极化液对老年患者心脏自主神经功能的影响

目的：探讨极化液对老年患者心脏自主神经功能的影响。方法将60例行择期胃癌根治术的老年非糖尿病患者分成C、G两组。 G组（n＝30）检测血糖后输注极化液（500 g／L 葡萄糖溶液50 mL＋正规胰岛素10 IU＋100 g／L KCl 3 mL）0.4 mL／（kg· h）至手术结束,用血糖仪监测术中末梢血糖。采用Holter记录术前和术后第1、2天20：00-7：00时间段心率变异性（ HRV）各频域成分的平均值,包括总功率（ TP）、高频功率（ HF）、低频功率（ LF）和极低频功率（ VLF）。结果两组患者术后TP、HF、LF和VLF较术前都显著降低（ P＜0.01）,而LF／HF手术前后没有明显变化（P＞0.05）。与术后第1天比较,术后第2天C组TP、HF、LF及VLF继续降低,而G组相应指标呈回升趋势,但差异无统计学意义（ P＞0.05）。术后第2天G组TP、LF和VLF明显高于C组（ P＜0.05）。结论手术后老年人心脏自主神经系统调节受损害程度重,术中应用极化液能防止术后2 d HRV的显著降低,有效改善心脏自主神经功能。     

桂附地黄丸对肺纤维化模型形成阶段肺组织TNF-α表达的影响

目的探讨桂附地黄丸防治肺纤维化的作用及机理。方法将大鼠随机分为正常对照组、模型对照组、桂附地黄丸组、强的松对照组,每组12只。除正常对照组外,各组用平阳霉素诱导肺纤维化模型大鼠,各用药组每天灌胃相应药液,第28天后处死各组大鼠,观察各组大鼠肺部病理组织学改变及肺组织中肿瘤坏死因子-α（TNF-α）表达。结果桂附地黄丸组、强的松对照组肺纤维化程度、肺组织TNF-α表达均显著低于模型对照组（P〈0.05）,且桂附地黄丸抑制肺组织TNF-α表达优于强的松对照组（P〈0.05）。结论桂附地黄丸能明显减轻平阳霉素所致的大鼠肺纤维化程度,抑制肺组织中TNF-α过度表达。     

吸烟和戒烟对心率变异性的影响

目的:探讨吸烟与戒烟对健康人群心率变异性(HRV)的影响。方法:随机选择不同中青年健康人群142例,分为吸烟组72例(≥5支·d-1,持续≥1年),不吸烟组70例(从不吸烟),对两组人群采集5 min心搏,由计算机自动对其进行短程HRV分析。然后不吸烟组连续吸两根同品牌香烟,分别于吸烟后即刻、20 min、1 h用同样方法采集5 min心搏进行短程HRV分析。吸烟组劝其戒烟,分别于开始戒烟后3天、1周、4周同样方法采集5 min心搏进行短程HRV分析。结果:(1)与不吸烟组相比,吸烟组人群VLF、LF、HF明显升高(P<0.05),SDNN明显降低(P<0.05),差异有统计学意义;(2)不吸烟组人群连续吸烟后HRV即刻就会发生改变,但HF升高更为明显(P<0.05),而在连续吸烟后30 min VLF、LF升高更显著(P<0.05),吸烟后1 h,VLF、LF及HF与吸烟前相比,差异无统计学意义(P>0.05);(3)吸烟组戒烟3天后VLF、LF、HF就开始显著下降,与戒烟前相比,两者差异有统计学意义,且随着戒烟时间的延长,VLF、LF、HF呈现持续下降趋势。结论:长期吸烟者的SDNN降低,VLF、LF及HF增加,这种改变在吸烟后即刻就会出现;戒烟可以使SDNN增加,而VLF、LF及HF降低。     

心率变异性分析评估不同因素致亚健康大鼠自主神经功能的影响

目的 基于心率变异性(heart rate variability,HRV)分析评估不同因素致亚健康大鼠自主神经功能的影响,确定HRV指标与亚健康状态的发生关系.方法 将42只雄性SPF级Wistar大鼠,按体质量随机分成7组,即多因素组、多因素干预组、热水游泳组、饮食限制组、睡眠不足组、单纯束缚组和正常对照组,每组6只,通过热水游泳、饮食限制、睡眠剥夺、束缚等方式建立亚健康大鼠模型,多因素干预组给予300 mg/kg的抗衰老片浸膏粉,并分别在造模结束后及恢复3d时遥测大鼠的心电图,利用HRV分析评估不同因素致亚健康大鼠自主神经功能情况.结果 与正常对照组比,时域分析显示亚健康大鼠的SDNN、RMSDD、STV、LTV均有所升高,且频谱分析显示亚健康大鼠VLF、LF、TP、LF/HF、LFnu上升和HFnu下降,且给予抗衰老片后能明显降低LF、LF/HF和LFnu(P＜0.05)和显著升高HFnu(P＜0.05),单因素logistic回归分析显示RRI、SDNN、LTV、LF、TP、LF/HF、LFnu、HFnu与亚健康产生密切相关(P＜0.05),且经逐步logistic 回归分析结果显示低下的HFnu(OR值=0.566,P=0.023)可作为评价亚健康产生的独立危险因子.结论 不同因素致亚健康大鼠的自主神经功能均出现明显的紊乱,且迷走神经活动抑制是亚健康产生的独立危险因素,可见基于HRV分析技术可无创性的客观评估机体亚健康状态的程度.     

氢化可的松诱发虚证状态对H22肝癌小鼠肿瘤增长的影响

目的?研究氢化可的松诱发的虚证状态对肝癌小鼠肿瘤增长的影响。方法?将雄性昆明种小鼠随机分为正常对照组、肿瘤模型组、氢化可的松组,氢化可的松肿瘤组,采用氢化可的松给药小鼠14?d造成虚证状态,给药第1天同步接种H22肝癌细胞至腋下复制荷瘤小鼠模型。动态观测小鼠体质量与肿瘤大小变化;处死小鼠后,取脾脏、胸腺称质量并计算脏器指数;采用实时荧光定量PCR技术检测肾上腺类固醇合成酶以及肿瘤增殖相关的mRNA表达;运用Western blot方法检测肿瘤Akt、p-Akt蛋白表达。结果?与正常对照组比较,肿瘤模型组脾脏显著增大（P＜0.05）,肾上腺Cyp11a1、Cyp11b1、Cyp11b2的基因表达显著下调（P＜0.05）;使用氢化可的松的小鼠脾脏和胸腺明显萎缩（P＜0.01）,肾上腺Star、Cyp11a1、Cyp21a1、Cyp11b1基因均下调（P＜0.05）。与肿瘤模型组比较,氢化可的松肿瘤组小鼠接种肿瘤第7天肿瘤体积减小（P＜0.05）,同时氢化可的松显著抑制肿瘤组织Akt1基因表达（P＜0.05）,促使Foxo3基因表达上调（P＜0.05）、抑制Akt、p-Akt蛋白表达。与氢化可的松组比较,氢化可的松肿瘤组小鼠脾脏、胸腺萎缩减轻,肾上腺类固醇合成酶基因表达均上调（P＜0.05）。结论?氢化可的松通过抑制内分泌免疫功能诱发小鼠虚证,短期使用小鼠肿瘤增殖减缓,而持续性虚损状态下促进肿瘤生长。      

恶劣心境患者血清超敏C反应蛋白水平与心率变异性相关研究

目的 探讨恶劣心境患者血清超敏C反应蛋白(hs-CRP)与心率变异性(HRV)水平及可能的心理生理机制.方法 采用心理健康测查表( PHI)对42例恶劣心境患者组(DD组)、33例重性抑郁症患者组(MD组)及30例健康对照组(NC组)进行心理健康水平和人格特质测定,并分析短时(5 min)心率变异性及血清hs-CRP水平,评定自主神经及免疫系统功能.结果 DD组PHI量表躯体化、焦虑、病态人格及疑心因子分明显高于MD组(P＜ 0.01或P＜0.05);DD组HRV频谱指标中SDNN、PNN50及HF较MD及NC组均显著下降(P＜0.01或P＜0.05),LF/HF较MD及NC组均明显升高(P＜0.05),血清hs-CRP水平较MD及NC组明显升高(P＜0.05或P＜0.01);PHI躯体化及焦虑因子与SDNN、VLF、LF及血清hs-CRP水平均相关(r=-0.27,-0.29、r=0.38,0.33、r=0.41,0.31、r=0.34,0.23,P＜0.05或P＜0.01),且血清hs-CRP水平与SDNN、RMSSD、SDSD、VLF、LF、HF及LF/HF均相关(r=-0.47,-0.45,-0.45,0.26,0.46,-0.51,0.10,P＜0.05或P＜0.01).结论 恶劣心境患者焦虑及躯体化程度更高,自主神经功能紊乱更加显著,且与血清hs-CRP水平增高具有相关性.     

心率变异性对儿童不明原因晕厥的诊断价值

目的:通过测定不明原因晕厥儿童的心率变异性(heart rate variability,HRV),研究其对不明原因晕厥儿童的诊断价值。方法:对49例不明原因晕厥儿童行直立倾斜试验(head up tilt test,HUT)诊断及动态心电图监测,分析HUT阳性患儿与阴性患儿HRV的差异。采用受试者操作特征(receiver operating characteristic,ROC)曲线分析HRV对不明原因晕厥患儿的诊断价值。结果:49例不明原因晕厥患儿经HUT诊断后,32例(65.3%)诊断明确,HUT的诊断阳性率为65.3%。HUT阳性组的SDNNi、rMSSD、TP、ULF、VLF、LF以及HF均明显高于HUT阴性组(P<0.05)。HUT阳性组的SDNN、pNN50以及三角指数与HUT阴性组相比,差异均无统计学意义(P>0.05)。SDNNi、rMSSD、TP、ULF、VLF、LF和HF对HUT的诊断预测具有一定价值。分别以ULF、LF和HF 12 947.00、9 462.50和9 509.00作为界值时,对诊断阳性率的预测效果较好,灵敏度分别为75.0%、68.8%和68.8%,特异度分别为64.7%、64.7%和64.7%。结论:HRV中的ULF、LF和HF可作为HUT诊断自主神经介导性晕厥的预测指标,界值分别为12 947.00、9 462.50和9 509.00,具有较好的灵敏度和特异度。     

长途运输应激对两种品系五指山小型猪自主神经功能的影响

目的 观察长途运输应激对两种品系五指山小型猪自主神经功能的影响. 方法 基于无创遥测技术,监测清醒自由活动状态下经21 h长途运输应激后和2个月恢复后,两种品系五指山小型猪心电图（ECG）和活动的改变,并用HRV分析评价其自主神经功能状况. 结果 （1）小型猪对照组具有明显的昼夜节律变化,白天以交感神经活动为主,晚上以副交感神经活动为主,且Black品系RRI、RMSSD、STV、VLF、LF和LF/HF比值均显著低于white品系（P〈0.05,P〈0.01）,而HR、LTv、TP和HF均显著高于White品系（P〈0.05,P〈0.01）;（2）与对照组比,长途运输应激后.小型猪RRI、SDNN、RMSSD、STV、LTV、TP、vLF、LF和LF/HF比值均明显降低（P〈0.01）,HR和HF增加（P〈0.05,P〈0.01）,且Black品系LTS组RRI、RMSSD、STV、VLF、LF和LF/HF比值均显著低于white品系LTS组（P＜0.05,P〈0.01）,而HR、LIV、TP和HF均显著高于White品系LTS组（P〈0.05,P〈0.01）;（3）长途运输应激小型猪的活动、心率及其HRV时域和频域指标均具有显著的相关性（P〈0.05,P〈0.01）. 结论 长途运输应激能使不同品系五指山小型猪的自主神经活动产生明显的差异,且Black品系五指山小型猪更易受长途运输应激的损害;另外,交感神经活动的降低可能是导致运输应激致小型猪生物学功能发生改变的主要原因之一.     

氢化可的松致SD大鼠肾阳虚证卵巢早衰模型研究

目的 探讨氢化可的松致SD雌性大鼠肾阳虚证卵巢早衰(POF)模型的大体情况、卵巢指数、子宫指数、动情周期紊乱情况、血清生殖激素水平的特征.方法 以8～9周龄SPF级成年性成熟雌性SD大鼠(未孕未产)为研究对象,模型组每日上午后下肢肌注氢化可的松32 mg· kg-1·d-1,1次/d,连续12 d,建立肾阳虚证大鼠POF模型,对照组为未注射氢化可的松的雌性SD大鼠.分两个阶段观察比较在造模结束后第2天、第14天两组在大鼠体质量、卵巢指数、子宫指数、动情周期、血清生殖激素水平的变化.结果 1)模型组大鼠第一阶段和第二阶段注射氢化可的松后体质量均低于对照组和注射前(P＜0.05),第一阶段和第二阶段体质量差异无统计学意义(P＞0.05);2)模型组大鼠动情周期紊乱,阴道涂片显示动情间期持续或延长;3)模型组大鼠第一阶段和第二阶段注射氢化可的松后卵巢指数均低于对照组和注射前(P＜0.05),第二阶段卵巢指数均数低于第一阶段(P＜0.05),子宫指数无明显差异(P＞0.05).4)与对照组和注射前相比,模型组大鼠第一阶段和第二阶段注射氢化可的松后血清E2下降,FSH、LH升高,FSH/LH升高,差异有统计学意义(P＜0.05);5)与模型组第一阶段相比,第二阶段血清E2下降,FSH/LH下降,差异有统计学意义(P＜0.05);模型组两个阶段的FSH、LH差异无统计学意义(P＞0.05).结论 氢化可的松致大鼠肾阳虚卵巢早衰模型大鼠体质量下降,呈明显阳虚证型,动情周期紊乱,动情间期延长或持续,卵巢指数降低,在给药结束后生殖激素异常,且在给药结束后14 d肾阳虚证持续.     

摄食行为对小型猪心脏自主神经功能的影响

目的 观察摄食行为对小型猪心脏自主神经功能的影响.方法 利用大动物无创遥测技术观察清醒活动状态下小型猪摄食前(BI)、摄食过程中(IP)、摄食后(AI)、AI2 h和AI 4h的心电图(ECG)和自主活动,并用HRV功率谱分析其自主神经功能.结果 与摄食前比较,小型猪摄食过程中心率(HR)、自主活动和标准化低频成分(LFnu)明显增加,RR间期(RRI)、总功率(TP)、极低频成分(VLF)、高频成分(HF)明显减少,LF/HF比值明显升高;且随着摄食后恢复时间的延长,小型猪HR、自主活动、LFnu均有所降低,而RRI、TP、VLF、HF均有所升高,LF/HF比值逐渐降低,并在摄食后2h、4h时变化显著;相关分析显示摄食行为与TP、VLF、HF、LF和LF/HF密切相关,多元线性逐步回归分析亦显示摄食行为与VLF、LF/HF和TP密切相关,且VLF起主要作用.结论 小型猪摄食行为不仅影响心脏活动;而且能引起小型猪心脏自主神经控制能力发生改变,其中VLF在摄食行为过程中占有重要作用.     

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.