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.

A randomized controlled trial for the effect of Modified Shenling Baizhu Powder on delaying the illness progress of COPD stable phase patients (GOLD 1-2 stages): A study protocol.

INTRODUCTION: As one of the most prominent public health and medical problems, Chronic Obstructive Pulmonary Disease (COPD) has a serious impact on the quality of life of participants and may even be life-threatening. While modern medicine has worked well to alleviate the symptoms of COPD, the current situation with this chronic disease is not encouraging. Lung-spleen qi deficiency syndrome is one of the common forms of COPD and the traditional Chinese medicine formula Modified Shenling Baizhu Powder is very frequently used in the treatment of this syndrome. However, no direct evidence is available to support the efficacy and safety of Modified Shenling Baizhu Powder for COPD treatment. METHODS: The study is a prospective, randomized, placebo-controlled, double-blind trial in which 270 eligible participants will be randomly assigned to either the experimental or control group in a 1:1 ratio. Both groups will receive the standard Western medication. Meanwhile, participants in the experimental group will undergo Modified Shenling Baizhu Powder, while those in the control group will undergo a matched placebo. The course of treatment is 6 months with 12 months of follow-up. Primary outcome is the forced expiratory volume in 1 second (FEV1) after bronchodi-lator use. The secondary outcomes include the declines and the between-group difference in the change from baseline to 18 months in FEV1 before bronchodilator use; the forced vital capacity (FVC), FEV1/FVC, FEV1%pred after bronchodilator use, modified British medical research council, COPD Assessment Test, St George's Respiratory Questionnaire (SGRQ); frequency, interval, duration and severity of COPD exacerbations; time to first COPD exacerbation; administration of rescue medication and a cost-effectiveness analysis; Smoking status. A safety assessment will also be performed during the trial. DISCUSSION: The results of this trial will provide comprehensive evidence of the efficacy of Modified Shenling Baizhu Powder for early-stage COPD and the potential mechanism by which Modified Shenling Baizhu Powder acts, which may provide reference for the treatment plan of COPD participants. TRIAL REGISTRATION: ChiCTR2000037873, Registered 2 September 2020.

[Insulin combined with selenium inhibit p38MAPK/CBP pathway and suppresses cardiomyocyte apoptosis in rats with diabetic cardiomyopathy].

Objective To investigate the effect of insulin in combination with selenium on p38-mitogen-activated protein kinase/CREB-binding protein (p38MAPK/CBP) pathway in rats with diabetic cardiomyopathy. Methods Fifty SD rats were randomly grouped into control group, diabetic cardiomyopathy (DCM) group, diabetic cardiomyopathy with insulin treatment (DCM-In) group, diabetic cardiomyopathy with selenium treatment (DCM-Se) group, and diabetic cardiomyopathy with insulin and selenium combination treatment (DCM-In-Se) group. Flow cytometry was used to analyze cell cycle. TUNEL staining was used to detect cardiomyocyte apoptosis. Western blotting was used to examine the levels of cyclin D1, cyclin E, Bax, Bcl-2, p38MAPK, p-p38MAPK, CBP and Ku70. Co-immunoprecipitation was used to examine the acetylation status of Ku70. Results Insulin in combination with selenium significantly inhibited cardiomyocyte apoptosis, increased Bcl-2 levels and decreased Bax, cyclin D1, cyclin E, p38MAPK, p-p38MAPK, CBP, Ku70 and acetylated Ku70 levels. Conclusion The combined treatment of insulin and selenium suppresses cardiomyocyte apoptosis by inhibiting p38MAPK/CBP pathway.

[The combined effects of insulin and selenium in improving insulin signal transduction in skeletal muscles of diabetic rats].

OBJECTIVE: To investigate the combined effects of insulin and selenium in improving the physiological parameters and insulin signal transduction in the skeletal muscles of diabetic rats. METHODS: 35 male SD rats were randomly divided into five groups: normal, diabetes, diabetes with insulin treatment (D-In group), diabetes with sodium selenite treatment (D-In-S group), and diabetes with insulin and sodium combination treatment (D-In-Se group), 7 rats in each group. The levels of blood glucose were measured using One Touch Sure Step Blood Glucose Meter. HbA1C levels were measured using microcolumn assay. The levels of insulin receptor substrate 1(IRS-1), phosphatidylinositol-3 kinase (PI3K) and glucose transporter 4(GLUT4) in skeletal muscle were examined by Western blotting and immunohistochemistry. RESULTS: Insulin combined with selenium could significantly lower blood glucose levels and markedly restore the diminished expression of in IRS-1, PI3K and GLUT4 levels in skeletal muscles of diabetic rats. CONCLUSION: There was positive cooperativity between insulin and selenium in reducing blood glucose levels in diabetic rats. The combined treatment of insulin and selenium may decrease blood glucose by upregulating IRS-1, PI3K and GLUT4 levels in skeletal muscles of diabetic rats.