy. This technique can also be used for targeted lung sampling in benign processes. The aim of this article is to describe a stepwise approach to performing RAB combined with fluoroscopy, r-EBUS, and CBCT to obtain targeted transbronchial lung cryobiopsies (TBLC).

Author Spotlight: Expanding Interventional Pulmonology Research with Robotic-Assisted Bronchoscopy

This article aims to describe a stepwise approach to performing robotic-assisted bronchoscopy combined with fluoroscopy, radial endobronchial ultrasound, and cone beam computed tomography to obtain targeted transbronchial lung cryobiopsies.&#160;

Robotic-assisted bronchoscopy (RAB) allows for targeted bronchoscopic biopsy in the lung. A robotic-assisted bronchoscope is navigated through the airways ...