颅脑损伤患者血浆NPY及CGRP检测的临床意义

目的 探讨血浆神经肽Y(NPY)和降钙素基因相关肽(CGRP)水平在不同程度颅脑外伤患者中的l临床意义.方法 采用放射免疫方法(RIA)对91例依据GCS评分法分为轻度、中度和重度的颅脑损伤患者及35例正常对照组的NPY、CGRP和ET-1水平进行检测.结果 轻、中、重三组颅脑损伤患者血浆NPY水平分别为(119.6±20.3)ng/L、(127.8±25.5)ng/L和(146.2±30.5)ng/L,显著高于正常对照组(65.2±13.2)ng/L,差异有统计学意义(P<0.01).轻、中度患者血浆CGRP含量分别为(54.3±5.6)ng/L、(57.5±7.4)ng/L,显著高于正常对照组(41.8±6.8)ng/L,差异有统计学意义(P<0.01);而重度患者组的CGRP水平(44.6±5.3)ng/L与对照组(41.8±6.8)ng/L问差异无统计学意义(P>0.05).结论 血浆NPY及CGRP水平与不同程度颅脑损伤患者的病情密切相关,并对患者预后的判定具有一定的临床参考价值.     

脓毒症患者血浆食欲素A水平的临床研究

目的:探讨脓毒症患者血浆食欲素A的变化和意义。方法:选择脓毒症并肥胖患者16例(肥胖脓毒症组),单纯脓毒症患者13例(单纯脓毒症组),单纯肥胖者13例(单纯肥胖组),正常体重者13例(正常体重组)。其中肥胖脓毒症组和单纯肥胖组的体重指数(BMI)均≥25kg/m2,且差异无统计学意义(P>0.05)。所有受试者均采用层析及放射免疫法测定血浆食欲素A的水平。结果:肥胖脓毒症组[(4.58±1.94)ng/L]与单纯脓毒症组[(4.82±2.50)ng/L]之间血浆食欲素A水平差异及单纯肥胖组[(2.37±1.01)ng/L]和正常体重组[(2.61±0.92)ng/L]之间血浆食欲素A水平差异无统计学意义(P>0.05);肥胖脓毒症组血浆食欲素A水平与单纯脓毒症组均显著高于单纯肥胖组和正常体重组(P<0.01)。各组内血浆食欲素A水平与BMI之间无相关性。结论:脓毒症患者血浆食欲素A水平升高,其原因可能与炎性反应引起的高代谢状态、组织低氧有关,或可能在炎性反应中发挥作用。     

支气管哮喘急性发作期患者血浆合肽素测定的临床意义

目的 探讨支气管哮喘急性发作期患者血浆合肽素测定的临床意义. 方法 选择46例支气管哮喘急性发作期患者和18例健康者(对照组)为研究对象,根据支气管哮喘患者急性发作期病情严重程度分为3组,其中轻～中度患者18例、重度患者15例、危重度患者13例,测定3组患者治疗前、后及对照组的血浆合肽素、血常规等指标,比较4组受检者相关指标有无差异.结果 治疗前危重度、重度、轻～中度支气管哮喘发作患者血浆合肽素水平分别为(1.08±0.21)μg/L、(0.72±0.16)μg/L、(0.46±0.10)μg/L,均明显高于对照组的(0.10±0.03)μg/L,差异有统计学意义(P<0.01);治疗前3组支气管哮喘患者血浆合肽素水平比较,差异有统计学意义(P<0.01).治疗后危重度、重度、轻～中度患者血浆合肽素水平分别为(0.13±0.03)μg/L、(0.15±0.04)μg/L和(0.12±0.04)μg/L,与对照组比较,差异均无统计学意义(P>0.05).支气管哮喘急性发作患者治疗前、治疗后血浆合肽素水平与PaO2均呈负相关(P<0.05),与PaCO2、血浆CRP水平、外周血白细胞总数均呈正相关(P<0.05).结论 血浆合肽素可作为判断支气管哮喘急性发作期患者病情严重程度及治疗疗效的一种观察指标.     

降钙素原与血清C-反应蛋白联合测定对严重多发伤患者早期细菌感染的诊断价值

目的 探讨降钙素原(PCT)与血清C-反应蛋白(CRP)联合测定对严重多发伤患者早期细菌感染的诊断价值.方法 应用双抗夹心免疫发光法测定血浆PCT含量,散射比浊法测定血浆CRP水平,对51例ISS≥16分的发生细菌感染的多发伤患者(感染组)伤后,30例健康志愿者(对照组)和46例伤后早期未并发感染的多发伤患者(未感染组)分别进行血浆PCT和CRP水平的测定.结果对照组PCT和CRP值分别为(0.80±0.19)ng/mL和(1.10±0.31)mg/L;感染组PCT和CRP值分别为(35.25±14.61)ng/mL和(46.86±18.59)mg/L,均较对照组明显升高(P<0.01);未感染组PCT值为(1.35±0.33)ng/mL,与对照组比较,差异无统计学意义(P>0.05),与感染组比较,差异有统计学意义(P<0.01);未感染组CRP值为(41.29±16.30)mg/L,与对照组比较,差异有统计学意义(P<0.01),与感染组比较,差异无统计学意义(P>0.05).结论 血浆PCT与CRP联合测定可为严重多发伤患者早期细菌感染提供更准确的诊断依据.     

Ⅲ型慢性前列腺炎患者血浆单胺类神经递质水平的研究

目的 研究Ⅲ型慢性前列腺炎(CP)患者血浆单胺类神经递质的水平与其合并CPPS、精神心理障碍等症状的关系. 方法采用高效液相-电化学法,测定20例健康志愿者及48例Ⅲ型CP患者血浆去甲肾上腺素(NE)、多巴胺(DA)水平,采用酶联免疫吸附试验测定其血浆5-羟色胺(5-HT)水平,分别比较其递质水平.结果 健康志愿者与单纯排尿症状组的Ⅲ型CP患者血浆NE分别为(341.3±62.4)ng/L和(327.1±68.7)ng/L,DA分别为(150.9±24.7)ng/L和(152.9±18.9)ng/L,5-HT分别为(174.2±47.1)ng/L和(192.4±43.7)ng/L,两组比较差别均无统计学意义(P>0.05).健康志愿者与伴有CPPS但不伴有精神心理障碍组的Ⅲ型CP患者NE分别为(341.3±62.4)ng/L 和(415.8±60.8)ng/L,两组差别有统计学意义(P<0.05).健康志愿者与伴有精神心理障碍的Ⅲ型CP患者DA分别为(150.9±24.7)ng/L 和(186.9±14.6)ng/L,5-HT分别为(174.2±47.1)ng/L和(124.8±31.6)ng/L,差别均有统计学意义(P<0.05).结论 伴有CPPS的Ⅲ型CP患者血浆NE显著高于健康志愿者;伴有精神心理障碍的Ⅲ型CP患者DA高于健康志愿者,而5-HT水平低于健康志愿者,提示血浆单胺类神经递质水平异常可能是引起CPPS和精神心理障碍的原因之一.     

子痫前期患者血浆uPA、TGF-β1含量变化及意义

目的 探讨子痫前期患者血浆尿激酶型纤溶酶原激活因子(uPA)和转化生长因子β1(TGF-β1)含量的变化及其在子痫前期发病中的意义.方法 采用酶联免疫吸附法测定70例子痫前期患者(子痫前期组,其中轻度患者30例,重度患者40例)和40例正常晚孕妇女(对照组)血浆uPA和TGF-β1含量.结果 ①正常晚孕组血浆uPA含量为(646.54±35.39)pg/mL,子痫前期组为(436.39±29.57)pg/mL,两组比较差异有统计学意义(P＜0.01);轻度子痫前期组为(468.81±14.91)pg/mL、重度子痫前期组为(417.11±48.47)pg/mL,均低于正常晚孕组(P均＜0.01);轻、重度组之间比较差异无统计学意义(P＞0.05);②正常晚孕组血浆TGF-β1含量为(9.85±3.19)ng/mL,子痫前期组为(14.32±4.37)ng/mL,两组比较差异有统计学意义(P＜0.05);轻度子痫前期组为(11.21±2.32)ng/mL、重度子痫前期组为(15.37±4.93)ng/mL,均高于正常晚孕组(P均＜0.05);轻、重度组之间比较差异无统计学意义(P＞0.05).③子痫前期患者血浆uPA和TGF-β1含量呈负相关(r=-0.497,P＜0.01).结论 子痫前期患者血浆uPA水平下降、TGF-β1水平升高与子痫前期发病及其严重程度有关.     

慢性心衰患者血浆C型利钠肽、肾上腺髓质素的变化及意义

目的 测定慢性心衰(CHF)患者血浆C型利钠肽(CNP)、肾上腺髓质素(ADM)水平,以探讨其与心衰严重程度的关系.方法 随机选取115例CHF患者与40例健康者,CHF组按照心功能Ⅱ、Ⅲ、Ⅳ级分为3个亚组,抽取空腹静脉血,采用放射免疫法测量其血浆CNP、ADM的水平.超声心动图测量CHF组左室射血分数(LVEF)值.结果 ①CHF组血浆CNP、ADM的水平(CNP:40.02±21.19 pg/ml;ADM:71.38±29.30 pg/ml)明显高于健康对照组(CNP:14.46±4.54 pg/ml、ADM:21.90±6.58 pg/ml,P＜0.01).②CHF组各亚组的血浆CNP、ADM的水平分别为:心功能Ⅱ级组(CNP:23.59±5.28 pg/ml、ADM:43.34±4.78 pg/ml),心功能Ⅲ级组(CNP:36.56±4.77 pg/ml、ADM:65.78±9.06 pg/ml),心功能Ⅳ级组(CNP:71.41±10.28 pg/ml、ADM:105.04±22.21 pg/ml),任意两组比较均有显著差异性,P＜0.01,③血浆CNP、ADM水平均与LVEF值呈负相关(CNP:r=-0.67,P＜0.01,ADM:r=-0.58,P＜0.05).结论 在CHF患者中,血浆CNP、ADM的水平与心力衰竭严重程度呈正相关,临床上可作为评估CHF严重程度及其预后的指标.     

妊娠期肝内胆汁淤积症外周血IL-12及TNF-α检测的临床意义

目的 观察妊娠期肝内胆汁淤积症(ICP)患者外周血清肿瘤坏死因子α(TNF-α)和白介素12(IL-12)的水平,探讨其与患者临床发病程度及围产结局的相关性.方法 选取本院产科2013年1月至2015年1月收治的113例ICP患者,根据发病程度分为三组:轻度ICP 31例、中度ICP 52例、重度ICP 30例,并以同期入院的101例健康孕产妇为对照组;抽取各组孕产妇清晨空腹外周血,采用ELISA试剂盒测定其血清TNF-α和IL-12的水平.结果 对照组、轻度ICP、中度ICP、重度ICP的IL-12水平分别为(8.22±1.05)ng/L、(27.2±3.25)ng/L、(46.5±3.83)ng/L、(66.3±5.24)ng/L,TNF-α水平分别为(31.2±4.52)ng/L、(67.2±6.25)ng/L、(82.3±7.79)ng/L、(126±13.2)ng/L,各组之间的差异均有统计学意义(P<0.01);ICP患者剖宫产率为61.1%(69/113),剖宫产患者IL-12、TNF-α水平分别为(62.3±7.35)ng/L、(93.2±11.4)ng/L,阴道分娩患者的分别为(58.3±6.04)ng/L、(87.5±10.7)ng/L,组间比较差异均有统计学意义(P<0.05);ICP患者不良妊娠结局发生率为35.4%(40/113),不良妊娠结局患者IL-12、TNF-α水平分别为(67.3±7.06)ng/L、(119±13.0)ng/L,正常妊娠者分别为(40.2±5.89)ng/L、(86.5±9.37)ng/L,组间比较差异均有统计学意义(P<0.01).结论 IL-12及TNF-α水平与ICP的发病程度呈正相关,可作为围产结局的预测指标.     

慢性心力衰竭患儿血浆肾上腺髓质素、C-型利钠肽及心肌作功指数测定

目的:探讨慢性心力衰竭(CHF)患儿血浆肾上腺髓质素(ADM)、C-型利钠肽(CNP)浓度和心肌作功指数(Tei指数)的变化.方法:42例CHF患儿,心功能Ⅱ级16例、Ⅲ级14例、Ⅳ级12例,原发疾病为扩张性心肌病12例,先天性心脏病19例,心内膜弹力纤维增生症等其他疾病11例.正常对照组11例.用同位素放射免疫分析法测定2组血浆ADM和CNP含量,超声心动图测定Tei指数、左室射血分数(LVEF).结果:CHF患儿治疗前血浆ADM和CNP含量高于正常对照组(P=0.000);治疗后血浆ADM和CNP含量均较治疗前降低(P＜0.05).CHF患儿血浆ADM、CNP含量和Tei指数随心功能级别的升高而升高(P＜0.05).心肌病组、先心病组及其他病组间血浆ADM、CNP含量和Tei指数差异无统计学意义(P均＞0.05).CHF组血浆ADM和CNP水平与Tei指数均呈正相关(r分别为0.87,0.59,P均＜0.001);与LVEF均呈负相关(r分别为-0.69,-0.48,P均＜0.01).结论:ADM有可能成为评估小儿CHF严重程度和预测CHF预后新的生化指标.     

妊娠期高血压疾病患者血浆B型钠尿肽的表达及与心脏功能关系的研究

目的 探讨妊娠期高血压患者血浆B型钠尿肽(BNP)水平变化与心脏功能等级的相关性,评价血浆BNP水平对子痫前期并发心力衰竭评估的意义.方法 回顾性分析2011年1月～2012年12月收治的195例患者血浆BNP水平,其中妊娠期高血压93例,轻度子痫前期76例,重度子痫前期26例,分析上述患者血清BNP水平与妊娠期高血压各期及心功能的等级的关系.结果 妊娠期高血压、轻度子痫前期和重度子痫前期血浆BNP水平呈逐渐增高的趋势,分别为(57.39±21.49)、(1007.44±150.46)、(2630.35±456.68)ng/L,差异有高度统计学意义(P＜0.01).同时上述重度子痫前期并发心力衰竭16例,其中心脏功能Ⅰ级患者血浆BNP水平为(1268.38±212.10)ng/L,心脏功能Ⅱ级患者血浆BNP水平逐渐升高为(4401.00±605.20)ng/L,心脏功能Ⅲ、Ⅳ级患者血浆BNP水平最高为(6789.50±981.51)ng/L,上述差异有统计学意义(P＜0.05).结论 检测妊娠期高血压患者血浆BNP水平对评价子痫前期病情及评估心脏功能具有一定临床意义.     

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.