一种新型PLGA/鱼皮胶原共轭静电纺丝膜的物理性能研究*

目的：研究一种新型聚乳酸-羟基乙酸共聚物[poly(lactic-co-glycolic acid), PLGA]/鱼皮胶原共轭静电纺丝膜的物理性能。方法：制备PLGA电纺膜(A组)、纯鱼皮胶原膜(B组)及新型PLGA/鱼皮胶原共轭静电纺丝膜(C组)3种膜,分别检测接触角、失重率、拉伸强度、断裂伸长率等物理性能,初步评价新型PLGA/鱼皮胶原共轭静电纺丝膜的物理性能,为其应用于种植引导组织再生提供理论依据。结果：新型PLGA/鱼皮胶原共轭静电纺丝膜(C组)具有良好的亲水性,接触角为68.52°;体外降解12周后失重率为(14.85±0.13)%,拉伸强度为(2.41±0.47) MPa,断裂伸长率为(77.98±25.72)%,失重率速率最小且仍保持一定的拉伸强度与断裂伸长率。结论：PLGA/鱼皮胶原共轭静电纺丝膜的物理机械性能能够达到临床要求,为进一步的细胞实验提供基础。     

静电纺丝聚乳酸-乙醇酸聚合物膜与大鼠嗅鞘细胞的生物相容性研究

目的 探索静电纺丝技术制作的聚乳酸-乙醇酸聚合物（PLGA）膜与大鼠嗅鞘细胞（olfactory ensheathing cells,OECs）的生物相容性。方法 体外培养纯化成年大鼠OECs,将细胞接种于静电纺丝PLGA膜上,使用相差显微镜观察静电纺丝PLGA膜上OECs的细胞形态与分布;用CFDA SE荧光染色检测接种后1～5 d内静电纺丝PLGA膜上OECs的增殖情况;以多聚赖氨酸（PLL）包被细胞做对照。将静电纺丝PLGA膜植入大鼠体内观察其与大鼠的组织相容性。结果 体外培养纯化所得的OECs的细胞纯度大于90%。相差显微镜下示OECs在静电纺丝PLGA膜孔隙中的纳米纤维上黏附良好,细胞状态佳,且特异性地沿纳米纤维方向生长。接种后1～5 d内OECs在静电纺丝PLGA膜上均正常增殖,细胞数目与对照组相比差异无统计学意义。静电纺丝PLGA膜局部移植后大鼠无死亡,PLGA膜与周围组织融合并部分降解。结论 静电纺丝PLGA膜具有良好的生物相容性,OECs在其膜上的黏附和增殖状况良好,是有潜力的神经修复组织工程化神经移植物。     

搭载紫杉醇脂质体的聚乳酸-羟基乙酸共聚物静电纺丝膜对神经干细胞增殖分化的影响

目的：探讨搭载不同浓度紫杉醇脂质体的聚乳酸-羟基乙酸共聚物（PLGA）静电纺丝膜对神经干细胞（NSCs）增殖和分化的影响，评价载有紫杉醇脂质体的PLGA静电纺丝膜在脊髓损伤组织工程修复中应用的可行性。方法：将紫杉醇脂质体和PLGA以不同比例混合，利用静电纺丝技术分别构建1、5和10 μg·L^-1紫杉醇脂质体PLGA静电纺丝膜。从胎鼠大脑组织中分离纯化NSCs。扫描电镜（SEM）检测各组紫杉醇脂质体PLGA静电纺丝膜纤维直径，免疫荧光染色鉴定分离纯化所得的NSCs。将NSCs分别培养在含有不同浓度（0、1、5和10 μg·L^-1）紫杉醇脂质体PLGA静电纺丝膜的培养基中（作为纯PLGA静电纺丝膜组和1、5及10 μg·L^-1紫杉醇脂质体PLGA静电纺丝膜组），MTT法检测各组NSCs增殖活性，RT-PCR法检测各组NSCs中Tuj-1和GFAP mRNA表达水平。结果：紫杉醇脂质体PLGA静电纺丝膜呈白色薄膜状。SEM检测，各组紫杉醇脂质体PLGA静电纺丝膜纤维直径比较差异无统计学意义（P>0.05）。免疫荧光染色，从胎鼠脑组织中分离出的细胞呈球状，所有细胞均有Nestin蛋白阳性表达。MTT法检测，5 μg·L^-1紫杉醇脂质体PLGA静电纺丝膜组NSCs增殖活性高于其他3组（P<0.05）。RT-PCR检测，与纯PLGA静电纺丝膜组比较，5 μg·L^-1紫杉醇脂质体PLGA静电纺丝膜组NSCs中Tuj-1 mRNA表达水平升高（P<0.05），GFAP mRNA表达水平降低（P<0.05）。结论：中等浓度紫杉醇能够促进NSCs增殖，诱导NSCs向神经元分化。载有中等浓度紫杉醇脂质体的PLGA静电纺丝膜在脊髓损伤修复中有一定的应用价值。     

聚乳酸乙醇酸共聚物与纳米羟基磷灰石共混制备组织工程纤维环支架的实验研究

目的探讨以聚乳酸乙醇酸共聚物(poly(lactic-co-glycolic acid),PLGA)与纳米羟基磷灰石(hydroxyapa-tite,HA)为原料,利用静电纺丝的技术制备出的三维多孔支架构建组织工程纤维环的可行性。方法将PLGA与HA溶解于丙酮中,配制20%(w/v)的溶液,磁力搅拌均匀后,进行静电纺丝,制备三维多孔支架。支架通过扫描电镜和磷酸盐缓冲液降解(phosphate buffered saline,PBS)的方式,观察支架的形貌和降解性能;利用CCK-8和伊红染色的方法观察支架的生物相容性。结果支架具有良好的纤维形貌,直径均匀,扫描电镜下可见HA结晶。支架在磷酸盐缓冲液中降解速度较快,8周时支架失重可达40%,表现出良好的降解性能。细胞毒性试验和伊红染色均表明细胞在支架上的生长情况较好,支架具有良好的生物相容性。结论 PLGA与HA共混制备的纳米纤维支架具有良好的空间结构和生物相容性,因此该支架是一种良好的组织工程纤维环支架材料。     

载顺铂联合氯喹聚乳酸静电纺丝膜对口腔鳞状细胞癌CAL-27细胞增殖的抑制作用

目的：观察载药聚乳酸（PLA）静电纺丝膜对口腔鳞状细胞癌CAL-27细胞的作用,探讨预防口腔癌术后复发的方法。方法：利用静电纺丝技术制备载顺铂（DDP）PLA静电纺丝膜（DDP/PLA膜）、载氯喹（CQ）/顺铂/氯喹PLA静电纺丝膜（CQ/DDP/CQ/PLA膜,复合膜）和载氯喹/顺铂PLA静电纺丝膜（CQ/DDP/PLA膜,共混膜）。通过扫描电镜（SEM）观察3种载药PLA静电纺丝膜的表面形态;紫外分光光度分析法测定PLA静电纺丝膜的降解速率;激光共聚焦显微镜观察自噬特异性蛋白LC3-Ⅱ在CAL-27细胞中的表达情况;MTT法检测CAL-27细胞生存率。结果：SEM观察,DDP/PLA膜、复合膜和共混膜纳米纤维连续,表面光滑,直径较均匀;载药PLA静电纺丝膜在21 d左右降解;第1天DDP/PLA膜、复合膜和共混膜对CAL-27细胞杀伤作用不明显,第3天以后,DDP/PLA膜组、复合膜组及共混膜组CAL-27细胞的生存率明显降低（P<0.05）;复合膜组和共混膜组LC3-Ⅱ荧光亮度均低于DDP/PLA膜组。结论：具有缓释效果的CQ/DDP/PLA纳米静电纺丝膜提高了CAL-27细胞对DDP的敏感性,增强了DDP对口腔癌CAL-27细胞的杀伤作用。     

自制编织型三维支架对体外神经膜细胞生长的影响及体内降解观察

目的:自制聚乙交酯-丙交酯(poly lactide-co-glycolide acid,PLGA)神经组织工程三维支架,观察该支架对体外神经膜细胞生长的影响及其体内降解情况及炎症反应,为后续研究奠定基础.方法:通过熔融、纺丝、拉伸、编织等步骤制作编织型三维PLGA支架,扫描电镜观察内部微管道的排列规律,测量微管道孔径大小.将原代培养的神经膜细胞接种到编织型三维支架上,采用倒置相差显微镜和扫描电镜观察细胞在支架上生长、黏附、增殖和凋亡情况,并与细胞培养皿和胶原海绵培养细胞进行对照.将携带神经膜细胞的三维支架植入大鼠脊柱两侧肌肉中,H-E染色观察支架在体内的降解情况及炎症反应.结果:支架外径为3 mm,微管道直径为100 μm,均匀平行排列.三维支架与细胞培养皿中的神经膜细胞细胞黏附率、增殖率无统计学差异,与胶原海绵培养细胞差异有统计学意义(P<0.05);三维支架与胶原海绵上的细胞凋亡率无统计学差异,二者均低于细胞培养皿培养细胞,差异有统计学意义(P<0.05).三维支架植入体内12周后完全降解,周围无明显炎性细胞浸润.结论:自制编织型三维支架对体外神经膜细胞生长无不良影响,体内能有效降解,具有良好的生物相容性.     

电纺壳聚糖与聚乙烯醇纤维膜的生物相容性研究

目的：制备壳聚糖与聚乙烯醇纤维膜并研究其体外的生物相容性,为应用于临床提供一定的理论依据。方法利用静电纺丝技术制备壳聚糖与聚乙烯醇纤维膜,通过扫描电子显微镜对其超微结构进行表征,采用溶血实验和细胞毒性实验评价其体外生物相容性。结果通过电纺制备的壳聚糖与聚乙烯醇纤维膜,质地均匀,伴有少量的珠状结构,纤维直径在60~300 nm之间,溶血实验显示溶血率为2.80%,无溶血作用,细胞毒性实验中,纤维膜的细胞增殖度为89.96%,细胞毒性为1级,评分合格,无细胞毒性。结论通过静电纺丝法可成功制备壳聚糖与聚乙烯醇纤维膜,生物相容性较好,有望应用于口腔临床中。     

VEGF同轴静电纺丝膜的体外血液相容性及生物学活性研究

目的 评价VEGF同轴静电纺丝膜的物理特性、体外血液相容性和生物学活性,探求其作为人工心血管替代材料的可行性.方法 通过静电纺丝技术制备VEGF同轴静电纺丝膜,然后进行体外溶血实验、动态凝血实验、凝血时间测定、血小板粘附实验、细胞毒性实验、体外细胞粘附实验对其血液相容性和生物学活性进行评价,并与涤纶(Dacron)作平行对照.结果 VEGF同轴静电纺丝膜的血液相容性较高,经统计学分析与Dacron之间差异无统计学意义(P＞0.05).VEGF同轴静电纺丝膜的体外细胞粘附实验中,经细胞计数Dacron为(5.34±0.94)×103,PCL-PEG静电纺丝膜为(7.82±0.85)×104,PCL-PEG/BSA同轴静电纺丝膜为(8.04±0.84)×104,PCL-PEG/BSA-VEGF同轴静电纺丝膜则为(1.39±0.76)×105,经统计学分析PCL-PEG静电纺丝膜和PCL-PEG/BSA同轴静电纺丝膜之间差异无统计学意义(P＞0.05),PCL-PEG静电纺丝膜和PCL-PEG/BSA同轴静电纺丝膜与Dacron之间差异有统计学意义(P＜0.05),而PCL-PEG/BSA-VEGF同轴静电纺丝膜与PCL-PEG静电纺丝膜和PCL-PEG/BSA同轴静电纺丝膜之间的差异具有统计学意义(P＜0.05).结论 VEGF同轴静电纺丝膜血液相容性较高,且更易于与内皮细胞粘附,显示其成为人工心血管替代材料的前景.     

PLGA/Ⅰ型胶原/壳聚糖复合人工硬脊膜生物相容性及力学性能的实验

目的:研究经Ⅰ型胶原、壳聚糖改性的PLGA膜的生物相容性及力学特性,研制出新型人工硬脊膜替代材料.方法:制作PLGA膜(膜Ⅰ)、PLGA/Ⅰ型胶原/复合膜(膜Ⅱ)、PLGA/Ⅰ型胶原/壳聚糖(9:1)复合膜(膜Ⅲ)、PLGA/Ⅰ型胶原/壳聚糖(5:5)复合膜(膜Ⅳ),并行接触角、吸水率、细胞毒性实验及材料力学实验的研究.结果:接触角:膜Ⅱ<膜Ⅲ<膜Ⅳ<膜Ⅰ,P<0.01;吸水率:膜Ⅰ<膜Ⅳ<膜Ⅲ<膜Ⅱ,P<0.01;细胞毒性实验示:第1天,各膜组间OD值差异无统计学意义,P>0.05.第3、7天,膜Ⅰ与Ⅱ、Ⅲ各组间,膜Ⅲ与膜Ⅳ组间差异有统计学意义,P<0.05.PLGA膜经Ⅰ型胶原和壳聚糖改性后,可以促进细胞在膜上的黏附、贴壁能力.各膜的力学性能比较,膜Ⅰ与膜Ⅱ、Ⅲ、Ⅳ之间差异有统计学意义,P<0.05,膜Ⅱ、Ⅲ和Ⅳ组间的差异无统计学意义.结论:PLGA膜的表面复合Ⅰ型胶原/壳聚糖(9:1)可以提高复合膜的生物相容性和力学特性.     

PLGA新型纳米支架的制备及其生物相容性

目的探讨和比较应用不同参数静电纺丝技术制备复合型聚乳酸-羟基乙酸[poly(lactic-co-glycolicacid),PLGA]纳米纤维缓释膜片的可行性,检测其表面特性以及生物相容性。方法使用不同参数制备纳米纤维膜,扫描电镜观察膜片表面形态;人牙周膜细胞(human periodontal ligament cells,hPLDCs)培养及鉴定后接种于空白膜上,扫描电镜观察细胞与膜的附着情况,以MTT[3-(4,5-dimethylthiaozol-2-yl)-2,5-dip henyltetrazolium bromide]实验检测不同浓度材料浸提液对细胞增殖变化情况的影响。结果随着PLGA流量增加,纳米纤维直径增加;细胞与PLGA膜复合后粘附良好且增殖状态无明显变化;不同浓度材料浸提液对牙周膜细胞增殖的影响无明显差异。结论通过不同参数静电纺丝制备的新型纳米纤维膜具有良好的生物相容性,可进一步作为多种药物及细胞因子载体构建缓释型支架,从而用于引导性牙周组织再生(guided tissue regeneration,GTR)或者牙周组织工程。     

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.