小檗碱对兔阴茎海绵体的舒张效应及作用机制

目的　观察小檗碱(berberine, Ber) 对离体兔阴茎海绵体平滑肌条的舒张效应, 探索其作用机制。方法　采用离体平滑肌张力变化记录技术观察Ber对离体兔海绵体肌条的作用。结果　在离体兔阴茎海绵体平滑肌标本上①Ber、西地那非(sildenafil, Sild)、罂粟碱(papaverine, Pap) 及氨力农(amrinone, Amr) 均可浓度依赖性地引起舒张效应, 其作用强度依次为Sild>Ber>Pap>Amr, EC50分别为0 .84, 6 .20, 15. 00 和27. 69μmol/L。②当NO合酶抑制剂L NAME (0. 1 mmol/L) 存在时, Ber的最大舒张效应由100 0 %降低到(84. 0 ±3 .4)%。当同时加入L Ar ginine (1 mmol/L) 时, 可部分对抗L NAME的作用, Ber对海绵体的最大舒张效应可恢复到(96 0 ±4 5)%。③Ber (1, 10μmol/L) 浓度依赖性地增强乙酰胆碱(ACh) 引起的舒张效应, ACh的最大效应分别由(72. 0 ±3 .6)%升高到(81. 0 ±5 .4)% 或(93. 0 ±6 .3)%。④Ber (1, 10μmol/L) 对KCl 去极化引起的收缩反应的作用微弱(P>0 .05)。结论　Ber对兔阴茎海绵体具有浓度依赖性舒张作用, 其机制与影响NO -cGMP信号通路有关。     

淫羊藿苷对大鼠阴茎海绵体压力和周围血压的影响

目的　了解淫羊藿苷对阴茎勃起功能的效果。方法　成年雄性Wistar大鼠 ,体重30 0～ 35 0 g。游离右侧颈总动脉和右侧阴茎海绵体 ,分别插管和 2 6G针头连接后与电生理仪连接。游离左侧海绵体神经 (CN ) ,采用电生理仪刺激器双极电极刺激 ,检测神经刺激下阴茎海绵体压力(ICP)和平均周围动脉压 (MBp)变化作为基础数值。通过左侧阴茎海绵体 2 6G针头插管注射 10 0 μl不同浓度淫羊藿苷、西地那非和罂粟碱作为对照组 ,10min后刺激CN并记录ICP和MBp变化。根据ICP与MBp的比值计算各种药物的EC50 。为了解淫羊藿苷的药物作用机制是否与NO cGMP有关 ,观察可溶性环鸟苷酸 (sGC)抑制剂H [1,2 ,4 ]二唑 [4 ,3 A]喹喔啉 (ODQ)和一氧化氮合酶(NOS)抑制剂Nω 硝基 L 精氨酸 (LNNA)对淫羊藿苷 (10 -4mol/L)诱发ICP/MBp变化的影响。结果　淫羊藿苷、西地那非和罂粟碱均显著提高ICP ,差异有显著意义 (P <0 0 1) ,淫羊藿苷、西地那非对MBp影响无显著意义 (P >0 0 5 ) ,而罂粟碱显著降低MBp ,差异有显著意义 (P <0 0 1)。淫羊藿苷、西地那非和罂粟碱对ICP/MBp变化的半数有效浓度 (EC50 )分别为 2 2 3μmol/L ,0 2 4 μmol/L ,9 73μmol/L。LNNA、ODQ显著抑制淫羊藿苷诱发增加ICP变化 (P <0 0 1)。结论　淫羊藿苷呈剂     

17β雌二醇对人桡动脉舒张作用的体外实验

目的:研究17β雌二醇(17β-estradiol,E2)对人桡动脉(RA)的舒张作用及其机制.方法:采用离体血管灌流的方法,观察E2对人RA的舒张作用以及NO合成酶抑制剂左旋硝基精氨酸甲酯(Nω-nitro-L-arginine methyl ester,L-NAME),8-Br-cGMP和鸟苷酸环化酶抑制剂美蓝(MB)对这一过程的影响.结果:观察到E2(0.1～100 μmol/L)可剂量依赖性地舒张血管且具有内皮依赖性;8-Br-cGMP(0.1～1×103 μmol/L)也可引起剂量依赖性的血管舒张效应.10 μmol/L MB使E2舒张人RA的作用完全消失.10 μmol/L L-NAME能部分抑制E2舒张TA的作用.结论:E2对RA的急性舒张作用具有内皮依赖性.此作用是E2通过非基因组方式使血管内皮细胞分泌NO、进而可能引起血管平滑肌细胞内的cGMP水平升高实现的.     

淫羊藿苷对家兔阴茎海绵体环核苷酸水平的影响

目的深入研究淫羊藿苷（icariin，ICA）的壮阳作用机制。方法采用^125I放射免疫测定法，以西地那非（sildenafil，Sild）为阳性对照，观察ICA对家兔阴茎海绵体平滑肌组织中cGMP和cAMP水平的影响。结果ICA能直接升高cGMP的含量，但对cAMP含量无显著影响。在cGMP激动剂硝普钠（SNP）存在下，ICA和Sild均能浓度依赖性地提高海绵体组织中cGMP浓度（P〈0.01），促进cGMP生成的EC50分别为4．62和0．42μmol／L。同样的条件下，ICA和Sild对cAMP的浓度均无显著影响（P〉0.05）。在cAMP激动剂前列腺素E1（PGE1）刺激下，ICA和Sild也能够提高海绵体组织中cAMP的浓度（P〈0．01），表现出浓度依赖性，促进cAMP生成的EC50分别为2．16、0．98μmol／L。结论ICA的壮阳作用机制与影响NO-cGMP信号通路有关，主要通过提高阴茎海绵体平滑肌中cGMP的浓度，从而舒张海绵体，增强阴茎勃起功能。     

ZnPPⅪ对肺动脉内皮依赖性舒张反应的影响

目的 :通过观察血红素氧化酶抑制剂锌原卟啉Ⅸ (zineprotoporphyrinⅨ ,ZnPPⅨ )对乙酰胆碱 (acetyl choline,Ach)内皮依赖性血管舒张反应的影响 ,探讨内源性一氧化碳 (carbonmonoxide,CO)对肺血管的舒张作用。方法 :取Wistar大鼠肺动脉环 ,制备Ach浓度效应曲线 ,冲洗后平衡 6 0min ,分别加入一氧化氮 (nitricoxide,NO)合成酶抑制剂L NAME 30 μmol/L或L NAME 30 μmol /L +ZnPPⅨ 10 μmol/L ,孵育 30min后 ,重复制备Ach浓度效应曲线 ,观察给药前后Ach浓度效应关系的变化。结果 :用去氧肾上腺素收缩肺动脉后 ,Ach能对内皮完整的肺动脉引起浓度依赖性舒张 ,血管环用L NAME孵育后 ,舒张反应受抑 ,10 -5mol/L的Ach只引起 (40 .3± 5 .1) %的舒张反应 ,而用ZnPPⅨ及L NAME共同孵育后 ,舒张反应进一步受抑或消失 ,10 -5mol/L的Ach只能引起 (11.1± 8.4 ) %的舒张反应或不引起舒张反应。结论 :ZnPPⅨ可抑制Ach的内皮依赖性舒张反应 ,提示内源性CO与NO共同参与了Ach的内皮依赖性血管舒张反应 ,CO对肺血管平滑肌有舒张作用     

17-β雌二醇对大鼠胸主动脉的舒张作用及其机制的研究

目的 :研究 1 7 β雌二醇 (E2 )对大鼠胸主动脉 (TA)的舒张作用及其机制。　方法 :采用体外血管灌流的方法 ,观察E2 对血管内皮完整和去内皮TA的舒张作用 ,以及雌激素受体 (ER)调节药他莫昔芬 (Tamoxifen)、左旋硝基精氨酸甲酯 (L NAME)、亚甲蓝 (MB)、四乙铵 (TEA)和格列本脲对这一过程的影响。　结果 :E2 (5× 1 0 -8～ 5×1 0 -5mol/L)可引起急性血管舒张 ,此作用具有剂量依赖性 ,而去内皮的血管舒张效应不明显 (P <0 .0 1 )。他莫昔芬 (1 0 -6mol/L)几乎能完全抑制E2 的舒张效应。一氧化氮 (NO)合成酶抑制剂L NAME(1 0 -5mol/L)部分抑制E2舒张TA的作用。MB是鸟苷酸环化酶 (GC)的抑制剂 ,1 0 -5mol/L的MB不仅有抑制E2 舒张TA的作用 ,而且有增强去甲肾上腺素 (NE)产生的收缩反应。钙激活钾通道 (KCa)的阻断药TEA (1 0 -4mol/L)和ATP敏感钾通道(KATP)的阻断药格列本脲 (1 0 -5mol/L)可减弱E2 的舒血管作用。　结论 :E2 对TA的急性舒张作用具有内皮依赖性。此作用是E2 通过非基因组方式使血管内皮细胞分泌NO ,进而引起血管平滑肌细胞 (VSMC)内的环磷酸鸟苷(cGMP)水平升高实现的 ,并且与KCa和KATP有关。     

ZnPP Ⅸ对肺动脉内皮依赖性舒张反应的影响

目的: 通过观察血红素氧化酶抑制剂锌原卟啉Ⅸ(zine protoporphyrin Ⅸ,ZnPP Ⅸ)对乙酰胆碱(acetylcholine, Ach)内皮依赖性血管舒张反应的影响,探讨内源性一氧化碳(carbon monoxide, CO)对肺血管的舒张作用.方法:取Wistar大鼠肺动脉环,制备Ach浓度效应曲线,冲洗后平衡60 min,分别加入一氧化氮(nitric oxide, NO)合成酶抑制剂L-NAME 30 μmol/L或L-NAME 30 μmol /L+ZnPP Ⅸ 10 μmol/L,孵育30 min后,重复制备Ach浓度效应曲线,观察给药前后Ach浓度效应关系的变化.结果:用去氧肾上腺素收缩肺动脉后,Ach能对内皮完整的肺动脉引起浓度依赖性舒张,血管环用L-NAME孵育后,舒张反应受抑,10-5mol/L的Ach只引起(40.3±5.1)%的舒张反应,而用ZnPP Ⅸ及L-NAME共同孵育后,舒张反应进一步受抑或消失,10-5mol/L的Ach只能引起(11.1±8.4)%的舒张反应或不引起舒张反应.结论:ZnPP Ⅸ可抑制Ach的内皮依赖性舒张反应,提示内源性CO与NO共同参与了Ach的内皮依赖性血管舒张反应,CO对肺血管平滑肌有舒张作用.     

手术前后结肠癌患者的血清NO变化及临床意义

目的　研究一氧化氮 (NO)在结肠癌患者手术前后血清中的浓度变化及其临床意义 ,探讨在结肠癌肿瘤免疫方面的作用。方法　采用硝酸还原法测定 31健康人和 4 3例结肠癌患者血清NO水平。结果　结肠癌患者术前血清NO含量 (116± 10 5 ) μmol/L显著高于健康人 (5 1 4 3± 16 2 ) μmol/L ,两者比较为P <0 0 5 ,结肠癌者术后 3天的血清NO含量为 (6 8 1± 5 4 3) μmol/L ,与术前组相比明显降低 (P <0 0 5 ) ,但术后 7天 (10 9 2± 79 8) μmol/L上升到接近术前水平 (P >0 0 5 ) ,有淋巴结转移组 (87 0± 6 5 8) μmol/L ,低于无淋巴结转移组 (10 8 9± 6 8) μmol/L(P <0 0 5 )。结论　NO可能在分子水平参与结肠癌的发生和发展。     

L-精氨酸对接振家兔外周血管功能保护作用的研究

目的探讨L 精氨酸对后肢接振家兔外周血管功能的保护作用及意义。方法将家兔随机分为单纯接振组 (A组 ) ,L 精氨酸组 (B组 )和对照组 (C组 ) ,并进行接振试验。从试验第 11天起 ,每隔 2d给予B组L 精氨酸 2 0mg/kg ,分别测定各组血浆一氧化氮 (NO)、内皮素 (ET)浓度进行测定分析。结果试验前及试验后第 10天、2 0天、3 0天 ,A组NO浓度分别为 ( 172 .40 0± 12 .3 5 0 ) μmol/L、( 167.915± 7.879) μmol/L、( 15 0 .0 88± 7.45 3 ) μmol/L、( 13 2 .3 13± 8.747) μmol/L ,ET浓度分别为 ( 4 3 .5 75±8.166) μg/L、( 4 6.2 13± 5 .44 8) μg/L、( 5 3 .788± 6.0 3 7) μg/L、( 66.613± 9.485 ) μg/L ;B组浓度分别为 ( 172 .85 0± 13 .3 2 3 ) μmol/L、( 167.788± 10 .5 3 1) μmol/L、( 164 .12 5± 8.3 80 ) μmol/L、( 161.813± 7.63 9) μmol/L ,ET浓度分别为 ( 4 3 .5 13± 4.90 1) μg/L、( 4 7.175± 7.481) μg/L、( 4 7.0 2 5± 5 .0 2 6) μg/L、( 4 7.60 0± 4.883 ) μg/L。随接振时间延长 ,A组NO浓度有明显降低、ET浓度有明显升高趋势 (P <0 .0 1) ;B组也有类似变化 ,但变化幅度较小。结论L 精氨酸可通过影响接振家兔血管内皮活性物质而保护外周血管功能。     

高脂血症白兔离体阴茎海绵体平滑肌收缩和舒张功能的变化

目的 研究高脂血症白兔离体阴茎海绵体平滑肌的收缩和舒张功能的变化,探讨高脂血症导致阴茎勃起功能障碍的机制.方法 将40只新西兰白兔随机分为实验组20只(高脂饲料喂养8周)和正常对照组20只(正常饲料喂养8周).两组白兔离体阴攀海绵体平滑肌肌条应用相应药物诱导收缩和舒张,并记录平滑肌肌张力的改变.结果 (1)实验组白兔的体重及血总胆同醇水平明显高于喂养前,实验组白兔的血总胆固醇水平明显高于正常对照组(均P<0.01).(2)实验组离体阴茎海绵体平滑肌在各剂量组去氧肾上腺素(0.5、1、5、10、50、100μmol)诱导下产生的收缩效应分另0为4.79%±2.00%、8.84%±2.95%、12.81%±3.77%、14.63%±5.38%、25.01%±6.14%和34.69%±8.53%,均明显高于正常对照组(1.00%±0.13%、2.60%±0.72%、4.28%±1.27%、5.91%±2.09%、6.49%±4.02%和5.64%±11.87%,P<0.01).(3)实验组白兔离体阴茎海绵体平滑肌在1、10、100 μmol剂量组乙酰胆碱诱导下产生的舒张效应分别为36.28%±4.71%、48.81%±4.36%和56.27%±11.93%,明显低于正常对照组(48.04%±4.78%、69.12%±5.27%和78.23%±5.30%,均P<0.01).实验组在硝普钠诱导下产生的舒张效应与正常对照组差异无统计学意义.实验组在0.25、1.25、2.5、12.5μmol剂量组法舒地尔诱导下产生的舒张效应分别为1.56%±0.43%、5.03%±1.02%、8.28%±1.35%和16.77%±3.57%,明显低于正常对照组(4.69%±1.23%、10.39%士2.05%、15.08%±3.04%、25.22%±3.72%,均P<0.01).结论 高脂血症白兔阴茎海绵体平滑肌收缩功能增强,同时合并内皮依赖的舒张功能减弱,上述变化参与高脂血症勃起功能障碍的发生.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.