Neuroprotection of progesterone against cerebral ischemia-reperfusion injury on rats and the effect on IP3 content

目的 探讨孕酮对大鼠局部脑缺血/再灌注损伤的神经保护作用及机制.方法 将大鼠随机等分为假手术组、正常对照组、孕酮组、溶剂(DMSO)组,采用线栓法制作大鼠局部脑缺血再灌注模型,TTC染色和ELISA法分别测定大鼠大脑梗死面积和梗死侧IP3的含量.结果 孕酮(8 mg/kg)治疗后大鼠脑梗死面积比例明显小于溶剂组(P＜0.05);溶剂组脑梗死侧的IP3含量显著低于假手术组和正常对照组,孕酮组脑梗死侧的IP3含量高于溶剂组(P＜0.05).结论 孕酮对大鼠局部脑缺血再灌注损伤有明显的神经保护作用,可能与通过恢复大鼠梗死侧大脑组织IP3有关.     

川芎嗪对成年大鼠脑缺血再灌注损伤后nNOS的表达和神经的影响

目的 探讨川芎嗪对大鼠脑缺血再灌注损伤后脑组织内神经元型一氧化氮合酶免疫阳性细胞表达变化,及其对海马齿状回、侧脑室室下区神经细胞增殖的影响.方法 动物分为正常组、假手术组、对照组、川芎嗪处理组.脑缺血再灌注损伤模型由线栓法阻塞大鼠大脑中动脉(MACO)制成.BrdU标记增殖细胞.免疫组化SABC法测定大鼠脑缺血再灌注损伤后,不同脑区在不同时间段的nNOS、BrdU免疫阳性细胞表达,Western blotting测定大鼠脑缺血再灌注损伤后,不同脑区在不同时间段的nNOS的表达.结果 免疫组化结果显示在大脑皮层、纹状体与尾壳核和海马均有nNOS的表达,Western blotting结果显示,对照组缺血侧各脑区内,nNOS表达较假手术组升高(P＜0.05),并随时间延长而递增.川芎嗪处理组大脑皮层、纹状区与尾壳核nNOS表达1、3 d组比对照组同时段表达降低(P＜0.05).川芎嗪处理组BrdU阳性细胞在侧脑室室下区(SVZ)缺血再灌注1、3 d组明显高于对照组(P＜0.05),川芎嗪处理组BrdU阳性细胞在海马齿状回(DG)缺血再灌注3 d、7 d组高于对照组(P＜0.05).结论 川芎嗪能抑制缺血后脑组织内早期nNOS的表达,对缺血后脑组织具有早期保护作用,并能促进SVZ和DG神经细胞增殖.     

丹红注射液对大鼠脑缺血再灌注损伤后TGF-β1表达的影响

目的 探讨丹红注射液对大鼠脑缺血再灌注损伤后TGF-β1表达的影响. 方法 选择健康成年SD大鼠(96只)为研究对象,随机分为正常对照组(8只)、假手术组(8只)、缺血再灌注组(40只)、药物干预组(40只),后两组根据不同再灌注时间点再分为6h、24h、48 h、72 h、7天共5个亚组,每个亚组8只.采用免疫组织化学方法检测大鼠脑组织中转化生长因子β1蛋白含量. 结果 缺血再灌注组、药物干预组各时间点组TGF-β1阳性细胞表达数均明显高于正常对照组和假手术组(P ＜0.05);6 h时,药物干预组TGF-β1阳性细胞表达与缺血再灌注组差异无显著性(P＞0.05),其余各时间点比较,药物干预组TGF-β1阳性细胞表达均明显高于缺血再灌注组(P＜0.05).丹红注射液干预后TGF-β1的表达上升,其中7天组表达明显高于其余各时间点干预组(P＜0.05).结论 丹红注射液能显著提高大鼠脑缺血再灌注损伤后TGF-β1的表达.     

Cystamine 对大鼠脑缺血再灌注后tTG表达的影响

目的 研究胱氨酸(Cystamine)对全脑缺血再灌注损伤后大鼠海马组织型转谷氨酰胺酶(tTG)表达的影响.方法 用四血管阻断法制作大鼠全脑缺血再灌注模型.将SD大鼠随机分为假手术组(n=8),全脑缺血组(n=48)及全脑缺血治疗组(n=48),全脑缺血组和全脑缺血治疗组按照缺血再灌注时间点的不同再将大鼠随机分为6h、12 h、1 d、3 d、5 d、7 d六个亚组,每个亚组8只.全脑缺血治疗组大鼠给予Cystamine腹腔注射(0.15 mg/g),全脑缺血组和假手术组大鼠给予生理盐水腹腔注射.TUNEL染色法观察细胞凋亡水平的变化,免疫组织化学方法分析再灌注后不同时间点海马CA1区tTG表达水平的变化.另取52只大鼠随机分为假手术组(n=4)、全脑缺血组(n=24)及全脑缺血治疗组(n=24),全脑缺血组和全脑缺血治疗组按照不同时间点每个亚组4只,免疫印迹方法测定tTG的表达.结果 缺血组再灌注24 h后TUNEL阳性细胞明显增加,1、3、5、7 d亚组与假手术组差异有统计学意义(P＜0.05);治疗组与缺血组相比,在1、3、5、7 d相应时间点亚组TUNEL阳性细胞数减少(P＜0.05).治疗组海马CA1区tTG平均阳性细胞数于全脑缺血后12 h开始下降,3、5、7 d亚组均明显低于缺血组(P＜0.05).治疗组海马tTG蛋白水平于缺血再灌注后1 d开始降低,3、5和7 d亚组显著低于缺血组(P＜0.05).结论 Cystamine可以降低大鼠全脑缺血再灌注后海马CA1区tTG的表达,从而对神经元细胞起到一定的保护作用.     

孕酮对大鼠脑缺血/再灌注损伤的神经保护作用及其对IP3含量的影响

目的探讨孕酮对大鼠局部脑缺血/再灌注损伤的神经保护作用及机制。方法将大鼠随机等分为假手术组、正常对照组、孕酮组、溶剂(DMSO)组,采用线栓法制作大鼠局部脑缺血再灌注模型,TTC染色和ELISA法分别测定大鼠大脑梗死面积和梗死侧IP3的含量。结果孕酮(8 mg/kg)治疗后大鼠脑梗死面积比例明显小于溶剂组(P<0.05);溶剂组脑梗死侧的IP3含量显著低于假手术组和正常对照组,孕酮组脑梗死侧的IP3含量高于溶剂组(P<0.05)。结论孕酮对大鼠局部脑缺血再灌注损伤有明显的神经保护作用,可能与通过恢复大鼠梗死侧大脑组织IP3有关。     

肾上腺髓质素对大鼠局灶性脑缺血再灌注后脑组织的保护作用

目的 探讨肾上腺髓质素在脑缺血再灌注大鼠脑内的表达情况及其对再灌注损伤的保护作用.方法 采用拴线法制成大鼠大脑中动脉缺血再灌注模型,阻断血流2 h后进行再灌注.应用免疫组织化学染色法检测不同时间点大鼠局灶性脑缺血再灌注后肾上腺髓质素的表达情况,并进行动态观察.结果 正常对照组大鼠脑内即有肾上腺髓质素表达,假手术组术后肾上腺髓质素表达略有增加,但与正常对照组相比差异无显著性意义(P＞0.05);大鼠脑缺血再灌注后肾上腺髓质素免疫阳性细胞增多,与正常对照组及假手术组相比差异均有显著性意义(P＜0.05);大鼠脑缺血再灌注后缺血侧和缺血对侧肾上腺髓质素免疫阳性细胞均增多,但以缺血侧区域增多最为明显.动态观察发现,脑缺血再灌注2 h后,肾上腺髓质素免疫阳性细胞即增多,缺血再灌注6 h达高峰,至1周仍明显增多.结论 脑缺血再灌注后肾上腺髓质素表达增强,对脑缺血再灌注损伤具有保护作用.     

复方中药丹星通络汤对大鼠局灶性脑缺血再灌注损伤的保护作用

目的:探讨复方中药丹星通络汤对大鼠局灶性脑缺血再灌注脑损伤的保护作用及机制. 方法:40只大鼠随机分为4组,即对照组(假手术 生理盐水)、模型组(缺血再灌注 生理盐水)、尼莫地平组(缺血再灌注 尼莫地平)、复方丹星通络汤组(缺血再灌注 复方丹星通络汤). 每组分别连续5 d灌胃口服生理盐水、尼莫地平、复方丹星通络汤. 线栓法制作局灶性脑缺血再灌注模型,缺血2 h后再灌注24 h. 检测血清乳酸脱氢酶(LDH)活力、大脑FAS细胞表达. 结果:模型组大鼠局灶性脑缺血再灌注后血清LDH活力明显高于对照组(P＜0.05), 尼莫地平组、复方丹星通络汤组血清中LDH活力明显降低(尼莫地平组vs 模型组,P＜0.01; 复方丹星通络汤组vs模型组,P＜0.05),尼莫地平组和复方丹星通络汤组间无显著性差异(P＞0.05). 模型组大脑FAS细胞表达明显高于对照,尼莫地平,复方丹星通络汤组(P＜0.01),与模型组比较,尼莫地平组、复方丹星通络汤组脑组织FAS阳性细胞数表达显著下调(P＜0.01),复方丹星通络汤组明显低于尼莫地平组(P＜0.01). 结论:复方丹星通络汤可有效地防止FAS及LDH升高, 对脑缺血再灌注脑损伤有显著保护作用.     

促红细胞生成素对大鼠全脑缺血再灌注后海马蛋白激酶B表达的影响

目的观察促红细胞生成素(EPO)对大鼠全脑缺血再灌注后海马CA1区蛋白激酶B表达的影响,进一步探讨EPO脑保护作用的机制.方法采用改良的Pulsinelli四血管阻断方法制作大鼠全脑缺血再灌注模型.将SD大鼠随机分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组.各组动物分别于缺血15min再灌注6h、24h、48h、72h、7d断头取脑.鼠脑灌注及固定后制作石蜡切片,HE染色观察海马的病理变化,用TUNEL方法检测海马CA1区神经细胞凋亡,免疫组织化学SP法观察磷酸化蛋白激酶B(p-PKB)表达.另外再取24只大鼠分为4组:正常组、假手术组、缺血再灌注组和EPO治疗组,应用Y型迷宫法对缺血再灌注7 d的大鼠进行缺血后学习和记忆功能的测定.结果 (1)TUNEL染色:假手术组48 h、72h可见个别阳性细胞.缺血再灌注组于再灌注24h可见少量阳性细胞;再灌注48h可见较多TUNEL阳性细胞,72h出现大量TUNEL阳性细胞,7d明显减少.EPO治疗组TUNEL阳性细胞在各时间点明显少于缺血再灌注组[(948.6±91.0)个vs(502.7±97.3)个,P＜0.01].(2)认知功能变化:全脑缺血再灌注后7 d大鼠学习能力降低,尝试次数明显增多(P＜0.01).EPO治疗组尝试次数减少,有显著性差异(P＜0.01).学习能力测试后24h记忆功能测定,结果发现缺血再灌注组成绩明显低下,EPO处理组可改善缺血造成的大鼠记忆功能障碍[(20.06±3.85)s vs(12.93±3.04)s,P＜0.01].(3)p-PKB免疫组化染色:缺血再灌注组于再灌注6h即出现p-PKB明显表达增高,72h达高峰,7 d明显下降.EPO治疗组于再灌注6h、48h、72h、7 d,p-PKB蛋白表达较缺血再灌注组增高[(25.42±3.86)vs(11.64±2.13),P＜0.01].(4)相关分析:TUNEL阳性细胞与p-PKB蛋白表达则呈负相关,而大鼠学习能力与海马CA1区存活神经细胞数呈正相关趋势.结论 EPO能减少大鼠脑缺血再灌注损伤后海马CA1区神经细胞的坏死和凋亡,减轻脑缺血再灌注损伤后大鼠学习、记忆功能障碍.EPO可能通过增强海马神经细胞p-PKB的表达,发挥神经细胞保护作用.     

低分子肝素对大鼠脑局灶性缺血再灌注后Bcl-2,Bax表达的影响及保护作用

目的:观察低分子肝素对大鼠脑缺血再灌注后不同时间点Bcl-2,Bax表达的影响及保护作用. 方法:①选用雄性SD大鼠54只,体质量280～330 g. 应用随机数字表法将大鼠分为3组:假手术组、缺血再灌注组和低分子肝素组,每组18只. ②应用免疫组化方法测定海马CA1区神经元细胞凋亡基因Bcl-2,Bax表达情况. ③采用两样本均数的t检验对两组间数据进行分析. 结果:大鼠54只均进入结果分析,缺血再灌注组大鼠脑缺血再灌注6,12,24 h时Bcl-2蛋白在神经元内表达的阳性细胞数较低分子肝素组同一时间点明显减少,两组比较具有显著的统计学意义(P＜0.05). 缺血再灌注组大鼠脑缺血再灌注6,12,24 h时Bax蛋白表达的阳性细胞数较低分子肝素组同一时间点明显增加,两组比较具有显著的统计学意义(P＜0.05). 结论:脑缺血再灌注损伤随再灌注时间延长而加重,低分子肝素可能通过减少Bax蛋白的表达,上调Bcl-2蛋白表达,从而减轻神经元的损伤及凋亡,起到脑保护作用.     

奥曲肽对局灶性脑缺血的保护作用

目的 观察奥曲肽(OCT)对局灶性缺血再灌注的保护作用并探讨相关作用机制.方法 80只SD大鼠随机分为4组,分别为假手术组,缺血再灌注组,OCT低剂量组及OCT高剂量组.在建立缺血再灌注模型各组分别使用安慰剂或OCT处理.参照Longa 5分制评分标准,分别在再灌注后的各观察时间段对大鼠进行神经功能评分;脑组织标本分别采用氯化三苯基四氮唑(TTC)染色进行梗死面积检测,并采用试剂盒检测丙二醛(MDA)和过氧化物歧化酶(SOD)含量.结果 高剂量OCT能够显著改善脑缺血再灌注组大鼠的功能评分.OCT高剂量组动物梗死面积明显小于缺血再灌注组(P＜0.05),MDA在OCT高剂量组的活性分别显著低于缺血再灌注组(P＜0.05),而SOD的活性OCT组则显著升高(P＜0.05).结论 OCT在大鼠脑缺血再灌注具有保护作用,可能是通过影响脑部的氧化来产生作用的.     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.