未经治疗精神分裂症患者面孔情绪认知功能的研究

目的 研究精神分裂症患者的面孔情绪认知功能障碍,探讨情绪认知缺陷与精神症状的相关性.方法 采用中国人面孔情绪测验(CFET)对38例未经治疗的精神分裂症患者进行测试,与50名正常健康者比较,同时作阳性与阴性症状量表(PANSS)评定.结果 分裂症患者六种基本情绪认知正确分均显著低于对照组(P ＜0.01),喜、怒、悲、惊、怕的远隔错误分显著高于对组(P ＜0.01).PANSS总分与CFET惊(r =0.33,P ＜0.05)和怒(r =0.32,P ＜0.05)的远隔错误分呈正相关;阳性症状评分与CFET怒的正确评分(r =-0.40,P ＜0.05)呈负相关,而与惊(r =0.35,P ＜0.05)和怒(r =0.34,P ＜0.05)的远隔错误分呈正相关.结论 分裂症患者存在广泛的情绪认知障碍,这种障碍与某些症状表现相关.     

女性精神分裂症患者面孔情绪认知及其与社会功能的相关性

目的 探讨精神分裂症患者治疗前后面孔情绪认知活动的变化及疾病稳定期患者面孔情绪认知缺陷与社会功能的相关性.方法 采用中国人面孔情绪测验(CFET)、阳性症状量表(SAPS)和阴性症状量表(SANS)对42例女性精神分裂症患者进行纵向评估观察.采用社会功能缺陷筛选量表(SDSS)对治疗后稳定期患者的社会功能进行评估.结果 精神分裂症患者入组时基线CFET总正确数评分[(76.62±13.07)分]和6种基本情绪正确数评分[喜(18.81±0.56)分、惊(14.10±4.61)分、怕(6.43±4.63)分、悲(12.12±4.68)分、厌(10.12±5.90)分、怒(15.05±4.60)分]均低于照组[分别为总分(105.13±5.54)分,喜(19.62±0.52)分,惊(18.33±1.72)分,怕(14.70±2.30)分,悲(18.28±1.31)分,厌(15.67±2.42)分,怒(18.46±1.32)分],差异有显著性(P＜0.01).患者人组时、治疗1个月和随访6个月时CFET的各项正确数评分差异无显著性(P＞0.05).相关分析显示,患者随访时SDSS评分与CFET总正确分(r=-0.509,P=0.001)及惊(r=0.325,P=0.04)、怕(r=-0.375,P=0.019)和悲(r=-0.367,P=0.021)的正确分呈负相关.结论 精神分裂症患者的面孔情绪认知缺陷具有素质性特点,与患者的社会功能障碍存在相关.     

康复期精神分裂症患者的认知评估及述情和情感障碍对照研究

目的：探讨康复期精神分裂症患者情绪认知缺陷、述情障碍和情感淡漠症状的相关性评估.方法：采用中国人面孔情绪测验（CFET）和多伦多述情障碍量表（TAS-26）对100例康复期精神分裂症患者进行测试,并与100名正常健康者比较,同时对患者作阴性症状量表（SANS）情感淡漠或迟钝分量表评定.结果：康复期精神分裂症患者CFET总分及6种基本情绪认知评分均显著低于对照组（P〈0.01）,TAS的总分、因子1、因子2和因子4评分均显著高于对照组（P〈0.01）.相关分析显著,患者CFET正确数评分与TAB的总分、因子1、因子2和因子4评分呈负相关,35项相关系数中27项（71.4%）差异有显著性.情感淡漠或迟钝分量表评分与一些CFET评分呈负相关,49项相关系数中9项（18.4%）差异有显著性,而与TAB评间,除眼神接触差评分与TAS总分呈正相关外（r=0.27,P=0.01）,余变量间相关均差异无显著性.结论：康复期精神分裂症患者的广泛的面孔情绪认知缺陷障碍可能更多地反应了一种素质性特征,存在某种共同的病理生理基础,而述情障碍和情感淡漠间可能具有不同的病理性情绪处理过程.     

精神分裂症患者情绪认知缺陷、述情障碍和情感淡漠的相关性研究

目的 探讨精神分裂症患者面孔情绪认知缺陷、述情障碍和情感淡漠症状的相关性.方法 采用中国人面孔情绪测验(CFET)和多伦多述情障碍量表(TAS-26)对82例精神分裂症患者进行测试,与88名正常健康者比较,同时对患者作阴性症状量表(SANS)情感淡漠或迟钝分量表评定.结果 精神分裂症患者CFET总分及6种基本情绪认知评分均显著低于对照组(P<0.01),TAS的总分、因子1、因子2和因子4评分均显著高于对照组(P<0.01).相关分析显示,患者CFET正确数评分与TAS的总分、因子1、因子2和因子4评分呈负相关,35项相关系数中27项(71.4%)差异有显著性.情感淡漠或迟钝分量表评分与一些CFET评分呈负相关,49项相关系数中9项(18.4%)差异有显著性,而与TAS评间,除眼神接触差评分与TAS总分呈正相关外(r=0.272,P=0.014),余变量间相关均差异无显著性.结论 分裂症患者的广泛的面孔情绪认知缺陷与述情障碍可能更多地反应了一种素质性特征,存在某种共同的病理生理基础,而述情障碍与情感淡漠间可能具有不同的病理性情绪处理过程.     

首发精神分裂症患者血清SIOOB蛋白水平的研究

目的探讨首发精神分裂症患者的血清S100B蛋白水平与精神分裂症及其认知功能的关系。方法纳入符合美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）精神分裂症诊断标准的首发精神分裂症患者（以下简称患者组）40例和正常对照者（以下简称对照组）40例，检测血清S100B蛋白水平，同时应用阳性和阴性症状量表（PANSS）和威斯康星卡片分类测验（WCST）韦氏记忆量表（WMS）评定患者的病情和认知功能，并进行两组间比较。结果患者组血清S100B蛋白水平明显高于对照组（P〈0．001）。患者组WCST的完成分类数得分低于对照组（P=0．004），而错误应答数、完成第一个分类所需应答数、持续性错误数、持续性应答和持续性错误百分数均高于对照组（P值均〈0．05），患者组WMS的长时记忆、短时记忆、瞬时记忆和记忆商数均低于对照组（P〈0．001）。患者组血清S100B蛋白水平与PANSS的总分、阴性症状分呈正相关（r分别为0．317、0．405，P均〈0．05），与WCST中的错误应答数、持续性应答及非持续性错误数呈正相关（r分别为0．393、0．359和0．378，P均〈0．05），与WMS中的短时记忆呈负相关（r为-0．320，P〈0．05）。结论首发精神分裂症患者血清S100B蛋白水平明显高于正常，其水平升高越明显，表明精神分裂症的严重程度和认知损害程度就越重。     

50例康复期精神分裂症患者利培酮治疗前后认知功能及情感障碍的临床研究

目的：研究利培酮治疗对康复期精神分裂症患者认知功能及情感障碍的影响,以及认知功能及情感障碍如述情障碍、情感淡漠等与阳性和阴性症状的关系.方法：对50例康复期精神分裂症患者,在利培酮治疗前后进行威斯康星卡片分类（WCST）、并采用阳性与阴性症状量表（PANSS）等测验.结果：治疗后WCST总测验次数、持续错误数、非持续错误数均少于治疗前,有显著性差异（P〈0.01或P〈0.05）.PANSS总分的改善与WCST总测验次数、持续错误数呈正相关;阳性症状量表分的下降与WCST总测验次数、持续错误数、非持续错误数呈正相关,与正确反应数呈负相关;而阴性症状量表分的下降与WCST的各项指标之间无明显相关关系.结论：经利培酮治疗后,康复期精神分裂症患者在症状改善的同时,认知功能及情感障碍也有明显提高,且认知功能及情感障碍的提高与阳性症状的改善存在着明显相关性,而与阴性症状的改善关系不大,提示两者可能存在异质性.     

非痴呆帕金森病患者眼区面孔情绪认知功能 与事件相关电位P300 的相关性分析

目的 通过对非痴呆帕金森病（PD）患者眼区面孔情绪识别功能和事件相关电位P300 检测,探 讨非痴呆PD 患者面孔情绪认知功能损害的特点,以及情绪识别与P300 潜伏期和波幅的相关性。方法 选取 2016 年8 月—2018 年6 月于安徽医科大学附属巢湖医院神经内科确诊的非痴呆PD 患者28 例作为非痴呆PD 组,选取同期该院健康体检者32 例作为对照组。应用眼区面孔情绪识别测验和P300 检测,观察喜、惊、恐、 悲、厌及怒的识别得分,以及P300 潜伏期和波幅,并比较6 种情绪识别得分与P300 潜伏期和波幅的相关性。 结果 与对照组比较,非痴呆PD 组在恐、悲及厌的情绪面孔识别得分较对照组低（P <0.05）,非痴呆PD 组 P300 潜伏期较对照组长（P <0.05）,波幅较对照组低（P <0.05）;P300 潜伏期与恐、悲、厌及怒得分呈负相 关（r =-0.718、-0.614、-0.818 和-0.829,P <0.05）,P300 波幅与悲、厌及怒得分呈正相关（r =0.824、0.928 和0.621,P <0.05）。结论 非痴呆PD 患者存在眼区面孔情绪认知功能损害,以恐、悲及厌负性面孔情绪认 知损害为主,进一步证实了基底节参与情绪认知加工的假说;P300 与面孔情绪识别得分具有良好的相关性, P300 潜伏期和波幅是反映早期非痴呆PD 患者情绪认知功能障碍的敏感指标。     

不同频率重复经颅磁刺激对精神分裂症患者 性激素水平及认知功能的影响

目的 探讨不同频率重复经颅磁刺激对精神分裂症患者血清泌乳素（PRL）水平及认知功能的 影响,为临床精神分裂症的治疗提供依据。方法 选取2017 年11 月—2019 年9 月在温州医科大学附属康宁 医院就诊的精神分裂症患者200 例作为实验组,并根据随机数字表法分为A 组和B 组,每组100 例。A 组给 予低频重复经颅磁刺激,B 组给予高频重复经颅磁刺激。选取同期健康体检者100 例作为对照组。采用放射 免疫法测定PRL 水平;采用阳性和阴性症状量表（PANSS）评估精神症状;采用重复性成套神经心理状态 量表（RBANS）评估认知功能。结果 与对照组比较,实验组血清PRL 水平和PANSS 阳性症状分、阴性 症状分及总分较高（P <0.05）;而RBANS 评分较低（P <0.05）。精神分裂症患者血清PRL 水平与RBANS 评分呈正相关（r =0.514,P =0.000）;而与PANSS 阳性症状分、阴性症状分及总分呈负相关（r =-0.462、 -0.501 和-0.487,均P =0.000）。与A 组比较,B 组治疗前后血清PRL、PANSS 及PANSS 阴性症状分的差值 较高;而PANSS 阳性症状分的差值较低（P <0.05）。结论 高频重复经颅磁刺激治疗精神分裂症降低血清 PRL 水平,改善RBANS 评分和PANSS 阴性症状分的效果优于低频重复经颅磁刺激;但改善PANSS 阳性症 状分的效果不如低频重复经颅磁刺激。     

精神分裂症患者NLR、氧化应激参数与精神症状的相关性

目的探讨精神分裂症患者中性粒细胞/淋巴细胞比值（NLR）、氧化应激参数与精神症状的相关性。方法选择64例精神分裂症患者和61例健康志愿者,检测并比较两组对象的NLR、总抗氧化状态（TAS）、总氧化状态（TOS）、氧化应激指数（OSI）、对氧磷酶1（PON1）和硫醇（Thiol）水平;采用阳性与阴性症状量表（PANSS）评价精神症状,分析NLR、PANSS评分和氧化应激参数间的关系。结果与健康对照组比较,精神分裂症组NLR、TAS、TOS明显增高（均P＜0.05）,Thiol、Thiol/OSI明显降低（均P＜0.05）;两组间PON1、OSI比较,差异均无统计学差异（均P＞0.05）。精神分裂症患者PANSS阳性分值与Thiol/OSI呈负相关（r=-0.264）;总分值与NLR呈正相关（r=0.251）,与Thiol/OSI呈负相关（r=-0.286）。精神分裂症组NLR与Thiol/OSI呈负相关（r=-0.340）,健康对照组NLR与Thiol/OSI未见相关（r=-0.040）。精神分裂症患者NLR与TOS、OSI均呈正相关（r=0.361、0.307）;Thiol/OSI与TOS、OSI均呈负相关（r=-0.685、-0.678）,与TAS、Thiol均呈正相关（r=0.256、0.416）。结论炎症和氧化应激在精神分裂症的发生、发展中起着重要作用,且与患者临床症状关系密切。NLR是一项可以反映精神分裂症患者氧化应激和精神症状信息的简单、廉价、适合常规应用的指标。     

急性期精神分裂症的基于事件前瞻记忆研究

目的探讨急性期、近期未服药精神分裂症患者是否存在基于事件前瞻记忆缺陷。方法 49例健康志愿者入组健康对照组;51例近期未服药的急性期精神分裂症患者入组精神分裂症组,进一步分为首发精神分裂症亚组（n=23）和慢性精神分裂症亚组（n=28）。应用基于事件前瞻记忆实验范式测评前瞻记忆,再认法测评回溯记忆,空间广度测验测评视空间觉工作记忆,应用阳性与阴性症状量表（PANSS）评定患者精神症状的严重程度。结果精神分裂症组的前瞻记忆、回溯记忆和视空间觉工作记忆成绩均低于健康对照组（P分别为0.008、0.016和0.001）,控制回溯记忆、视空间觉工作记忆等因素后,精神分裂症组的前瞻记忆成绩仍低于健康对照组（P〈0.05）。精神分裂症组的前瞻记忆与受教育程度呈正相关（r=0.405,P〈0.05）,与年龄、病程、PANSS总分及阴性分均呈负相关（r分别为-0.41、-0.5、-0.345和-0.486,均P〈0.05）。首发精神分裂症亚组与慢性精神分裂症亚组前瞻记忆、回溯记忆和视空间觉工作记忆成绩的组间差异均无统计学意义（均P〉0.05）。结论急性期精神分裂症存在明显的基于事件前瞻记忆缺陷,首发和慢性精神分裂症患者的前瞻记忆缺陷程度相似,精神分裂症的前瞻记忆缺陷属于原发性认知缺陷。     

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.