医学生反刍思维、自尊与抑郁的关系研究

目的 探讨反刍思维、自尊与抑郁的关系.方法 应用抑郁自评量表(SDS)、反刍思维量表(RRS)、自尊量表(SES)对172名医学院学生进行测查.结果 根据SDS评分标准,有抑郁倾向的大学生占35.7％(60/168);独生和非独生大学生在RRS总分、强迫思考和反省深思上得分差异有统计学意义(P＜0.05),症状反刍差异无统计学意义(P＞0.05);不同居住地的大学生RRS总分和症状反刍得分在统计学上差异边缘显著;反刍思维各因子性别差异无统计学意义(P＞0.05);大学生自尊水平性别差异有统计学意义(P＜0.05),城乡、独生与非独生之间比较,差异无统计学意义(P＞0.05);反刍思维与抑郁呈正相关,自尊与抑郁、反刍思维呈负相关;除强迫思考外,其余变量均可预测抑郁.结论 医学生心理健康状况值得高度关注,反刍思维、自尊对抑郁具有预测作用.     

生命意义感在童年虐待经历与抑郁情绪的中介效应

目的:探究大学生群体中生命意义对儿童期心理虐待和抑郁情绪的中介效应。方法:采用儿童心理虐待量表(CTQ-SF)、人生意义问卷(MLQ)、病人健康问卷抑郁量表(PHQ-9),对1 878名在校大学生进行问卷调查。结果:(1)儿童期心理虐待中的情感虐待、躯体虐待维度和抑郁在性别上的差异有统计学意义,女生情感虐待得分高于男生(P=0.001),男生躯体虐待得分高于女生(P<0.001),女生抑郁得分高于男生(P=0.001)。(2)不同抑郁程度在儿童期心理虐待、人生意义的各个维度及其总分比较,差异有统计学意义(P<0.001)。(3)儿童期创伤与抑郁得分均呈正相关(r=0.157,P<0.01),与人生意义得分呈负相关(r=-0.48,P<0.05);人生意义得分与抑郁呈负相关(r=-0.342,P<0.01)。(4)人生意义感、儿童期心理虐待和抑郁情绪的中介效应显著,占总效应的10.24%。结论:儿童期心理虐待与其抑郁关系密切,人生意义感在大学生儿童期心理虐待和抑郁间起部分中介作用。     

苏北地区消化系统疾病患者的心理社会因素研究

目的 探讨苏北地区消化系统疾病患者的心理社会因素及其与疾病的相关性,评价患者的心理状态及其相关因素,为消化系统疾病的临床治疗提供新的视角.方法 采用生活满意度指数B量表(LSIB)、抑郁自评量表(SDS)和社会支持评定量表(SSRS)对112例消化系统疾病患者(患病组)和108例健康者(对照组)进行问卷调查,资料采用t检验和χ2检验相关分析.结果 患病组的生活满意度指数低于对照组,差异有统计学意义(P＜0.01);抑郁指数高于对照组,差异有统计学意义(P＜0.01);社会支持总分和三个维度的得分均低于对照组,差异有统计学意义(P＜0.01).患者的生活满意度与社会支持中的社会支持总分、主观支持、客观支持呈正相关(P＜0.01),与抑郁指数呈负相关(P＜0.01);患者的抑郁指数和社会支持度中的客观支持和社会支持总分呈负相关(P＜0.05).患病组的抑郁发生率高于对照组,差异有统计学意义(P＜0.05).结论 不同心理状态和社会支持对消化系统疾病的影响不同;消化系统疾病患者的心理社会问题较突出,应有针对性地对消化系统疾病患者提供心理支持和社会支持,改善患者的生活质量和疾病的预后.     

汶川地震重灾区群众五态性格变化及其与心身状况、应对方式关系的研究

目的 调查汶川地震一年半后灾区群众五态性格变化情况及其与灾后心身状况、应对行为的关系.方法 采用五态性格量表、症状自评量表(SCL-90)、应对方式问卷对北川、绵阳地区480名受灾群众进行调查.结果 (1)五态性格调查中,太阳得分显著低于常模,差异有统计学意义(P＜0.001);少阳、阴阳和平、太阴维度得分均高于常模,差异有统计学意义(P＜0.001);少阴维度得分与常模无明显差异.(2)五态性格与心身健康状况相关分析显示,强迫、人际敏感因子得分与太阳存在显著负相关(P＜0.05);躯体化、强迫、抑郁、焦虑、恐怖、偏执因子得分与少阳存在显著负相关(P＜0.05);恐怖因子与阴阳和平存在显著负相关(P＜0.01);SCL-90各因子均与少阴无显著相关(P＞0.05);人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子与太阴存在显著正相关(P＜0.01).(3)应对方式各维度均与太阳存在显著正相关(P＜0.05);自责、幻想、合理化维度与少阳存在显著正相关(P＜0.01);解决问题、幻想与阴阳和平存在显著正相关(P＜0.05);自责、幻想、退避、合理化与太阴存在显著正相关(P＜0.01).结论 震后一年半灾区群众五态性格已发生变化.心身健康状况和应对方式与五态性格有密切关系,性格偏阳者心身健康状况优于偏阴者.     

脑梗死患者的心理状况及其对社会支持的影响

目的 调查脑梗死(cerebral infarction)患者社会支持和心理状况,分析心理状况对社会支持的影响.方法 32例脑梗死患者与32例健康对照者应用社会支持个人资源询问表(PRQ)进行社会支持评分,同时对两组受试者采用抑郁自评量表(CESD)和焦虑自评量表(SAS)进行心理状况评估.结果 脑梗死患者社会支持各项得分均低于对照组,差异有统计学意义(P＜0.01);脑梗死患者CESD和SAS的得分明显高于对照组,差异有统计学意义(P＜0.01);脑梗死患者的主观社会支持得分及社会支持总分与CESD得分呈负相关(P＜0.05);脑梗死患者的客观支持、主观支持的得分及社会支持总分与SAS得分呈负相关(P＜0.05).结论 脑梗死患者存在明显的心理障碍,并且其心理状况影响社会支持水平.     

社区经历创伤事件青少年家庭教养方式与心理韧性的关系研究

目的 探讨社区经历创伤事件青少年家庭教养方式与心理韧性的关系,为社区青少年教育方式提供依据。方法 于2013年6-12月,采用多阶段分层整群抽样法抽取辽宁省沈阳市、大连市、锦州市、丹东市、营口市、辽阳市6市共6 152例中小学生,对其中1 793例经历创伤事件的社区青少年应用家庭教养方式量表调查其家庭教养方式,应用青少年心理弹性量表调查其心理韧性水平,比较不同特征社区经历创伤事件青少年的家庭教养方式及心理韧性得分。家庭教养方式与心理韧性的相关性分析采用Pearson相关分析;心理韧性的影响因素分析采用线性回归分析。结果 是否曾是学生干部青少年权威型家庭教养方式得分间差异有统计学意义（P＜0.05）;不同性别、是否曾是学生干部青少年专制型家庭教养方式得分间差异有统计学意义（P＜0.05）;不同年龄青少年放任型家庭教养方式得分间差异有统计学意义（P＜0.05）。不同年龄、性别、居住地及是否曾是学生干部青少年心理韧性得分间差异有统计学意义（P＜0.05）。权威型家庭教养方式的得分与心理韧性各维度的得分及总分均呈正相关（r为0.158～0.475,P＜0.05）;专制型家庭教养方式的得分分别与目标专注、人际协助、情绪控制、积极认知维度的得分及心理韧性总分呈负相关（r为-0.411～-0.141,P＜0.05）;放任型家庭教养方式的得分分别与目标专注、家庭支持、情绪控制维度的得分及心理韧性总分呈正相关（r为0.068～0.181,P＜0.05）。多元线性回归分析结果显示,权威型家庭教养方式、专制型家庭教养方式、是否曾是学生干部、年龄、性别是心理韧性得分的影响因素。结论 社区经历创伤事件青少年家庭教养方式与心理韧性存在相关关系,家长应采取正确的教育方式,提高学生心理韧性。     

精神分裂症抑郁症状影响因素及与病耻感关系

目的 探讨精神分裂症患者抑郁症状的影响因素及与病耻感的关系.方法 采用精神病患者病耻感评估量表、卡尔加里精神分裂症抑郁量表对148例精神分裂症患者进行问卷调查.结果 精神分裂症患者的抑郁发生率为31.08％;不同年龄患者抑郁体验因子得分差异有统计学意义(P＜0.05);不同职业的患者抑郁体验因子得分差异有统计学意义(P＜0.05);不同病程自我评价因子得分差异有统计学意义(P＜0.05).与抑郁总分相关性具有统计学意义的变量包括:病耻感总分(r=0.495,P＜0.01)、社交因子(r=0.409,P＜0.01)、能力因子(r=0.496,P＜0.01).与抑郁体验因子相关性具有统计学意义的变量包括:病耻感总分(r=0.474,P＜0.01)、社交因子(r=0.349,P＜0.01)、能力因子(r=0.491,P＜0.01)、治疗因子(r=0.194,P＜0.05);与自我评价因子相关性具有统计学意义的变量包括:病耻感总分(r=0.419,P＜0.01)、社交因子(r=0.407,P＜0.01)、能力因子(r=0.399,P＜0.01).结论 精神分裂症患者抑郁症状较常见.病耻感越强,精神分裂症患者抑郁症状越严重.     

居家老年人生命质量及其影响因素研究

目的 调查居家老年人生命质量及其影响因素,为提高居家老年人生命质量提供依据。方法 2014年1-5月,采用便利抽样法,对北京市海淀区中关村社区和甘家口社区内250例老年人进行调查。共发放调查问卷250份,回收有效问卷214份,有效率为85.6%。采用自制调查问卷,包括：老年人一般资料问卷、健康问题问卷、养老成本问卷、简易健康状况调查（SF-36）量表及《老年人能力评估》问卷,对老年人生命质量及其影响因素进行分析。结果 不同子女状况、文化程度、退休前职业、医疗付费方式、主要经济来源、月平均收入的老年人简易SF-36量表总分比较,差异无统计学意义（P＞0.05）。不同性别、婚姻状况、居住情况、身体状况、饮食方式的老年人简易SF-36量表总分比较,差异有统计学意义（P＜0.05）。年龄与简易SF-36量表总分呈负相关（r=-0.187,P＜0.01）。不同月均医疗、药品开销,月均娱乐费用,月均陪护费用老年人简易SF-36量表总分比较,差异有统计学意义（P＜0.05）。不同月均饮食费用,月均住房费用,月均日常保健费用,月均水、电、煤气、有线电视、电话费用,其他费用老年人简易SF-36量表总分比较,差异无统计学意义（P＞0.05）。月均医疗、药品开销与简易SF-36量表总分呈负相关（r=-0.304,P＜0.001）;月均娱乐费用与简易SF-36量表总分无直线相关关系（r=0.129,P=0.059）;月均陪护费用与简易SF-36量表总分呈负相关（r=-0.145,P=0.033）。老年人疾病指数、日均服药种类、片剂数量与老年人简易SF-36量表总分呈负相关（r=-0.382、-0.310、-0.380,P＜0.01）。未发生不良事件老年人简易SF-36量表总分为（121.1±12.2）分,高于发生不良事件老年人的（113.9±16.0）分（t=3.566,P＜0.01）。有注射类药物老年人简易SF-36量表总分为（116.4±9.2）分,无注射类药物老年人简易SF-36量表总分为（119.1±14.1）分,差异无统计学意义（t=-0.781,P＞0.05）。老年人日常生活活动能力（ADL）总分与老年人简易SF-36量表总分呈正相关（r=0.324,P＜0.01）,老年人精神状态总分、感知觉与沟通总分、社会参与总分与老年人简易SF-36量表总分呈负相关（r=-0.196、-0.324、-0.435,P＜0.01）。多因素分层回归分析结果显示,社会参与总分、疾病指数、身体状况对居家老年人生命质量有影响（P＜0.05）。结论 促进老年人的社会参与、减少多种疾病及并发症的发生是提高老年人生命质量的重要措施。     

社区综合管理对原发性骨质疏松症患者认知和行为的影响研究

目的 探讨社区综合管理对原发性骨质疏松症患者认知和行为的影响.方法 2009年9月,选择上海市闸北区彭浦新村街道社区卫生服务中心门诊确诊的年龄＞55岁的女性原发性骨质疏松症患者226例为研究对象,依据患者登记的社区卫生服务点将其分为对照组和干预组,每组113例.对照组进行常规药物治疗,干预组在常规药物治疗基础上进行社区综合管理.记录两组患者干预前后原发性骨质疏松症认知量表、饮食及生活习惯量表、运动自我效能量表、运动行为量表得分及变化,研究结束时对社区医师和干预组患者进行访谈.结果 (1)两组患者干预前原发性骨质疏松症认知量表4个方面得分及总分比较,差异均无统计学意义(P＞0.05);干预后比较,在预防保健知识、危险因素方面得分及总分差异有统计学意义(P＜0.05).(2)两组患者干预前饮食及生活习惯量表各方面比较,除经常接受直射日照(≥4次/周)外,差异均无统计学意义(P＞0.05);干预后比较,在经常食用鱼虾、虾皮,经常食用深绿色蔬菜,经常接受直射日照,经常服用钙剂方面差异有统计学意义(P＜0.05).(3)两组患者干预前运动自我效能量表各因素得分及总分比较,除物理环境因素得分外,差异均无统计学意义(P＞0.05);干预后比较,仅物理环境因素得分及总分差异有统计学意义(P＜0.05).(4)两组患者干预前运动行为量表各方面比较,差异均无统计学意义(P＞0.05);干预后比较,仅在过去1年经常进行锻炼、坚持锻炼时间≥3个月方面差异有统计学意义(P＜0.05).(5)干预组综合指导完成率为93.8%.结论 对原发性骨质疏松症患者进行社区综合管理,能够提高其对疾病的认知水平,促进其采取促进健康行为.     

社区老年人心理弹性现状及影响因素研究

目的 了解社区老年人心理弹性现状及影响因素,为提升老年人应对负性事件的能力,提高心理弹性提供建议和依据。方法 采用滚雪球抽样法,于2012年12月-2013年1月选取天津市2个社区的250例老年人为研究对象,采用一般资料问卷和老年人心理弹性量表进行调查分析。结果 收回有效问卷210份,有效回收率为84.0%。老年人心理弹性总分为（115.7±15.7）分,其中家庭凝聚力维度得分最高,为（25.6±3.5）分,精神寄托维度得分最低,为（9.1±3.0）分。单因素分析结果显示,不同现居住状况、经济状况、子女居住地及与子女、亲戚、朋友、邻居交流状况的老年人心理弹性得分间差异有统计学意义（P＜0.05）。Pearson相关分析表明,老年人现居住状况、经济状况、子女居住地及与子女、亲戚、朋友、邻居交流状况均与老年人心理弹性呈相关关系（P＜0.05）,纳入回归分析,结果表明现居住状况及与子女、朋友、邻居交流状况对老年人心理弹性的影响有统计学意义（P＜0.05）。结论 老年人心理弹性处于中等偏上水平,现居住状况及与子女、朋友、邻居交流状况是其影响因素,社区、社会及医护工作者应重视老年人心理弹性的塑造,通过多种途径提高老年人心理弹性水平。     

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.