慢性心衰患者血清FGF21水平分析及与CHF的相关性研究

目的 检测慢性心力衰竭(CHF)患者血清成纤维细胞生长因子21(FGF21)水平,并分析CHF与血清FGF21的相关性.方法 选取2018年10月至2020年10月于本院行住院治疗的慢性心力衰竭患者132例作为研究组,另选取同期于本院健康体检者110名作为对照组.两组均采用酶联免疫吸附法(ELISA)检测患者血清中FGF21水平,同时,检测血浆N末端β型钠尿肽前体(NT-pro-BNP)、血清肌钙蛋白T(CTnT)、总胆固醇(TG)、血清三酰甘油(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平,并使用彩超检测左室射血分数(LVEF)、左室舒张末期内径(LVEDd),分析CHF与血清FGF21的相关性.结果 研究组LVEF、FGF21、CTnT、血浆NT-pro-BNP、TG、TC及LDL-C水平均高于对照组,HDL-C水平低于对照组(P<0.05);研究组不同NYHA心功能分级患者FGF21、CTnT及NT-pro-BNP水平均高于对照组(P<0.05),且心功能越差,CHF患者FGF21、CTnT及NT-pro-BNP水平越高;FGF21与CTnT呈正相关(r=0.268,P<0.01);FGF21与NT-pro-BNP呈正相关(r=0.282,P<0.01);FGF21与LVEF呈负相关(r=-0.339,P<0.01).结论 CHF患者体内血清FGF21水平较高,且与疾病相关生化指标呈正相关,与疾病LVEF呈负相关,因此,临床需加强GHF患者血清FGF21等指标的检测,联合指标检测在判定疾病严重程度等方面具有显著的临床价值.     

FGF21在2型糖尿病不同体质指数患者中的表达及其与糖脂代谢的相关性研究

目的研究血清成纤维细胞生长因子21(FGF21)在2型糖尿病不同体质指数(BMI)患者中的表达及其与糖脂代谢的相关性。方法选择2015年1月至2016年5月在首都医科大学附属北京天坛医院内分泌科住院治疗的2型糖尿病患者170例,根据BMI不同分为三组:正常组56例(BMI 18.5~24.9 kg/m~2)、超重组63例(BMI25~28 kg/m~2)、肥胖组51例(BMI>28 kg/m~2),同期选择BMI<25 kg/m~2的健康体检者30例作为对照组。采用双抗夹心酶联免疫吸附测定法检测所有受试者血清FGF21水平,同时测定受试者空腹状态下血糖、血脂、胰岛素、C肽等生化指标,并计算胰岛素抵抗指数(HOMA-IR)。运用线性相关分析血清FGF21水平与血糖、血脂、BMI、病程的关系,多元线性回归分析影响血清FGF21的影响因素。结果 2型糖尿病各亚组与健康对照组空腹血糖、糖化血红蛋白、空腹胰岛素(FIN)、HOMA-IR、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、FGF21比较差异均有统计学意义(P<0.05),2型糖尿病各亚组内比较:与BMI正常组比较,超重组FIN升高,肥胖组FIN、HOMA-IR、TG、TC、FGF21均升高(P<0.05);与超重组比较,TG、TC、FGF21均升高(P<0.05)。Spearman相关分析提示,2型糖尿病患者中血清FGF21水平与FIN(r=0.019,P=0.012)、CP(r=0.377,P<0.001)、TG(r=0.363,P<0.001)、TC(r=0.172,P=0.025)、BMI(r=0.230,P=0.002)呈正相关,与病程呈负相关(r=-0.172,P=0.025)。多元线性逐步回归分析,模型提示CP、TG与FGF21密切相关(P<0.05),标准回归方程为:YFGF21=62.475XC肽+14.263XTG+145.031(P<0.001,R2=0.12)。结论 2型糖尿病患者血清FGF21水平随着BMI的增加而上升;血清FGF21水平可能受肥胖与糖脂代谢等因素的影响。     

脑心通联合氨氯地平治疗原发性高血压伴动脉粥样硬化效果观察

目的:探究脑心通联合氨氯地平治疗原发性高血压伴动脉粥样硬化的效果。方法:选取80例原发性高血压伴动脉粥样硬化患者为研究对象,用随机数字表法分为对照组与研究组各40例,对照组接受氨氯地平联合阿托伐他汀钙片治疗,观察组接受脑心通联合氨氯地平治疗,比较两组治疗效果。结果:治疗后,研究组血压、颈动脉斑块面积、颈动脉内中膜厚度及低密度脂蛋白、血清总胆固醇、三酰甘油水平均低于对照组,高密度脂蛋白水平高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:脑心通联合氨氯地平治疗原发性高血压伴动脉粥样硬化患者的效果优于氨氯地平联合阿托伐他汀钙片治疗效果。     

原发性高血压患者瘦素及脂蛋白水平的临床观察

目的 通过检测原发性高血压患者血清瘦素、脂蛋白水平变化,探讨血清瘦素与脂蛋白的相关性及其临床价值.方法 原发性高血压患者80例(分为Ⅰ期和Ⅱ期)、对照组30名测定外周血瘦素、高密度脂蛋白及低密度脂蛋白水平,分析血清瘦素水平与高密度脂蛋白、低密度脂蛋白的关系.结果 (1)原发性高血压患者血清瘦素及低密度脂蛋白水平均显著高于NC组(P<0.05), 高密度脂蛋白水平显著低于NC组(P<0.05);Ⅱ期与Ⅰ期比较,血清瘦素及低密度脂蛋白水平均显著增高(P<0.05),高密度脂蛋白水平显著降低(P<0.05).(2)原发性高血压患者外周血瘦素水平与高密度脂蛋白水平呈显著性负相关(r=-0.307、P<0.05),与低密度脂蛋白水平呈显著性正相关(r=0.516,P<0.05).结论 原发性高血压患者体内存在瘦素和高密度脂蛋白、低密度脂蛋白的异常表达,三者变化与血压分级有关,原发性高血压患者瘦素水平与脂蛋白具有相关性.     

红细胞分布宽度和血清Hcy表达水平对原发性高血压患者心血管风险的影响

目的:探究红细胞分布宽度(RDW)及血清高半胱氨酸(Hcy)表达水平对原发性高血压患者心血管风险的影响。方法:选取2015年12月-2018年12月本院收治的原发性高血压患者158例为研究对象,将其按照高血压患者心血管疾病风险分层标准分为低危组(n=73)、中危组(n=50)及高危组(n=35)。比较三组常规实验室指标、RDW和血清Hcy水平。分析原发性高血压患者血清Hcy水平与RDW的相关性,分析原发性高血压患者心血管风险的影响因素。结果:三组收缩压(SBP)、舒张压(DBP)、低密度脂蛋白胆固醇(LDL-C)、胱抑素C(Cys-C)及超敏C反应蛋白(hs-CRP)比较,差异均有统计学意义(P0.05)。中危组RDW和Hcy水平均高于低危组(P0.05)。高危组RDW和Hcy水平均高于中危组(P0.05)。原发性高血压患者血清Hcy水平与RDW呈正相关(P0.05)。RDW与Hcy为原发性高血压患者心血管风险的独立危险因素(P0.05)。结论:RDW及血清Hcy表达水平为原发性高血压患者心血管风险的独立危险因素,临床可通过检测原发性高血压患者RDW和血Hcy水平预测心血管事件高危风险人群。     

高胆固醇血症患者缺血修饰白蛋白、血脂与炎症标志物水平关系的研究

目的 考查高胆固醇血症患者缺血修饰白蛋白(IMA)、血脂及炎症标志物水平之间关系,以及IMA在动脉粥样斑块形成和氧化应激中的作用.方法 检测37例动脉粥样硬化患者及37例健康志愿者血清中葡萄糖、总胆固醇、高密度脂蛋白(HDL)胆固醇、低密度脂蛋白(LDL)胆固醇、甘油三酯、氧化修饰LDL(ox-LDL)、抗ox-LDL自身抗体、高灵敏度C反应蛋白(hs-CRP)及IMA浓度.结果 高胆固醇血症患者组总胆固醇、LDL胆固醇、甘油三酯、ox-LDL、抗ox-LDL自身抗体、hs-CRP及IMA水平较对照组显著增高(P＜0.05),而HDL胆固醇水平较对照组显著降低(P＜0.05).IMA水平与总胆固醇、LDL胆固醇、抗ox-LDL自身抗体及hs-CRP水平之间有显著相关性.另外,hs-CRP与总胆固醇、HDL胆固醇、LDL胆固醇、甘油三酯、ox-LDL及抗ox-LDL自身抗体之间亦有显著相关性.结论 高胆固醇血症与炎症标志物及氧化应激标志物的表达增高相关,并降低血清白蛋白结合钴的能力,从而导致IMA水平增高.IMA与氧化应激及动脉粥样斑块的形成有相关性,证明了其在疾病发生、发展中可能起到重要作用.     

动脉粥样硬化性脑梗塞患者血清胆红素和血脂的相关性分析

目的探讨动脉粥样硬化性脑梗塞患者血清胆红素和血脂的相关性。方法选择我院2011年1月-2012年5月收治的65例动脉粥样硬化性脑梗塞患者作为观察组,同期健康体检者68例作为对照组,观察动脉粥样硬化性脑梗塞患者的血清胆红素及血脂水平,分析患者血清胆红素和血脂的相关性。结果观察组血清总胆红素（TBI）、高密度脂蛋白胆固醇（HDL-C）均明显低于对照组,而血清胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）均明显高于对照组,组间差异均有统计学意义（P〈0.05）;血清胆红素与低TC、TG、LDL-C呈负相关,与HDL-C呈正相关。结论动脉粥样硬化性脑梗塞患者血清TBI和血脂具有相关性,低水平胆红素及高水平低密度脂蛋白胆固醇是发生疾病的危险信号,应当引起临床关注。     

血清胆红素与高血压病颈动脉粥样硬化的相关性研究

目的:通过临床病例,分析血清胆红素与高血压病颈动脉粥样硬化的相关性。方法:测定96例高血压病患者总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)及选择性抑制法测定总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,及30例对照组的TBIL、DBIL、IBIL、TC、TG、LDL-C、HDL-C、ox-LDL等数据,并进行统计学分析。结果:与正常组相比较,高血压病组的TBIL、IBIL血清胆红素水平差异有统计学意义(P<0.05);高血压病组的TC、LDL、ox-LDL的值均高于对照组,而HDL值低于对照组,差异有统计学意义(P<0.05);对高血压病合并颈动脉粥样硬化患者的TBIL、DBIL、IBIL与ox-LDL分别呈显著负相关(P<0.05)。结论:血清胆红素与血脂相关,能参与脂质代谢,低血清胆红素是高血压病患者发生颈动脉粥样硬化的危险因素。     

脂肪肝与四高症的相关性分析420例

目的:了解脂肪肝与四高症(高血压、高血糖、高血脂、高尿酸血症)发生的相关性,认识其危害程度.方法:通过检测2800名体检人群血清中的血糖的水平、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、尿酸(UA),并结合血压测定及腹部B超检查.结果:通过数据整理统计分析,检出脂肪肝420例(15.00%,420/2800);男性脂肪肝患病率明显高于女性(X2=11.07,P＜0.01);其中脂肪肝组高血压、高血糖、高TG、高TC、高尿酸血症明显高于非脂肪肝组.结论:脂肪肝的发病率与高血压和血清中的TG、TC、GLU、UA水平有密切的相关性,应大力开展健康教育,加强自我保健意识,从而减低脂肪肝与四高症的密切程度.     

H型高血压患者血清ADMA、Hcy、IL-6水平与脂质代谢及颈动脉内膜中层厚度的关系

目的分析H型高血压患者血清非对称性二甲基精氨酸(ADMA)、同型半胱氨酸(Hcy)、白介素-6(IL-6)水平与脂质代谢及颈动脉内膜中层厚度(IMT)的关系。方法选取2016年1月—2018年12月内蒙古医科大学附属医院老年医学中心一病区治疗的高血压患者100例为研究对象,根据高血压患者血清Hcy水平分为H型高血压组(n=43)和非H型高血压组(n=57),另选同期在医院进行体检的健康志愿者50例为健康对照组。比较各组血清ADMA、Hcy、IL-6、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白B(ApoB)、载脂蛋白A1(ApoA1)水平及IMT、ApoB/ApoA1比值,采用Pearson法分析H型高血压患者ADMA、Hcy、IL-6水平与LDL-C、HDL-C、ApoB、ApoA1、ApoB/ApoA1比值、IMT的相关性,采用多因素Logistic回归分析H型高血压发病的影响因素。结果 H型高血压组患者的ADMA、Hcy、IL-6、TG、TC、LDL-C、ApoB、ApoB/ApoA1,IMT均高于非H型高血压组和健康对照组(F=227.382、193.151、191.308、108.244、84.074、63.034、155.234、160.809、61.550,P均=0.000),HDL-C、ApoA1水平均低于非H型高血压组和健康对照组(F=71.983、15.753,P均=0.000)。经Pearson相关性分析,H型高血压患者的ADMA、Hcy、IL-6与TG、TC、LDL-C、ApoB、ApoB/ApoA1、IMT呈正相关(r均在0.432-0.562内,P均<0.01),与HDL-C、ApoA1呈负相关(r均在-0.513～-0.471内,P均<0.01)。经多因素Logistic回归分析,ADMA、Hcy、IL-6、ApoB、ApoB/ApoA1、IMT均可能是H型高血压的危险影响因素(OR=1.654～2.731,P均<0.01)。结论 H型高血压患者血清ADMA、Hcy、IL-6水平变化与脂质代谢及IMT有关联,对上述指标进行监测对于H型高血压的治疗预防有重要意义。     

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.