Fe2O3 纳米磁流体热疗治疗小鼠结肠癌实验研究

目的研究Fe2O3纳米磁流体热疗对小鼠结肠癌的治疗效果。方法磁流体直接局部注射到小鼠皮下肿瘤组织,交变磁场下加热至43℃,计算瘤体积抑制率,肿瘤组织及各个脏器做病理检测。结果 Fe2O3纳米磁流体在交变磁场(alternatingmagnetic field,AMF)中升温迅速。热疗组相比磁流体对照组、磁场对照组、空白对照组,热疗6天后瘤体体积抑制率分别为50.87%、50.50%、76.57%,P<0.05,差异有统计学意义。病理检测证实肿瘤组织部分凋亡,而正常脏器无变化。结论 Fe2O3纳米磁流体热疗可抑制小鼠结肠癌的增长,对结肠癌的治疗有一定作用,但并不能完全抑制肿瘤的生长。实验证明热疗安全可靠。     

三氧化二砷对胰腺癌 BXPC-3 细胞移植瘤的体内抑制作用

目的 探讨三氧化二砷在体内对胰腺癌 BXPC-3 细胞移植瘤的抑制作用,并探讨其初步机制。方法 建立胰腺癌裸鼠移植瘤模型,随机分为4组：模型组,低剂量、高剂量 (2.5、5.0 mg/kg) 三氧化二砷组和吉西他滨组,各组 ip 给药,作用2周后,检测实验前后裸鼠体质量变化,观察药物对肿瘤生长的影响,免疫组化检测肿瘤细胞增殖因子 ki-67 的表达,TUNEL 法检测移植瘤组织的细胞凋亡。结果 给药2周后,各组裸鼠体质量变化差异不显著,三氧化二砷和吉西他滨均可抑制裸鼠移植瘤的体积和质量,且三氧化二砷 (5 mg/kg) 组作用较强;免疫组化结果显示三氧化二砷可明显降低细胞增殖因子 ki-67 的阳性表达;TUNEL 检测表明三氧化二砷可明显诱导移植瘤肿瘤细胞凋亡。结论 三氧化二砷可抑制胰腺癌 BXPC-3 细胞在裸鼠体内的生长;作用机制可能为抑制肿瘤细胞增殖及促进肿瘤细胞凋亡。     

磁流体热疗对肺癌A549裸鼠移植瘤抑制作用的实验研究

目的探讨Fe304磁流体热疗对人肺癌A549裸鼠移植瘤生长的抑制作用。方法将人肺癌A549细胞接种于裸鼠背部皮下建立移植瘤模型,当肿瘤长至直径(6～8mm)时,在预实验的基础上随机分为4组:对照组、低剂量(67.5mg/ml)组、中剂量(90.0mg/ml)组、高剂量(112.5mg/ml)组。3个实验组在注射0.2ml磁流体后24h,分别在交变磁场作用下作用30min,光纤传感器测量肿瘤内部和肛门的温度,每周测量肿瘤体积,观察磁流体热疗后肿瘤体积的变化、瘤体的病理变化,对肿瘤生长影响。结果中、高剂量组的温度可以上升至有效治疗温度(>42℃),热疗后第21天,与对照组比较,中、高剂量组瘤体的增长受到明显的抑制(P<0.05),抑制效果与剂量呈剂量-效果依赖关系。组织学检查肿瘤细胞呈凋亡、坏死样改变。结论磁流体热疗可以明显诱导人肺癌A549凋亡、导致坏死,抑制肺癌裸鼠移植瘤的生长。     

选择性环氧合酶-2抑制剂NS398对人肺癌裸鼠移植瘤生长抑制作用研究

目的 探讨选择性环氧合酶-2抑制剂NS398对人肺癌裸鼠移植瘤的生长抑制作用及其机制。方法 建立人肺癌A549细胞的裸鼠皮下移植瘤模型,成瘤后20只裸鼠随机分为4组：对照组、NS398低剂量（1.5mg/kg）组、NS398中剂量（3.0mg/kg）组和NS398高剂量（4.5mg/kg）组。各组均采用腹腔注射给药,每周3次,共4周。给药期间每隔7日测量肿瘤体积。最后一次给药次日,处死裸鼠完整剥取肿瘤,测量肿瘤重量并计算抑瘤率。TUNEL法检测各组移植瘤标本细胞凋亡情况,免疫印迹法检测survivin、XIAP和cleaved caspase-3蛋白表达情况。结果 NS398各剂量组肺癌移植瘤生长速度均慢于对照组,各剂量组肿瘤重量显著低于对照组（P<0.01,P=0.000）,呈剂量依赖性。各剂量组的抑瘤率分别为30.18%、46.50%和53.87%。TUNEL法结果显示,与对照组比较,NS398各剂量组凋亡指数均显著增加（P<0.01,P=0.000）,并呈剂量依赖性。免疫印迹法结果显示,与对照组比较,NS398各剂量组survivin和XIAP蛋白表达量均显著减少,cleaved caspase-3蛋白表达量均显著增加（P=0.000）,也呈明显剂量依赖性。结论 NS398能明显抑制人肺癌裸鼠移植瘤的生长,并诱导肿瘤细胞凋亡,其机制可能与下调survivin和XIAP蛋白表达,上调cleaved caspase-3蛋白表达有关。     

大蒜素对荷子宫内膜癌裸小鼠移植瘤生长的影响及其机制研究

目的 研究大蒜素（allitridi）对荷子宫内膜癌裸小鼠移植瘤生长的影响及其机制。方法 取对数生长期子宫内膜癌Ishikawa细胞,皮下注射接种的方法制备荷子宫内膜癌裸小鼠模型,成瘤后取60只裸小鼠模型随机分为模型组、大蒜素高（40mg/kg）、中（20mg/kg）、低（10mg/kg）剂量组和顺铂2mg/kg组,每组12只;各治疗组均隔天腹腔注射给药1次,共给药治疗5次。治疗完成后剥取肿瘤组织并称量、计算抑瘤率;HE染色法观察肿瘤组织形态学变化;TUNEL染色法观察肿瘤组织细胞凋亡状况并计算凋亡指数（apoptosis index,AI）,免疫组织化学法（immunohistochemistry,IHC）观察肿瘤组织bcl-2、Bax、caspase-3蛋白表达并进行半定量分析,计算Bax/bcl-2比值。结果 大蒜素各组和顺铂组裸小鼠移植瘤肿瘤组织细胞呈皱缩、片状坏死等病理性改变,凋亡细胞数量明显增多,以大蒜素高剂量组最为显著。与模型组比较,大蒜素高、中剂量组和顺铂组瘤体重量显著减轻（P<0.05,P<0.01）,抑瘤率显著升高（P<0.01）,肿瘤组织bcl-2蛋白表达显著下调（P<0.05,P<0.01）,Bax和caspase-3蛋白表达显著上调（P<0.05,P<0.01）,Bax/bcl-2表达比值显著升高（P<0.01）。与顺铂组比较,大蒜素高剂量组Bax/bcl-2表达比值显著升高（P<0.05）。结论 大蒜素对荷子宫内膜癌裸小鼠移植瘤生长具有抑制作用,其机制可能与大蒜素能够下调bcl-2表达、上调Bax和caspase-3表达、提高Bax/bcl-2表达比值进而促进肿瘤细胞凋亡有关。     

冬凌草甲素对卵巢癌细胞紫杉醇耐药性的拮抗作用及其机制研究

目的 探讨冬凌草甲素体内外对卵巢癌细胞紫杉醇耐药性的拮抗作用及其机制。方法 通过大剂量冲击法,诱导制备耐紫杉醇的人卵巢癌HO-8910PM细胞株（HO-8910PM/PIX）,用不同浓度冬凌草甲素处理HO-8910PM/PIX细胞;或在冬凌草甲素作用HO-8910PM/PIX细胞前以NF-κB激活剂TPA进行预处理。给药后,细胞经DAPI染色,荧光显微镜下观察细胞形态变化;CCK-8法检测细胞增殖;流式细胞仪检测细胞凋亡情况;Western blotting检测卵巢癌细胞中NF-κB蛋白的表达。建立裸鼠卵巢癌皮下移植瘤模型。接种后8周,观察冬凌草甲素对裸鼠皮下移植瘤生长的影响;免疫组织化学法检测肿瘤组织中NF-κB的阳性表达。结果 与对照组相比,冬凌草甲素呈浓度相关性抑制卵巢癌HO-8910PM/PIX细胞增殖,显著诱导细胞凋亡,而TPA可显著削弱冬凌草甲素诱导细胞凋亡的作用。与HO-8910PM细胞相比,NF-κB在HO-8910PM/PIX细胞中表达显著上调,冬凌草甲素可抑制HO-8910PM/PIX细胞中NF-κB的表达。冬凌草甲素可显著抑制裸鼠卵巢癌皮下移植瘤生长,明显减弱移植瘤组织中NF-κB的阳性表达。结论 冬凌草甲素体内外对卵巢癌细胞紫杉醇耐药性具有拮抗作用,该作用可能通过抑制NF-κB的表达而实现。     

姜黄素抑制人宫颈癌CaSki细胞裸鼠移植瘤的生长

目的 探讨姜黄素对人宫颈癌CaSki细胞裸鼠皮下移植瘤生长的抑制作用。方法 建立人宫颈癌裸鼠皮下移植瘤模型,35只荷瘤裸鼠随机分为5组,姜黄素高剂量(200 mg/kg)、中剂量(100 mg/kg)、低剂量(50 mg/kg)组、溶剂对照组和顺铂组(3 mg /kg),每组7只,姜黄素连续灌胃给药15 d,顺铂组每3 d腹腔注射给药,共5次。停药24 h后处死裸鼠,测量裸鼠体重、移植瘤体积、瘤重,计算抑瘤率;光镜下观察移植瘤组织形态学变化;结果 处理组的移植瘤体积均明显小于空白对照组(P结论 姜黄素对人宫颈癌CaSki细胞移植瘤的生长具有明显的抑制作用。     

大黄素对胰腺癌裸鼠皮下移植瘤抑癌基因去甲基化作用

目的 通过建立胰腺癌Panc1细胞株皮下移植瘤模型,探讨大黄素对胰腺癌皮下移植瘤抑癌基因p16、RASSF1A、ppENK启动子区CpG岛的去甲基化作用的影响。方法 首先建立人胰腺癌细胞裸鼠模型,后给予不同药物浓度的大黄素（0、30、50、70mg/kg）处理裸鼠,观察大黄素对裸鼠移植瘤生长的影响,采用MSP、RT-PCR以及Western blot法分别检测不同组别移植瘤的3个抑癌基因甲基化状态以及mRNA、蛋白的改变。结果 大黄素能够抑制胰腺癌裸鼠皮下移植瘤的生长,随着大黄素浓度的升高,其对胰腺癌裸鼠移植瘤的生长抑制率逐渐升高,特别50、70mg/kg浓度组与对照组比较,差异有统计学意义（P<0.05）。MSP结果显示大黄素可使裸鼠移植瘤组织的甲基化条带减弱,非甲基化条带增强,同时可以使经RT-PCR和Western blot法结果证实的低表达或无表达的mRNA和蛋白表达增强或者重新表达,与对照组比较,差异有统计学意义（P<0.05）。结论 通过体内实验笔者证实大黄素可以对胰腺癌裸鼠移植瘤抑癌基因p16、RASSF1A、ppENK发挥不同程度的去甲基化作用,使因启动子区甲基化而失表达的抑癌基因重新表达,大黄素抑制胰腺癌裸鼠移植瘤生长可能和其具有对抑癌基因去甲基化作用有关。     

清热利湿外治法对宫颈癌荷瘤裸鼠抗肿瘤作用与MARK信号通路的关系

[目的] 探讨清热利湿外治法对HPV（+）宫颈癌荷瘤裸鼠模型抗肿瘤作用及对ERK及P38/MAPK信号通路的影响。[方法] 建立人宫颈癌Siha细胞荷瘤裸鼠皮下移植瘤模型,裸鼠成瘤后,按随机数字表法分为5组,即顺铂组、空白对照组和清热利湿外治法高剂量（0.942 8 mg/kg）、中剂量（0.471 4 mg/kg）、低剂量组（0.235 7 g/kg）,连续用药观察28天。停药24小时后处死裸鼠,完整取出肿瘤组织,测量肿瘤体积及体质量,计算抑瘤率。将肿瘤组织切片后,HE染色法观察肿瘤的形态学变化,运用免疫组化SP的方法,检测肿瘤组织中的p-ERK及p-p38蛋白表达水平。[结果] 清热利湿外治法用药组的移植瘤体积均明显小于空白对照组（P<0.05）,高、中、低剂量组抑瘤率分别为36.23%、31.24%和14.94%;HE染色法显示清热利湿外治法用药组裸鼠的移植瘤组织出现明显坏死改变;清热利湿外治法中剂量、高剂量治疗组的p-ERK及p-p38蛋白水平明显下降,与空白对照组比较差异有统计学意义（P<0.05）。[结论] 清热利湿外治法对人宫颈癌Siha细胞移植瘤的生长具有明显抑制作用;其作用机制可能与下调ERK/P38 MARK（丝裂原活化蛋白激酶）信号转导通路的磷酸化水平有关。     

人参皂甙Rg3对胰腺癌裸鼠皮下移植瘤血管生成拟态的研究

目的 本实验通过建立胰腺癌SW-1990细胞株皮下移植瘤模型,探讨人参皂甙Rg3对胰腺癌皮下移植瘤血管生成拟态的影响。 方法 首先建立人胰腺癌细胞裸鼠模型,后给予不同药物浓度的人参皂甙Rg3(0、5、10、20mg/kg)处理裸鼠,观察人参皂甙Rg3对裸鼠移植瘤生长的影响,免疫组化-PAS双染观察人参皂甙Rg3对裸鼠胰腺癌皮下移植瘤血管生成拟态和血管内皮因子CD31的影响,并用荧光定量PCR和Western blot法分别检测MMP-2、MMP-9在mRNA和蛋白水平的表达。 结果 人参皂甙Rg3能够抑制胰腺癌裸鼠皮下移植瘤的生长,其中20mg/kg人参皂甙Rg3组最明显;Western blot法和荧光定量PCR示用药组与空白组比较,MMP-2、MMP-9在蛋白和mRNA水平的表达下降,且差异有统计学意义(P<0.05);免疫组化-PAS双染后发现血管拟生(+)和CD31(+)数量均较空白组减少。 结论 通过体内实验笔者证实人参皂甙Rg3能够通过降低MMP-2、MMP-9的表达来抑制胰腺癌血管生成拟态的形成。     

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.