血管内皮生长因子在大鼠子痫前期模型中的作用

目的:探讨血管内皮生长因子在大鼠子痫前期模型中的作用。方法:选择清洁级W istar大鼠,随机分为两组,每组14只。对照组于妊娠第7天皮下注射生理盐水;亚硝基左旋精氨酸甲酯(L-NAM E)组于妊娠第7天皮下注射一氧化氮合成酶(NOS)抑制剂L-NAM E,每日125 m g/kg体重。两组均于妊娠第8天每天测量大鼠尾动脉血压,若血压增高合并尿蛋白大于或等于( )时,大鼠子痫前期模型确立。同时,测定两组大鼠血小板数值和血清VEGF浓度后,立即处死大鼠测胎鼠及胎盘重量;采用免疫组化法检测胎盘VEGF表达量。结果:L-NAM E组孕鼠出现类似子痫前期特征,表现为血压明显升高至(145.3±4.6)mmHg,尿蛋白含量增加为(814.3±57.5)m g/L,血小板数显著减少至(467.1±76.3)×109/L及胎鼠胎盘重量明显减轻;对照组孕鼠血压(101.4±7.6)mmHg,尿蛋白(398.2±82.3)m g/L,血小板计数(837.20±71.4)×109/L。两组比较差异均有显著性(P均<0.05)。对照组血清VEGF浓度明显大于L-NAM E组[(13.62±3.33 vs 8.71±2.42)ng/L],胎盘中的VEGF表达量对照组也明显高于L-NAM E组[(0.89±0.19 vs 0.58±0.12)OD],差异均有显著性(P<0.01)。结论:大鼠血清VEGF水平降低和胎盘表达VEGF量下降参与子痫前期的发生。     

子痫前期病人血清可溶性血管内皮生成因子受体1水平的检测

目的探讨子痫前期病人血清可溶性血管内皮生成因子受体1(sFlt-1)水平的变化及其意义。方法采用酶联免疫吸附试验(ELISA)法测定30例子痫前期病人(子痫前期组)产前和产后48 h血清血管内皮生成因子(VEGF)及sFlt-1水平。并以45例健康孕妇作为对照(对照组),其中早期妊娠18例、中期妊娠12例、晚期妊娠15例。晚期妊娠组及子痫前期组均随访至产后(正常产后组、子痫前期产后组)。结果中期妊娠组VEGF水平与早期及晚期妊娠组比较,差异均有统计学意义(t=3.456、2.274,P<0.01、0.05)。早、中期妊娠组sFlt-1水平与晚期妊娠组比较,差异有统计学意义(t=3.494、2.244,P<0.05)。正常产后组VEGF与sFlt-1水平均较晚期妊娠组减低,差异有显著性(t=3.595、2.338,P<0.01、0.05)。子痫前期组血清VEGFs、Flt-1水平与晚期妊娠组比较,差异均有显著性(t=11.785、8.643,P<0.01)。子痫前期产后组VEGFs、Flt-1水平与正常产后组比较差异无统计学意义(t=1.986、1.018,P>0.05)。妊娠32周前发病及伴胎儿生长受限的子痫前期病人血清sFlt-1水平较妊娠32周后发病及不伴胎儿生长受限的子痫前期病人血清sFlt-1水平明显升高(t=2.305、2.286,P<0.05)。子痫前期组血清sFlt-1水平与24 h尿蛋白总量呈明显正相关(r=0.517,P<0.01)。母体血清sFlt-1与VEGF水平呈明显负相关(r=-0.383,P<0.05)。结论子痫前期病人血清sFlt-1水平升高且与子痫前期发病时间和疾病严重程度相关。     

血管内皮功能指标与子痫前期严重程度关系及对孕妇流产预测效能研究

目的:探讨血管内皮功能指标与子痫前期严重程度的关系及对流产的预测效能。方法:选择114例子痫前期孕妇为观察组，根据临床表现的严重程度，分为轻度子痫前期组和重度子痫前期组；另选同期接受产检的正常孕妇为对照组。检测两组血管内皮功能指标[可溶性细胞内皮因子(sEng)、可溶性血管内皮生长因子受体-1(sFlt-1)、内皮素-1(ET-1)和血管内皮生长因子(VEGF)],分析血管内皮功能指标与24 h尿蛋白水平的关系，使用受试者工作特征(ROC)曲线分析血管内皮功能指标对子痫前期孕妇发生流产的预测效能。结果:观察组血清sEng、sFlt-1、ET-1水平均高于对照组，VEGF水平低于对照组(均P<0.05);重度子痫前期组确诊时血清sEng、sFlt-1、ET-1水平均高于轻度子痫前期组，VEGF水平低于轻度子痫前期组(均P<0.05);观察组产后血清sEng、sFlt-1、ET-1水平较确诊时明显降低，VEGF水平较确诊时明显升高(均P<0.05);经Pearson相关性分析，观察组确诊时24 h尿蛋白水平与血清sEng、sFlt-1、ET-1水平呈正相关，与VEGF水平...     

血管生长抑素和血管内皮生长因子与子痫前期发病的关系

目的:检测外周血中血管生长抑素(AS)、血管内皮生长因子(VEGF)水平,探讨与子痫前期发病的关系。方法:取58例孕妇外周血,其中正常妊娠组20例;轻度子痫前期组17例;重度子痫前期组21例。ELISA方法检测血清AS、VEGF的浓度。结果:①子痫前期组AS水平显著高于对照组,差别有显著性(P<0.05)。②子痫前期组VEGF平均水平显著低于对照组,差别具有显著性(P<0.05)。③轻度子痫前期组和重度子痫前期组之间AS、VEGF水平差别均没有显著性(P>0.05)。④在子痫前期患者中AS与VEGF之间存在关联关系,呈显著负相关(r=-0.560,P<0.05;r=-0.572,P<0.05)。结论:AS和VEGF在子痫前期患者外周血中有显著变化,两者之间呈显著负相关,可能是子痫前期发病的重要因素之一。     

血清中sFlt-1、sEng水平及胎盘中Endoglin表达的变化与子痫前期相关性研究

目的:通过对子痫前期患者血清中的可溶性血管内皮生长因子受体1(sFlt-1)和可溶性Endoglin(sEng)的表达水平以及胎盘中Endoglin蛋白的表达水平的测定,探讨它们在子痫前期发生中的作用.方法:采用酶联免疫吸附试验(ELISA)夹心法检测并比较10例轻度子痫前期患者、30例重度子痫前期患者及40例正常晚期妊娠妇女血清中的sFlt-1和sEng的水平.并通过免疫组化SP法测定三组妊娠妇女胎盘中Endoglin蛋白的表达.结果:(1)正常妊娠组血清中sFlt-1水平低于轻度子痫前期组和重度痫前期组,各组比较差异有显著性(P<0.01).但轻度子痫前期组与重度子痫前期组比较差异无统计学意义(P>0.05).(2)正常妊娠组血清中sEng水平和胎盘组织中Endoglin的平均光密度低于轻度子痫前期组,轻度子痫前期组低于重度子痫前期组,各组比较差异有显著性(P<0.01).(3)血清中sEng的水平与胎盘组织中Endoglin的表达水平(MOD值)呈正相关关系.结论:sFlt-1和sEng在子痫前期患者的外周血中高表达,Endoglin蛋白在子痫前期胎盘中的表达增高,血清中sFlt-1与sEng可能参与了子痫前期的发生和发展.     

PAPP-A及VEGF在子痫前期患者血清中的表达及其相关性研究

目的 观察子痫前期患者血清中妊娠相关血浆蛋白A (PAPP-A)及血清血管内皮生长因子(VEGF)表达情况,探讨其与子痫前期病情严重程度的关系.方法 选择2013年1月至2014年12月在上海市浦东医院门诊行常规产前检查并分娩的子痫前期孕妇60例为子痫前期组,根据病情严重程度将其分为轻度子痫前期组30例,重度子痫前期组30例.选取同期行本院门诊产前检查并住院分娩的正常孕妇30例为对照组.分别采用酶联免疫吸附试验测定三组孕妇血清中的PAPP-A水平和VEGF的水平,分析其与子痫前期患者病情严重程度的关系.结果 重度子痫前期组新生儿出生体重[(3.4±0.5) kg]低于轻度子痫前期组[(3.6±1.4) kg]和对照组[(3.7±0.5) kg],差异均具有统计学意义(P<0.05);重度子痫前期组患者血清PAPP-A值、VEGF值和24 h尿蛋白值分别为(900.6 ± 379.0) μg/ml、(7.2±4.2) pg/ml、(2.5±1.2) g/24 h,轻度子痫前期组分别为(783.8±204.7) μg/ml、(5.3±1.4) pg/ml、(1.4±0.3) g/24 h,均分别高于对照组的(592.9±222.9) μg/ml、(4.8±2.8) pg/ml、(0.2±0.1) g/24 h,差异均具有统计学意义(P<0.05);重度子痫前期组的血清PAPP-A值和24 h尿蛋白值均高于轻度子痫组,差异具有统计学意义(P<0.05);Speraman相关分析显示,血清PAPP-A值和血清VEGF值呈明显的正相关(r=0.574,P<0.05).结论 PAPPA及VEGF均参与了子痫前期的发生及发展.     

子痫前期血清及尿液中VEGF、PLGF水平变化及其意义研究

目的探究子痫前期者血清以及尿液当中血管内皮生长因子(VEGF)和胎盘生长因子(PLGF)水平变化和病情程度之间的关系及其对子痫前期所具有的预测意义。方法抽取78例受试者,将26例正常妊娠者设为A组,26例轻度子痫前期者设为B组,26例重度子痫前期者设为C组,通过酶联免疫吸附试验对三组孕妇血清以及尿液中的VEGF和PLGF水平进行检测。结果 B组与C组血清以及尿液中的VEGF和PLGF水平对比差异均具统计学意义(P0.05),子痫前期者血清中PLGF水平比尿液中的水平高,而尿液中的VEGF水平则高于血清中的水平。A组血清VEGF和PLGF水平均比尿液中的水平高。结论孕妇的血清以及尿液中的VEGF和PLGF水平和子痫前期的病情程度有着明显相关性,对孕妇尿液中VEGF和PLGF水平进行检查可对子痫前期具有一定的预测作用。     

重度子痫前期患者脐静脉血清中VEGF及sFlt-1的表达及其对内皮细胞损伤的影响

目的 探讨重度子痫前期患者脐静脉血清中血管内皮生长因子(vascular endothelial growth factor,VEGF)和可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase receptor 1,sFlt-1)表达的特点,及其对内皮细胞损伤的影响.方法 采用ELISA试剂盒定量检测10例正常妊娠及10例重度子痫前期患者脐静脉血清中sFlt-1及VEGF的蛋白表达水平.分别将两组血清在体外干预人脐静脉内皮细胞株(EVC-304)生长,利用:①荧光标记的牛血清白蛋白检测内皮细胞的单层屏障功能;②MTT法检测内皮细胞的增殖能力;③硝酸还原酶法检测内皮细胞的一氧化氮合成能力;以评估两组血清对内皮细胞功能的影响.结果 ①与正常妊娠组相比,重度子痫前期组患者脐静脉血清中sFlt-1蛋白水平明显升高;而游离VEGF蛋白水平明显降低,两者呈负相关.②与正常妊娠组相比,重度子痫前期组脐静脉血清可使内皮细胞功能明显受损,包括:(1)通过单层内皮细胞的牛血清白蛋白浓度升高,即内皮细胞的单层屏障功能受损;(2)内皮细胞增殖能力明显被抑制;(3)培养液中NO浓度明显降低.③内皮细胞功能损伤程度与重度子痫前期组脐静脉血清中sFlt-1/VEGF水平成正相关.结论 子痫前期患者血清中sFlt-1和VEGF表达失衡,与子痫前期内皮细胞损伤密切相关,可能是参与子痫前期发生发展的重要机制之一.     

葛根素对子痫前期大鼠胎盘组织VEGF表达的影响

目的观察葛根素对子痫前期大鼠的治疗作用以及对胎盘组织血管内皮生长因子(VEGF)表达的影响。方法采用经孕鼠尾静脉缓慢滴注内毒素复制大鼠子痫前期模型。选取SD雌性孕鼠30只,随机分为正常妊娠组(C组)、子痫前期组(P组)和葛根素治疗组(T组)。孕14d给予T组葛根素治疗。孕21d收取胎盘组织,免疫组织化学方法检测胎盘VEGF的表达;测量新生小鼠体质量。结果新生小鼠体质量(g)比较:C组(4.97±0.14),P组(4.71±0.22),T组(4.85±0.05),3组间差异有统计学意义(P<0.01)。VEGF表达:C组(171.96±5.00),P组(181.17±3.74),T组(182.05±6.14),3组间差异有统计学意义(P<0.05),但两两比较P组和T组之间无差异,且均高于C组。结论葛根素对子痫前期大鼠有治疗作用,但尚未能证实其作用机制与VEGF途径有关。     

妊娠高血压综合征血清血管内皮生长因子与子宫螺旋动脉血流动力学参数的相关性

目的观测妊娠高血压综合征(PIH)患者血清血管内皮生长因子(VEGF)与子宫螺旋动脉血流动力学参数,探讨二者与病情严重程度的关系。方法应用彩色多普勒超声检测PIH患者54例(观察组,其中妊娠高血压亚组32例、子痫前期亚组15例、子痫期亚组7例)及正常孕晚期孕妇78例(对照组)子宫螺旋动脉的搏动指数(PI)、阻力指数(R1)及收缩期最大血流速度与舒张末期速度比值(S/D),同时检测血清VEGF水平并进行比较和相关分析。结果观察组PI、RI、S/D值均高于对照组,而VEGF水平低于对照组,差异均有统计学意义(P<0.05,P<0.01)。VEGF水平比较,子痫期亚组<子痫前期亚组<妊娠高血压亚组(P<0.05)。RI水平比较,子痫期亚组>子痫前期亚组>妊娠高血压亚组,子痫期亚组S/D值高于子痫前期亚组和妊娠高血压亚组。PIH患者血清VEGF含量分别与子宫螺旋动脉PI(r=-0.80,P<0.01)、RI(r=-0.81,P<0.01)及S/D比值(r=-0.84,P<0.01)呈负相关。结论检测血清VEGF及彩色多普勒超声监测PIH患者子宫螺旋动脉,可间接推测胎儿宫内缺氧情况,可为临床诊断及治疗PIH提供可靠的依据,     

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.