骨髓干细胞动员归巢兔栓塞肺组织机制的研究

目的:观察骨髓干细胞(bone marrow stem cells,BMSCs)动员后向栓塞肺组织归巢的情况,初步探讨BMSCs归巢栓塞肺组织的可能机制。方法:选取45只健康的中国大耳白兔,随机分成模型组、实验组、干预组3组,每组15只。经股静脉穿刺置管注入自体血栓、建立兔急性肺血栓栓塞症(pulmonary thromboembolism,PTE)模型。其中,模型组仅建立PTE模型;实验组及对照组在建立模型前4 d、建立模型后即刻按10μg/(kg.d)皮下注射粒细胞集落刺激因子(granulocyte-colony stimulating factor,G-CSF),共5 d;干预组在建立兔PTE模型后即刻按1 mg/kg静脉注射地塞米松。大体标本HE染色行病理检查,免疫组化法检测肺组织栓塞区、边缘区、正常区CD34及基质细胞衍生因子(stromal cell-de-rived factor-1,SDF-1)的表达,进行图像分析。结果:(1)大体标本观察:3组兔肺组织均存在损伤性改变,表现为片状出血灶、局部肺组织苍白区、肺组织膨胀不全等;(2)光镜下病理观察:3组兔肺组织栓塞区均表现为肺间质水肿充血、肺泡腔出血渗出,其中实验组栓塞区肺间质中可见较多体积较大的单个核细胞浸润,而干预组中未见单个核细胞浸润、炎性细胞浸润较少;(3)肺组织CD34免疫组化染色与图像分析结果:CD34主要表达在栓塞区,边缘区少量表达,正常区很少量表达。实验组栓塞区CD34的表达明显高于模型组、干预组,干预组CD34的表达最低(P<0.01),且实验组栓塞区内浸润的CD34阳性单个核细胞较多,模型组少见,而干预组未见到;(4)肺组织SDF-1免疫组化染色与图像分析结果:SDF-1主要表达在栓塞区,边缘区、正常区均无表达。实验组栓塞区SDF-1的表达明显高于模型组、干预组,干预组SDF-1的表达最低(P<0.01)。结论:PTE发生后存在CD34阳性BMSCs向栓塞肺组织归巢现象;PTE发生后肺组织栓塞区SDF-1表达加强可能是吸引CD34阳性BMSCs归巢栓塞肺组织的机制之一;使用G-CSF动员后能明显加强PTE后肺组织栓塞区SDF-1的表达,从而吸引更多的CD34阳性BMSCs归巢到栓塞肺组织。     

SDF-1/CXCR4轴在大鼠急性心肌梗死后BMSCs“归巢”中的作用

目的:观察祛瘀生新中药对急性心肌梗死后基质细胞衍生因子-1/配体CXC型趋化因子受体4(stromal cel1 derived factor-1/CXC chemokine receptor 4,SDF-1/CXCR4)轴的影响,探讨活血化瘀法对心肌梗死后骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)"归巢"的动员效应机制。方法:清洁级Wistar大鼠50只随机分为正常组、模型组、假手术组、中药组、西药组,每组10只。中药组大鼠术前3 d给药,1次·d-1。7 d后,检测外周血BMSCs含量,免疫组织化学检测各组大鼠心肌组织SDF-1、CXCR4表达水平及心肌c-kit细胞数,并观察心肌组织HE染色结果。结果:与假手术组比较,模型组心肌组织SDF-1、CXCR4表达均增加(P<0.05)。与模型组比较,中药组、西药组SDF-1、CXCR4表达水平及c-kit细胞数均增加,并能减轻心肌组织的病理损伤。结论:祛瘀生新法有动员BMSCs"归巢"的作用。     

基质衍生因子-1对脐带血CD34+细胞增殖及归巢相关功能影响的研究

目的 探讨基质衍生因子-1(SDF-1)对脐带血(UCB) CD34+细胞增殖及归巢相关功能影响.方法 采用流式细胞仪测定、造血祖细胞培养、结晶紫染色测定、Transwell实验等方法.结果 ①SDF-1在体外能通过抑制UCB CD34+细胞凋亡增强细胞生存能力;②与其他造血因子协同SDF-1可在一定程度上促进粒系祖细胞增殖;③SDF-1能提高CD34+细胞的黏附能力和迁移能力.结论 SDF-1能够应用于UCB CD34+细胞体外培养,增强UCB CD34+细胞的归巢相关功能.     

粒细胞集落刺激因子对家兔后肢缺血治疗作用观察

目的:观察粒细胞集落刺激因子(G-CSF)对缺血性疾病的治疗作用.方法:25只家兔均切断左侧股动脉及其分支,制作实验兔左后肢缺血模型后,随机分2组:实验组(n=15)皮下注射重组人G-CSF(rhG-CSF)动员兔自体干细胞释放和迁移至缺血组织,对照组(n=10)给予等体积生理盐水.连续监测血常规;术后4周,2组均行腹主动脉造影观察侧支循环血管形成情况,取内收肌和腓肠肌组织行HE染色并计数微血管密度,应用免疫组织化学方法检测内收肌和腓肠肌组织中血管内皮生长因子(VEGF)阳性表达的血管数.结果:实验组家兔侧支循环血管条数、微血管密度及VEGF阳性表达的血管数均大于对照组(P均＜0.05),缺血状态得到改善.结论:应用G-CSF使骨髓干细胞动员后,可促进缺血组织血管新生,增加缺血组织血液灌注,改善肢体缺血状态.     

Effects of G-CSF on nerve repair and mobilization of bone marrow stem cells in rat models of focal cerebral ischemic stroke

目的 研究粒细胞集落刺激因子(granulocyte-colony stimulating factor,G-CSF)对卒中后骨髓干细胞的动员与血管再生和神经修复的影响.方法 线栓法制备大鼠大脑中动脉栓塞(middle cerebral artery occlusion,MCAO)模型,成功造模大鼠(60只)分为生理盐水对照组和G-CSF治疗组.治疗组皮下注射G-CSF[2、10、50、250 μg/(kg·d)],对照组以等量生理盐水进行处理.治疗1、3、5、7d后,进行行为学评分并取外周血计数单个核细胞,提取RNA进行RT-PCR检测单个核细胞CD31、CXCR4mRNA的表达水平;实验动物灌注固定后取脑组织切片检测G-CSF作用后脑组织中CD31、CD133及基质细胞衍生因子SDF-1表达.结果 与生理盐水对照组相比,G-CSF治疗组神经功能有明显的改善(P＜0.05);G-CSF作用后外周血中单个核细胞数量明显增加;G-CSF低剂量作用组[2、10μg/(kg·d)]外周血单个核细胞CD31及CXCR4mRNA表达随着用药时间的延长而增强;高剂量[50、250μg/(kg·d)]在短时间内(1、3 d),外周血单个核细胞CD31、CXCR4 mRNA随着用药剂量的升高而增强,250μg/(kg· d)最强,且随着用药时间的延长(5、7d),G-CSF 作用逐渐减弱;G-CSF作用后脑组织内皮细胞标志CD31、CD133及SDF-1阳性表达明显增加.结论 G-CSF能改善MCAO后大鼠症状,其机制可能在于动员骨髓干细胞进入外周血并促进脑组织SDF-1表达以趋化干细胞,继而促进脑组织的血管再生和神经修复.     

缺血性脑卒中大鼠模型骨髓干细胞的动员和神经修复作用

目的研究粒细胞集落刺激因子(granulocyte-colony stimulating factor,G-CSF)对卒中后骨髓干细胞的动员与血管再生和神经修复的影响。方法线栓法制备大鼠大脑中动脉栓塞(middle cerebral artery occlusion,MCAO)模型,成功造模大鼠(60只)分为生理盐水对照组和G-CSF治疗组。治疗组皮下注射G-CSF[2、10、50、250μg/(kg.d)],对照组以等量生理盐水进行处理。治疗1、3、5、7 d后,进行行为学评分并取外周血计数单个核细胞,提取RNA进行RT-PCR检测单个核细胞CD31、CXCR4 mRNA的表达水平;实验动物灌注固定后取脑组织切片检测G-CSF作用后脑组织中CD31、CD133及基质细胞衍生因子SDF-1表达。结果与生理盐水对照组相比,G-CSF治疗组神经功能有明显的改善(P<0.05);G-CSF作用后外周血中单个核细胞数量明显增加;G-CSF低剂量作用组[2、10μg/(kg.d)]外周血单个核细胞CD31及CXCR4 mRNA表达随着用药时间的延长而增强;高剂量[50、250μg/(kg.d)]在短时间内(1、3 d),外周血单个核细胞CD31、CXCR4 mRNA随着用药剂量的升高而增强,250μg/(kg.d)最强,且随着用药时间的延长(5、7 d),G-CSF作用逐渐减弱;G-CSF作用后脑组织内皮细胞标志CD31、CD133及SDF-1阳性表达明显增加。结论 G-CSF能改善MCAO后大鼠症状,其机制可能在于动员骨髓干细胞进入外周血并促进脑组织SDF-1表达以趋化干细胞,继而促进脑组织的血管再生和神经修复。     

基质金属蛋白酶9在粒细胞集落刺激因子诱导的造血干/祖细胞动员中的作用

目的探讨基质金属蛋白酶9(MMP-9)在粒细胞集落刺激因子(G-CSF)诱导的造血干/祖细胞(HSPC)动员中的作用。方法应用酶联免疫吸附试验(ELISA)、免疫组织化学、逆转录聚合酶链反应(RT-PCR)等方法测定了健康供者稳态及G-CSF动员第5天骨髓、外周血MMP-9蛋白及mRNA水平的变化,比较富含MMP-9的细胞系HT1080无血清培养上清孵育前后CD34+细胞表面CXCR4表达及对基质细胞衍生因子1(SDF-1)的迁移能力的变化,将rhMMP-9与rhSDF-1孵育后应用Western印迹检测MMP-9对SDF-1的降解作用,观察注射MMP-9化学抑制剂(MPI)ο-邻二氮杂菲对G-CSF动员BALB/c小鼠外周血成熟白细胞计数(WBC)和干/祖细胞的数量的影响。结果G-CSF动员第5天,骨髓上清MMP-9浓度增加了6.6倍(P<0.01),骨髓组织表达MMP-9的中性粒细胞明显增多。动员后骨髓单个核细胞MMP-9mRNA表达水平上调(P<0.05)。rhSDF-1与rhMMP-9短期孵育后可被后者降解。HT1080无血清培养上清液能够上调脐血和动员外周血富集的CD34+细胞的CXCR4表达水平(均P<0.05)及增强CD34+细胞向SDF-1浓度梯度迁移能力(均P<0.05),该效应可被MPI阻断(P<0.05)。与G-CSF共注射MPI后BALB/c小鼠外周血成熟WBC(12.3×106/L±1.2×106/L)和造血祖细胞集落形成单位(69U/2×105MNC±3U/2×105MNC)数量显著低于对照组(P<0.05)。结论MMP-9可能通过裂解SDF-1、上调CD34+细胞表面SDF-1特异性受体CXCR4的表达及增强CD34+细胞迁移能力在G-CSF介导的HSPC动员中发挥重要作用。     

BMP4/SDF-1壳聚糖缓释体联合BMSCs修复骨缺损的可行性分析

目的探讨骨形成蛋白4/基质细胞衍生因子1(BMP-4/SDF-1)释体联合骨髓间充质干细胞(BMSCs)修复骨缺损的可行性。方法冷冻干燥和乳化交联法制备BMP-4/SDF-1壳聚糖缓释体,通过电镜扫描观察缓释体形态,酶联免疫吸附测定法检测BMP-4和SDF-1的缓释作用;体外分离培养兔BMSCs,Transwell检测缓释体对BMSCs的趋化作用,单核细胞直接细胞毒性实验检测细胞因子缓释体对兔BMSCs的增殖作用,定量聚合酶链反应检测成骨相关指标[碱性磷酸酶(ALP)/骨钙素(OCN)]茜素红染色观察带有细胞因子的缓释体对BMSCs矿化结节形成能力。结果空白组、BMP-4组、SDF-1组、BMP-4/SDF-1组的兔BMSCs增殖随着时间的增长而逐渐升高,且BMP-4/SDF-1组的兔BMSCs增殖率显著高于其他各组,差异有统计学意义(P<0.05)。将共培养的兔BMSCs小室进行结晶紫染色发现,BMP-4/SDF-1组细胞穿膜数目相对空白组、BMP-4组、SDF-1组显著增多(P<0.05)。复合缓释体与兔BMSCs共培养7 d后BMP-4/SDF-1组ALP和OCN表达均明显高于其他组,差异有统计学意义(P<0.05)。BMP-4/SDF-1矿化结节较空白组、BMP-4组和SDF-1组明显增多。结论制备兔骨缺损模型,将SDF-1/BMP-2壳聚糖换实体与兔骨髓间充质干细胞联合植入兔局部骨缺损处,促进黏附增殖,诱导成骨分化填补骨缺损,BMP-4/SDF-1壳聚糖缓释体支架可以作为理想的骨缺损修复材料。     

自体骨髓干细胞动员治疗右心衰竭的实验研究

目的:探讨粒细胞集落刺激因子(G-CSF)对野百合碱(MCT)诱导的大鼠右心衰竭(RHF)的治疗作用. 方法:动物随机分为3组:正常对照组(CON组)、MCT组、MCT/G-CSF组,腹腔注射野百合碱诱导大鼠右心衰竭模型,采用G-CSF动员自体骨髓干细胞(BMSC),动员结束后采集外周血标本,流式细胞仪检测外周血单个核细胞中CD34 细胞含量.第4周分别对3组大鼠进行血流动力学检测,处死大鼠,取肝、心脏、肺组织行苏木精-伊红(H-E)染色. 结果:①单个核细胞中CD34 细胞含量在MCT/G-CSF组明显高于MCT组、对照组,差异均具有统计学意义(P<0.01).②实验第35d,MCT组血流动力学指标明显高于对照组 (P<0.05),RHF造模成功;MCT/G-CSF组则低于MCT组(P<0.05),说明G-CSF干预治疗取得疗效.③MCT组大鼠右心室、肝脏、肺组织出现RHF的病理学改变,MCT/G-CSF组的病理学改变部分逆转. 结论:G-CSF能动员骨髓干细胞,部分逆转RHF的血流动力学和病理学改变、减缓RHF的发展,可以用于RHF的研究和治疗.     

骨髓干细胞动员对心肌梗死大鼠心功能的影响

目的探讨应用粒细胞集落刺激因子(G-CSF)动员大鼠自体骨髓干细胞治疗心肌梗死,对心功能的影响及其可能机制.方法用异丙肾上腺素(ISO)制作大鼠心肌梗死模型,用骨髓干细胞动员剂G-CSF动员自体骨髓干细胞释放和迁移至心肌梗死灶,于用ISO后24,48 h杀死大鼠,取出心脏;用ISO后4周,先用MPA-V多导生理仪检测大鼠血流动力学、心功能指标,随后杀死大鼠,取出心脏,通过免疫组化、HE染色和VG染色方法观察大鼠心梗灶的CD34 细胞的浸润及心肌再生、心肌纤维化的情况.结果用ISO后4周,G-CSF动员组大鼠血流动力学指标、心功能参数均比对照组改善.用ISO后24h后,动员组大鼠心梗区可见CD34 细胞浸润,并有CD34 阳性的新生心肌细胞生长,4周后瘢痕组织少,心肌纤维化程度轻,心肌基本结构得到保护.结论急性心梗发生后,应用G-CSF能动员自体骨髓干细胞向心梗灶内迁移、存活和向心肌细胞、血管内皮细胞等分化;并通过心肌再生、抑制缺血心肌纤维化和保护缺血心肌基本结构,而改善心功能.     

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.