异基因外周血干细胞移植(S999方案)治疗白血病的临床观察

目的　采用S999方案中异基因外周血干细胞移植 (allo PBSCT)治疗白血病 ,评价其疗效并观察移植物抗宿主病 (GVHD)等并发症。方法　 1999年 9月～ 2 0 0 2年 9月间 ,共完成allo PBSCT治疗成人白血病 5 0例 ,其中慢性粒细胞白血病 (CML) 2 8例 ,急性髓细胞白血病 (AML) 13例 ,急性淋巴细胞白血病 (ALL) 9例。外周血干细胞动员方案 :格拉诺赛特 (G CSF) 5 μg·kg- 1 ·d- 1 × 5d ;移植预处理主要采用环磷酰胺 (CTX) +足叶乙甙 (VP16) +全身照射 (TBI)方案 :CTX 5 0～ 60mg·kg- 1 ·d- 1 × 2d ;VP162 0mg·kg- 1 ·d- 1 × 2d或 5 0mg·kg- 1 ·d- 1 × 1d ,TBI 6.5～ 8.0Gy单次照射或l2 .0Gy分 3次照射 ;GVHD预防采用常规环孢素A(CsA)+短程氨甲喋呤 (MTX)和霉酚酸脂 (MMF)联合CsA +MTX两种方案。结果　本组患者除 1例移植早期因并发真菌感染而导致败血症死亡外 ,余 49例均获得完全供体型造血功能重建。中性粒细胞恢复至 0 .5× 10 9/L及血小板恢复至 2 0× 10 9/L的中位时间分别为移植后 14d( 10～ 2 2d)及 19d( 10～ 68d)。 49例移植成功者发生急性GVHD 16例 ( 3 2 .7% ) ,其中Ⅲ～Ⅳ度 5例 ( 10 .2 % )。 3 6例生存 6个月以上者发生慢性GVHD 2 4例( 66.7% ) ,其中广泛性 5例 ( 13 .9% )。MMF +CsA +M     

非清髓异基因造血干细胞移植联合伊马替尼治疗慢性粒细胞白血病的临床研究

目的　探讨非清髓造血干细胞移植联合伊马替尼(格列卫、STI571)在治疗慢性粒细胞白血病(CML)中的作用。方法　10例CML患者中3例为慢性期,4例为加速期,3例为急变期。移植前、后口服格列卫(400～1500mg/d)治疗,预处理方案为福达拉宾,环磷酰胺和阿糖胞苷联合抗胸腺细胞球蛋白或CD3单抗。供者HLA配型4例完全相合,2例1个位点不相合,1例2个位点不相合的同胞,1例3个位点不相合的同胞及2例半匹配的母亲供者。干细胞来源为重组人类粒细胞集落刺激因子(rhG- CSF,格拉诺赛特)动员的外周血造血干细胞(PBSC),移植物抗宿主病(GVHD)的预防以环孢菌素A和霉酚酸酯(骁悉)为主,部分病例加用甲氨蝶呤、CD3单抗及CD25单抗(塞尼派)。结果　10例患者均获得不同程度的嵌合状态,3例获得完全嵌合(>95%),7例获得44%～95%的混合嵌合。7例混合嵌合状态的患者经调整免疫抑制剂、供者淋巴细胞/PBSC输注,格列卫治疗,6例患者在移植后1 5～10个月转变为完全嵌合。移植后中性粒细胞>0. 5×109/L所需天数为16d(10～21d);血小板大于20×109/L所需天数为10d(4～15d)。移植期间1例患者移植后45d因肠道感染,颅内出血死亡。另1例患者移植后27d因多脏器衰竭死亡。8例患者随访7～23个月,6例发生Ⅰ～Ⅱ度GVHD,2例发生Ⅲ～Ⅳ度GVHD,除1例因慢性GVHD死     

异基因外周血干细胞移植治疗二例急性白血病

目的 :评价异基因外周血干细胞移植 (allo PBSCT)治疗急性白血病的疗效。方法 :预处理方案 :改良BUCY。预防移植物抗宿主病 (GVHD)方案 :CsA +短程MTX ,用G CSF 5 μg/kg·d-1× 4～ 5d进行造血干细胞动员。分离单个核细胞 5 .5 3～ 6 .92× 10 8/kg。结果 :2例患者移植后均重建造血。粒细胞 >0 .5× 10 9/L ,+12d ;血小板 >2 0×10 9/L ,+13d。 1例发生慢性GVHD。结论 :allo PBSCT有造血重建快 ,采集干细胞方便 ,供者易接受之优点 ,是一种治疗急性白血病的有效方法     

人类白细胞抗原不相合造血干细胞移植治疗白血病的临床研究

目的 :探讨应用人类白细胞抗原 (humanleukocyteantigen ,HLA)不相合供体造血干细胞移植治疗白血病。方法 :总结我所于 2 0 0 0年 7月至 2 0 0 1年 12月进行的 7例HLA不相合造血干细胞移植 ,其中包括 3例慢性髓性白血病、3例急性非淋巴细胞性白血病、1例急性淋巴细胞白血病。干细胞来源 :6例为外周血干细胞 ,1例为骨髓干细胞。预处理方案为改良马利兰 (busulfan ,BU) /环磷酰胺 (cyclophosphamide,CY)或BU/CY +抗胸腺细胞球蛋白 (antithymocyteglobulin ,ATG)。预防急性移植物抗宿主病 (graftversushostdisease,GVHD)采用环孢霉素A及短疗程氨甲喋呤 ,5例患者加用霉酚酸酯 (骁悉 )。结果 :1例为骨髓造血干细胞 ,采集骨髓单个核细胞数 3 .4 1× 10 8kg-1,6例为粒细胞集落刺激因子 (granlocytecolony stimulatingfactor,G CSF)动员后外周血干细胞 ,平均接受8.4 6× 10 8kg-1(4.3 0× 10 8～ 15 .3 5× 10 8kg-1)供者外周血单个核细胞 ,平均 + 13天 (+ 11～ + 16天 )中性粒细胞(absoluteneutrophilcount,ANC)大于 0 .5× 10 9L-1。平均 + 16天 (+ 11～ + 2 3天 )血小板大于 2 0 .0× 10 9L-1。发生急性Ⅰ～Ⅱ度GVHD 3例 (42 .9% ) ,无 1例严重的急性GVHD ,发生慢性广泛性GVHD 2例 (2 8.6% )。中位随访时间 1     

无血缘关系供体外周血造血干细胞移植治疗白血病的临床研究

目的 :观察无血缘关系供体外周血造血干细胞移植 (PBSCT)治疗白血病的疗效及其并发症的防治。 方法 :用 HL A配型完全相合的无关供体移植治疗白血病 3例。预处理方案为 :例 1采用环磷酰胺 (CTX) +全身照射 (TBI) ;例 2采用 CTX+TBI+抗胸腺细胞球蛋白 (ATG) ;例 3采用 CTX+TBI+ATG+依托泊苷 (VP16 )。 3例患者输入单个核细胞数 (/ kg)分别为5 .90× 10 8、6 .43× 10 8和 6 .0 1× 10 8,CD34 +细胞 (/ kg)分别为 6 .34× 10 6、2 .6 2× 10 6和 2 .30× 10 6;急性移植物抗宿主病(GVHD)预防采用霉酚酸酯 (MMF)联合环孢素 A (Cs A)和短程甲氨蝶呤 (MTX)方案。 结果 :3例患者均顺利造血重建 ,无 1例发生 度或 度以上急性 GVHD;例 1患者移植后 180 d细胞遗传学复发 ,停用 Cs A后 2个月 Ph染色体消失 ,且出现局限性慢性 GVHD;例 2患者移植后 2 2 0 d出现局限性慢性 GVHD;例 3患者移植后 30 0 d有复发趋势 ,停用 Cs A 2周后完全缓解。结论 :无关供体 PBSCT可用于治疗白血病 ;MMF联合 Cs A和短程 MTX可用于预防无关供体移植急性 GVHD的发生。     

非骨髓清除性异基因外周血造血干细胞移植(NST)治疗恶性血液病的初步临床研究

目的　探讨NST治疗恶性血液病的效果及毒性。方法　急性粒细胞白血病未分化型 (AML -M1)、慢性髓细胞白血病 (CML)、骨髓增生异常综合征 (MDS -RA)患者各 1例 ,供体为其HLA配型完全相合的同胞。供体动员方案 :G -CSF 30 0 μg/ 12h× 5d后分离采集外周血干细胞。所获CD34 + 细胞数分别为 6 .36× 10 6/kg、9.72×10 6/kg、6 .6 2× 10 6/kg ;单个核细胞数 (MNC)分别为 14.0× 10 8/kg、10 .47× 10 8/kg、8.5 8× 10 8/kg ;T细胞总数分别为 8.80× 10 8/kg、7.12× 10 8/kg、5 .6 7× 10 8/kg ;CFU -GM数分别为 16 2个 / 2× 10 5MNC、184个 / 2× 10 5MNC、182个 / 2× 10 5MNC。预处理方案 :Fludarabine:30mg/m2 ·d-1× 6d ,Bu :4mg/kg·d-1× 2d ,ALG :12mg/kg·d-1× 4d ,Ara-C :10 0mg/m2 ·d-1× 3d。单用环胞菌素 (CSA)预防移植物抗宿主病 (GVHD)。移植后未用造血生长因子。结果　患者均能顺利完成预处理方案 ,没有严重并发症出现。移植后 10～ 13d造血重建。未发生急性GVHD。随访10 0～ 16 0d ,血常规、骨髓象均正常 ,1例发生肝脏型慢性GVHD。结论　NST能有效治疗恶性血液病 ,方案相关毒性小 ,适用范围广 ,移植相关并发症少 ,造血重建迅速。     

脐血造血干细胞移植治疗小儿慢性粒细胞白血病

目的 :研究脐血造血干细胞移植治疗小儿慢性粒细胞白血病的疗效及特点。方法 :给一例 12岁男性慢性粒细胞白血病慢性期的患儿移植HLA配型基本相合的同胞脐血。预处理选用BU CY方案 (马利兰 4mg·kg- 1 × 4d ,环磷酰胺 6 0mg·kg- 1 × 2d)。预防移植物抗宿主病 (GVHD)采用环孢霉素A(CsA)。移植有核细胞数为 2 0× 10 7·kg- 1 。结果 :移植后 2 2d(+2 2d)微卫星位点分析显示移植物植入成功 ,+2 5d骨髓显示造血开始重建 ,+42d中性粒细胞 >0 .5× 10 9·L- 1 ,+91dBCR ABL融合基因表达转阴 ,且受者血型由O型转为供者血型B型。随访 15 0d ,未发生急、慢性GVHD。结论 :脐血造血干细胞移植对小儿慢性粒细胞白血病有根治性治疗作用 ,它具有GVHD发生率低、程度较轻、重建造血慢等特点。     

异基因造血干细胞移植治疗白血病临床总结

目的　总结 84例异基因造血干细胞移植 (包括 :同胞异基因造血干细胞移植、无血缘关系异基因造血干细胞移植和脐血干细胞移植 )治疗白血病的疗效和生存状况。方法　预处理方案CML采用标准BuCy方案 (马利兰 4mg/kg·d× 4,环磷酰胺 60mg/kg·d× 2 ) ;ALL采用E TBICy方案 (VP 165 0mg/kg× 1,TBI10 0 0～ 110 0cGy ,分 3次完成 ,CTX60mg/kg·d× 2 ) ;AML采用BuACy方案 (马利兰 4mg/kg·d× 2 ,Ara c3 .0g/m2 ·d× 2 ,CTX60mg/kg·d× 2 )。移植物抗宿主病的预防采用CsA +MTX +IVIg方案。结果　 84例中 47例仍然无病存活 ( 5 4 7% )。移植后 10 0天存活 64人 ( 75 2 % ) ;10 0天内死亡原因分别为 :急性GVHD ,MOF ,CMV间质性肺炎 ,播散性感染 ,早期复发 ,和植入失败 ;移植后 10 0天～ 2年内死亡 16例 ,死亡原因分别为疾病复发、CMV感染和慢性GVHD ,移植后存活超过 2年者中无死亡病例 ,最长生存已 9年。CML61例目前仍无病存活 3 7例 ( 60 6% ) ,AML15例仍无病存活 7例 ( 4 6 6% ) ,ALL8例仍无病存活 3例 ( 3 8% )。结论　异基因造血干细胞移植可使相当部分白血病患者获得长期无病存活 ,其中部分患者获得治愈。本组患者移植后 10 0天内死亡原因主要是急性GVHD ;移植后 10 0天～ 2年内死亡的主要原因是疾     

异基因外周血干细胞移植治疗高危白血病

目的　探讨异基因外周血干细胞移植(allo-PBSCT)治疗高危白血病的疗效。方法　25例高危白血病患者,中位年龄34（5.5～52）岁,接受了HLA配型相合同胞供者外周血干细胞移植,其中急性白血病（AL）15例,（第一次完全缓解1例,为Ph染色体阳性,第二次及以上完全缓解期7例,复发7例,包括2例异基因骨髓移植(BMT)后复发;慢性粒细胞性白血病（CML）4例;（第2次慢性期、加速期、急变期、BMT后复发各1例）;骨髓增生异常综合征(MDS)6例,移植物抗宿主病（GVHD）预防方案采用经典环孢霉素（CsA）加氨甲蝶呤（MTX）。结果　所有患者均植活,中性粒细胞数恢复至≥0.5×109/L和血小板数≥20×109/L的中位时间分别为移植后14(10～18) d和11（7～45） d。发生II度及以上急性GVHD13例,包括1例III度GVHD,未发生IV度急性GVHD。23例可评估患者中16例(70%)诊断慢性GVHD。移植相关死亡率为16%,复发6例,4例经回输供者淋巴细胞获得再次缓解。19例患者无病存活,中位随访时间为304（94～1 963） d。2年总生存率、无病生存率及复发率分别为64%、58%及25%。结论　allo-PBSCT可治疗高危白血病患者,降低移植后复发率,延长无病生存。对有高危因素的血液系统恶性肿瘤患者,选择PBSCT替代骨髓移植更有优势。     

异基因外周血造血干细胞移植治疗急性再生障碍性贫血1例报告

目的　探讨异基因外周血造血干细胞移植治疗急性再生障碍性贫血的疗效及其长期造血重建。　方法　急性再障患者 ,2 0岁 ,供者为其胞弟 ,HL A配型完全相合。供者造血干细胞动员方案 :粒细胞集落刺激因子4 5 0 μg/d× 5 d(8.8μg· kg- 1· d- 1 )。预处理方案 :环磷酰胺 5 0 mg· kg- 1· d- 1× 4 d,抗胸腺细胞球蛋白 1 5 mg·kg- 1 · d- 1 × 3d。移植有核细胞数 5 .1 0× 1 0 8kg- 1 ,CD34 + 3.0 1× 1 0 6 kg- 1 ,粒单系克隆形成单位 4 .2 0× 1 0 5kg- 1 。　结果　移植后 1 5 d造血重建。短片段串联重复序列 (STR)检测证实供者干细胞在受者体内植活。随访 1年 ,血髓象均正常 ,未发生急、慢性移植物抗宿主病。　结论　异基因外周血造血干细胞移植可有效治疗急性再障     

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.