β-cat和cyclin D1表达与胰腺癌临床病理学的关系

①目的　探讨 β 连环蛋白 (β cat)的异常表达和细胞周期素D1 (cyclinD1 )高表达与胰腺癌发生、浸润、转移和预后的关系。②方法　应用免疫组织化学PicTureTM 二步法 ,检测 47例胰腺癌组织、1 2例胰腺导管上皮内肿瘤 (上皮中度不典型增生 )和 1 0例正常胰腺组织中 β cat和cyclinD1的表达。 ③结果　β cat在 1 0例正常胰腺组织均呈正常表达 ,而cyclinD1均呈阴性。β cat在胰腺导管上皮内肿瘤和胰腺癌中的表达率分别为 50 .0 %和 68.1 % ,两者比较差异无显著性 (χ2 =0 .689,P >0 .0 5) ;cyclinD1在胰腺导管上皮内肿瘤和胰腺癌中的表达率分别为 50 .0 %和 74.5 % ,两者比较差异无显著性 (χ2 =0 .2 1 3 ,P >0 .0 5)。β cat异常表达率与胰腺癌的转移和 1年生存率显著相关 (χ2 =6 .2 30 ,5 .495 ,P均 <0 .0 5)。cyclinD1的表达率与胰腺癌的增殖和分化程度有关 (P =0 .0 0 6 ,χ2 =6 .1 90 ,P <0 .0 5)。β cat异常表达与cyclinD1高表达在胰腺导管上皮内肿瘤和胰腺癌中均呈显著的正相关 (P =0 .0 0 2 ,χ2=6 .937,P <0 .0 1 ;r=1 .0 0 0 ,0 .845 ,P <0 .0 1 )。④结论　β cat异常表达导致cyclinD1的激活而引起细胞增殖和分化失控 ,在胰腺癌的发生机制中可能发挥重要作用。β cat异常表达可作为判断胰腺     

人脑胶质瘤中cyclin D2的表达及其与细胞增殖的关系

目的 :研究人脑胶质瘤中cyclinD2蛋白的表达与肿瘤恶性程度的关系及其对细胞增殖活性的影响 .方法 :采用免疫组化方法检测 5 2例人脑胶质瘤和 8例正常人脑组织标本中cyclinD2和PCNA的表达水平 ,计算两者标记指数 ,统计分析两者之间及其与胶质瘤病理分级之间的关系 .结果 :正常脑组织中无cyclinD2或PCNA表达 .随着人脑胶质瘤病理分级的增高 ,cyclinD2平均标记指数明显升高 .在WHO分级Ⅰ～Ⅳ级胶质瘤中 ,Ⅰ ,Ⅱ ,Ⅲ级与Ⅳ级、Ⅰ级与Ⅲ级以及低度恶性胶质瘤 (Ⅰ～Ⅱ )与高度恶性胶质瘤 (Ⅲ～Ⅳ )之间标记指数存在显著性差异 (P <0 .0 5 ) .类似cyclinD2 ,PCNA标记指数随脑胶质瘤恶性程度增高而升高 .cyclinD2与PCNA的平均标记指数呈明显正相关 (r =0 .6 5 4 ,P <0 .0 1 ) .结论 :人脑胶质瘤中cyclinD2的表达与细胞增殖活性和病理学分级密切相关 ,很可能参与了人脑胶质瘤细胞的恶性转化 .     

P57Kip2和PCNA在乳癌中的表达及其与预后关系

①目的　探讨有丝分裂抑制因子 (P5 7Kip2 )、增殖细胞核抗原 (PCNA)蛋白表达与乳癌预后的关系。②方法　以免疫组化S P法检测 138例乳癌组织P5 7Kip2 和PCNA蛋白的表达水平。③结果　在 138例乳癌组织中P5 7Kip2 蛋白阳性 5 5例 (39.86 % ) ,其中低表达 39例 (70 .91% ) ,高表达 16例 (2 9.0 9% )。PCNA低指数表达 6 3例 (45 .6 5 % ) ,PCNA高指数表达 75例 (5 4 .35 % )。P5 7Kip2 蛋白的表达与乳癌组织腺管形成、细胞核多形性、核分裂象计数和组织学分级呈负相关 (χ2 =5 .11～ 11.0 1,P <0 .0 1) ;单因素预后分析显示P5 7Kip2 蛋白高表达组生存期长于低表达组 (χ2 =6 .93,P <0 .0 1) ,PCNA高指数表达组生存期短于低指数表达组 (χ2 =5 .13,P <0 .0 5 ) ;P5 7Kip2 阳性并PCNA低指数表达组、P5 7Kip2 阳性并PCNA高指数表达组、P5 7Kip2 阴性并PCNA低指数表达组和P5 7Kip2 阴性并PCNA高指数表达组生存期依次缩短 (χ2 =7.32 ,P <0 .0 1)。④结论　P5 7Kip2 和PCNA的联合检测有利于更准确地判断细胞增殖活性和预后 ;P5 7Kip2 在乳癌中的不同表达水平可能与不同的调控方向有关。     

低氧诱导因子-1α表达与胰腺癌增殖和凋亡的关系

①目的　研究胰腺癌组织中低氧诱导因子 1α(HIF 1α)的表达与胰腺癌增殖和凋亡的关系。②方法应用免疫组织化学方法 ,检测 4 7例胰腺癌和 1 0例正常胰腺组织中HIF 1α、增殖细胞核抗原 (PCNA)及Bcl 2蛋白的表达。③结果　 4 7例胰腺癌组织HIF 1α表达阳性率为 5 5 .3% ,1 0例正常胰腺组织均呈阴性表达。HIF 1α阳性表达率在有周围脏器浸润的胰腺癌组织中为 6 6 .7% ,无浸润者为 35 .3% ,二者间有显著性差异 (χ2 =4 .32 ,P <0 .0 5 ) ;伴淋巴结和远隔脏器转移的胰腺癌组织HIF 1α阳性表达率为 72 .0 % ,高于无转移者的 36 .4 % ,其差异有显著意义 (χ2 =6 .0 1 ,P <0 .0 1 )。HIF 1α阳性表达率与胰腺癌的大小、组织学分级和 1年生存率无关 (χ2 =2 .0 7～ 2 .5 2 ,P >0 .0 5 )。在 4 7例胰腺癌组织中高增殖活性 2 8例、低增殖活性 1 9例。 1 0例正常胰腺的腺胞均呈低增殖状态。胰腺癌细胞增殖程度与胰腺癌淋巴结或远处脏器转移及病人术后生存时间均密切相关 (χ2 =5 .98、6 .1 9,P <0 .0 5 ) ;而与胰腺癌的大小、分化程度和浸润无关 (χ2 =2 .0 1～ 3.74 ,P >0 .0 5 )。 1 0例正常胰腺癌组织Bcl 2蛋白均呈阳性表达 ,4 7例胰腺癌组织中Bcl 2蛋白的阳性表达率为 2 9.8%。Bcl 2蛋白表达与胰腺癌的大小、     

非小细胞肺癌Bax蛋白表达及其与细胞凋亡和增殖的关系

①目的　探讨非小细胞肺癌Bax蛋白表达与细胞凋亡和增殖的关系。②方法　采用免疫组化SABC法 ,检测 4 3例非小细胞肺癌及 2 0例癌旁正常肺组织石蜡包埋标本Bax蛋白及增殖细胞核抗原 (PCNA)表达 ;以PCNA标记细胞增殖指数 (MI)检测其增殖活性 ;用TUNEL法检测细胞凋亡 ,并计算细胞凋亡指数 (AI)。③结果肺癌组织Bax蛋白的表达显著低于癌旁正常肺组织 (χ2 =5 .6 5 3,P <0 .0 5 ) ;肺癌组织中AI和MI均明显高于癌旁正常肺细胞 (t′ =8.2 79、9.6 2 0 ,P <0 .0 0 1) ;Bax蛋白表达阳性的肺癌组织细胞AI明显高于Bax表达阴性细胞 (t=2 .6 17,P <0 .0 5 )。④结论　肺癌组织Bax蛋白表达下调 ,细胞增殖及凋亡均较活跃 ;Bax蛋白的过度表达具有促进肺癌细胞凋亡作用     

增殖细胞核抗原在胰腺癌中的表达及意义

目的　通过检测增殖细胞核抗原 (PCNA)蛋白在胰腺癌及其他胰腺疾病组织中的表达 ,探讨其临床意义。方法　应用链霉素抗生物素过氧化酶免疫组化法对 32例原发性胰腺导管腺癌、12例正常胰腺组织、10例良性疾病组织进行PCNA蛋白检测。结果　PCNA蛋白在原发性胰腺导管腺癌、正常胰腺组织和良性疾病组织中均表达 ,其PI值分别为 30 2 6± 14 2 3、2 1 6 3± 6 76和 8 0 9± 3 6 0 ,后两组与胰腺癌组比较差异有显著性 (P <0 0 5 )。PCNA蛋白表达在组织学高、中分化、临床Ⅰ～Ⅱ期及无淋巴结转移组显著低于组织学低分化、临床Ⅲ～Ⅳ期及有淋巴结转移组 (P <0 0 5 )。结论　PCNA蛋白能较好地反映胰腺癌的恶性程度和增生活性     

胃癌雌激素受体与增殖细胞核抗原的关系

目的 :分析胃癌组织中雌激素受体 (Estrogenreceptor,ER)与细胞周期蛋白D1 (cyclinD1 )、增殖细胞核抗原 (Pro liferatingcellnuclearantigen,PCNA)蛋白表达情况及它们之间的相互关系 ,探讨雌激素对胃癌细胞增殖的影响。方法 :用流式细胞光度术检测 31例胃癌组织及 10例正常胃组织中ER和cyclinD1 的表达量 ;用免疫组织化学方法检测胃癌组织及正常胃组织中ER和PCNA蛋白表达等级 ,并进行统计分析。结果 :胃癌组织ER及cyclinD1 表达量明显高于正常胃组织 ,且胃癌组织ER表达量与cyclinD1 表达量之间存在正相关关系 (rs=0 4 0 ,P <0 0 5 )。免疫组化胃癌组织ER及PCNA蛋白阳性表达率明显高于正常胃组织 ,且胃癌组织ER表达等级与PCNA蛋白表达等级之间存在正相关关系 (rs=0 4 4 ,P <0 0 5 )。结论 :雌激素在胃癌发生、发展中有促进细胞增殖的作用 ,部分胃癌有可能是雌激素依赖性肿瘤     

p57kip2在膀胱癌的表达及意义

目的 :探讨细胞周期蛋白依赖性激酶抑制因子 p5 7kip2 蛋白在膀胱癌的表达及临床意义。方法 :采用免疫组化技术检测p5 7kip2 蛋白和增殖细胞核抗原 (PCNA)在 5 0例膀胱癌和 14例正常膀胱黏膜中的表达。结果 :p5 7kip2 蛋白阳性表达率在膀胱癌组织中为 4 6 % (2 3/ 5 0 ) ,显著低于正常膀胱黏膜组织 78.6 % (11/ 14 ) (χ2 =4 .6 6 0 ,P <0 .0 5 ) ,并与膀胱癌组织病理分级、生存率显著相关 (χ2 =8.5 92 ,P <0 .0 5 ;χ2 =4 .5 4 6 ,P <0 .0 5 ) ,但与临床分期无关 (χ2 =0 .5 73,P >0 .0 5 )。PCNA阳性表达率在膀胱癌组织中为 6 0 % (30 / 5 0 ) ,显著高于正常膀胱黏膜组织的 0 % (0 / 14 ) (χ2 =15 .812 ,P <0 .0 1) ,并与膀胱癌组织病理分级 ,临床分期和生存率显著相关 (P <0 .0 5 )。p5 7kip2 和PCNA蛋白的表达呈负相关 (r =- 0 .4 4 3,P <0 .0 1)。结论 :p5 7kip2 的低表达与膀胱癌的发生发展密切相关 ,可以作为判断膀胱癌不良预后的参考指标。     

P53蛋白和增殖细胞核抗原在前列腺癌中的表达及意义

目的　探讨前列腺癌中P5 3蛋白和增殖细胞核抗原 (PCNA)表达的意义。②方法　用免疫组织化学技术 ,对 30例前列腺癌和 2 0例良性前列腺增生组织中P5 3蛋白和PCNA进行检测。③结果　 6 3.3%前列腺癌中存在P5 3蛋白的异常表达 ,良性前列腺增生组织P5 3蛋白均表达阴性 ;前列腺癌PCNA增殖指数明显高于良性前列腺增生组织 (t′ =8.31,P <0 .0 0 1) ,P5 3蛋白及PCNA表达均与前列腺癌的组织学分级及病人预后有关 (P5 3:Hc=7.73,P <0 .0 5 ;z=2 .5 5 ,P <0 .0 5 .PCNA :F =36 .2 5 ,q =3.2 5～ 8.96 ,P <0 .0 1.t=5 .2 5 5 ,uc=2 .843,P <0 .0 0 1) ,前列腺癌P5 3蛋白阳性表达者PCNA增殖指数明显高于P5 3蛋白阴性表达者 (t=4.46 6 ,P <0 .0 0 1)。④结论　p5 3基因突变可能是促进前列腺癌发生发展和导致肿瘤细胞增殖异常活跃的重要因素 ;P5 3蛋白表达与PCNA增殖指数可作为鉴别前列腺良恶性肿瘤 ,以及判断前列腺癌的恶性程度和预测预后的综合性指标之一。     

胰腺癌组织中a—连环素的表达

目的　探讨α 连环素 (α Cat)在胰腺癌组织中的表达及与其生物学行为的关系。②方法　应用免疫组织化学PicTureTM二步法 ,检测 47例胰腺癌组织、5例正常胰腺组织及 12例癌周正常胰腺组织中α Cat的表达 ;同时检测 47例胰腺癌组织中细胞增殖核抗原 (PCNA)的表达。③结果　α Cat蛋白主要定位于正常胰腺腺泡和导管上皮细胞间的连结处 ,正常胰腺和癌周正常胰腺组织均呈阳性表达 ,6 1.7%的胰腺癌组织表达减低 ;α Cat表达与胰腺癌的组织学分级、淋巴结和肝转移显著相关 (χ2 =4.47～ 15 .46 ,P <0 .0 5 ,0 .0 1) ,而与胰腺癌大小、增殖程度、侵袭能力及 1年生存率无关 (χ2 =0 .0 7～ 2 .77,P均 >0 .0 5 )。④结论　胰腺癌存在α Cat基因的失活及蛋白表达的下调 ,α Cat蛋白可作为评估胰腺癌分化和转移 ,尤其是肝转移的重要生物学指标。     

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.