胃癌组织中COX-2与P300/CBP表达的研究

目的：研究胃癌组织中环氧化酶-2（COX-2）和核蛋白P300/CBP的表达变化,并探讨两者与胃癌生物学行为的关系。方法：用免疫组织化学S-P法检测不同分化程度胃癌组织和正常胃黏膜组织中COX-2和P300/CBP的表达变化。结果：（1）COX-2在胃癌组织的表达阳性率为37.8%,明显高于正常胃黏膜组织（0.0）,P<0.05;在低分化型胃癌阳性率为56.1%,明显高于高中分化型胃癌组织（8.0%）,P<0.05。（2）P300/CBP在胃癌组织的表达阳性率为10.6%,明显低于正常胃黏膜组织（72.2%）,P<0.05;在低分化型胃癌阳性率为4.9%,低于高中分化型胃癌组织（20.0%）,但P>0.05,差异无显著性。（3）COX-2表达阳性率在胃癌淋巴结转移组和远处转移组均显著高于非转移组,P<0.05;P300/CBP表达阳性率在胃癌的淋巴结转移组和远处转移组均低于非转移组,但P>0.05,差异无显著性。（4）胃癌组织中COX-2和P300/CBP表达呈现负相关倾向。结论：COX-2和P300/CBP在胃癌组织中表达异常,在胃癌的发生、发展中起重要作用,可作为辅助临床判断胃癌分化程度和转移生物学行为的有用指标。     

胃癌组织Cx４３和Smad１及Smad２的 mRNA表达及相关性研究

目的　检测胃癌组织中间隙蛋白４３(Connexin４３,Cx４３)和Smad１及Smad２的mRNA,探讨三者的表达及相关性.方法　对６０例胃癌组织和３０例正常 胃组织(距肿瘤１０cm 以上认为是正常组织)采用逆转录聚合酶链反应(RT－PCR)对Cx４３mRNA、Smad１mRNA 与Smad２mRNA 进行检测并分析三者的相关性. 结果　正常胃组织Cx４３mRNA 和Smad１mRNA(０．８１±０．０３和０．８９±０．０４)高于胃癌组织(０．５２±０．０７和０．４３±０．０６)的表达,P ＜０．０５;正常胃组织中Smad２mRＧ NA(０．３７±０．０３)低于胃癌组织(０．７５±０．０６)的表达,P ＜０．０５;高中分化胃癌Cx４３mRNA 和Smad１mRNA(０．６５±０．０４和０．５５±０．０３)高于低分化胃癌(０．４３±０．０６ 和０．３４±０．０５)的表达,(P ＜０．０５);高中分化胃癌Smad２mRNA(０．６３±０．０４)低于低分化胃癌(０．８４±０．０６)的表达,(P ＜０．０５);胃癌中无淋巴结转移Cx４３mRNA 和 Smad１mRNA 的表达(０．７４±０．０３和０．５６±０．０３)高于有淋巴结转移(０．３９±０．０７和０．３６±０．０５),(P ＜０．０５);胃癌中无淋巴结转移Smad２mRNA 的表达(０．５３±０． ０４),低于有淋巴结转移(０．８８±０．０５),P ＜０．０５;胃癌中Cx４３mRNA 和Smad１mRNA 在TNMⅠ－Ⅱ期的表达(０．６３±０．０５和０．５７±０．０２)高于TNMⅢ－Ⅳ(０．４７± ０．０６和０．３６±０．０６),P ＜０．０５;Smad２mRNATNMⅠ－Ⅱ期的表达(０．６０±０．０４)低于TNMⅢ－Ⅳ(０．８２±０．０５),P ＜０．０５,上述指标与年龄、性别无统计学意义(P ＞ ０．０５).胃癌组织中Cx４３mRNA 与Smad２mRNA 呈负相关性r＝－０．５３,P ＝０．００３１;Smad１mRNA 与Smad２mRNA 呈负相关性,r＝－０．４９,P ＝０．００６３;Cx４３ mRNA与Smad１mRNA 呈正相关性,r＝０．４５,P ＝０．００８４.结论　Cx４３mRNA 与Smad１mRNA 在胃癌组织中低表达而Smad２mRNA 在胃癌组织中的表达上 调,它们三者可能在胃癌的发生发展中起到协同作用,可能通过协同作用参与了胃癌的进展及转移.     

胃癌组织中1,25-二羟维生素D3、TGF-β1和Smad2蛋白的表达

目的:探讨1,25-二羟维生素D3及TGF-β/Smads信号通路与胃癌的关系。方法:收集93例胃癌组织和30例正常胃黏膜组织,采用免疫组化染色法检测1,25-二羟维生素D3及TGF-β1、Smad2蛋白的表达。结果:胃癌组织中1,25-二羟维生素D3表达水平低于正常胃黏膜组织(t=133.850,P<0.001),TGF-β1、Smad2表达水平高于正常胃黏膜组织(t=71.502、35.988,P<0.001)。1,25-二羟维生素D3、TGF-β1和Smad2的表达水平与胃癌的分化程度、临床分期、浸润深度及淋巴结转移关系密切(P<0.001)。胃癌组织中1,25-二羟维生素D3与TGF-β1、Smad2的表达呈负相关(r=-0.583,-0.462,P<0.001),TGF-β1与Smad2的表达呈正相关(r=0.425,P<0.001)。结论:1,25-二羟维生素D3可能通过调控TGF-β/Smads信号通路参与了胃癌的发生发展。     

p300/CBP、Smad4在非小细胞肺癌组织中的表达

目的：探讨p300/CBP、Smad4蛋白在非小细胞肺癌（NSCLC）组织中的表达及其临床意义。方法：采用免疫组化SABC法检测60例NSCLC组织和20例正常肺组织中p300/CBP、Smad4的表达,分析两者相关性,并探讨其与NSCLC临床病理特征之间的关系。结果：p300/CBP在NSCLC组织中表达率为65.0%,过表达率为51.7%。Smad4在NSCLC组织中表达率为63.3%。p300/CBP和Smad4均与NSCLC淋巴结转移、分期等临床病理学参数有关（P〈0.05）。p300/CBP的表达还与NSCLC分化有关（P〈0.05）。p300/CBP、Smad4在NSCLC组织中阳性表达率呈中度负相关（P〈0.05）。结论：联合检测p300/CBP和Smad4的表达,在预测NSCLC的恶性生物学行为方面可能比单因素检测更具意义。     

巨噬细胞移动抑制因子和p~(53)及MVD在食道鳞癌组织中的表达与意义

目的:探讨巨噬细胞移动抑制因子(MIF)、p53和CD34在食管鳞癌组织表达的相关性。方法:应用免疫组织化学技术对63例食管鳞癌(ESCC)组织中的MIF、p53的表达,新生血管热区的CD34阳性微血管密度(MVD)进行研究。结果:食道鳞癌MIF、p53总体阳性表达率及MVD分别为93.8%(60/64)、84.3%(54/64)及(31.12+12.20)/高倍视野,明显高于正常胃黏膜组(P<0.05),伴有淋巴结转移的癌组织中p53及MVD水平均高于无淋巴结转移的癌组织(P<0.05),MIF、p53和MVD在低分化食管鳞癌的表达率分别为:100%、95.2%和(40.13±20.04)/高倍视野,与高分化食管鳞癌组织差别具有显著性(P<0.05);MIF和p53及MVD表达呈正相关(P<0.05)。结论:MIF、p53和MVD在低分化胃癌、淋巴结转移组织中表达明显增高,且两者的表达有呈明显的正相关。提示MIF是与食道癌密切相关的因子之一。     

胃癌组织中Smad4和Galectin-3的表达及相关分析

目的 为了探讨胃癌组织中Smad4和Galectin-3的表达情况及相互关系.方法 采用免疫组织化学方法检测Smad4和Galectin-3在胃癌、临近正常组织及转移淋巴结中的表达,并使用同济千屏HPIAS-2000图像分析软件进行定量分析.结果 Smad4则主要在正常组织细胞浆中表达,在胃癌组织中分化越低,染色强度越弱,尤其在低分化胃癌中更为明显(P<0.001).与正常组织相比,Smad4减弱具有明显差异性(P<0.01).Galectin-3阳性表达以及染色强度与胃癌的分化程度密切相关(P<0.001),分化越低,染色强度越深,在淋巴结转移的癌组织中表达明显(P=0.001),与正常组织比较,具有显著的差异性(P<0.001).结论 在相同胃癌组织中Galectin-3表达增强,Smad4蛋白表达减弱,同时检测,有利于提高胃癌诊断的准确性.     

p16蛋白、RUNX3蛋白在胃癌组织中的表达及其临床意义

目的 观察p16蛋白、RUNX3蛋白在胃癌组织中的表达及其与胃癌病理特征、预后的关系.方法 应用免疫组织化学链霉菌素- 生物素法(SP法),对52例胃癌组织行p16蛋白、RUNX3 蛋白检测,并与胃黏膜正常的16例检测结果对照.结果 p16蛋白、RUNX3蛋白在胃癌组织中的阳性表达率明显低于其在正常胃黏膜组织中的表达;在低分化、未分化胃癌组织中的阳性表达率明显低于高、中分化胃癌组织,在有淋巴结转移的胃癌中,p16蛋白、RUNX3蛋白阳性表达率显著低于无淋巴结转移组阳性表达率(P<0.05,P<0.01).结论 p16蛋白、RUNX3蛋白表达缺失与胃癌的发生、分化程度及淋巴结转移有密切关系.     

β-连环素和Axin的表达与胃癌发生及预后关系的研究

目的探讨β-连环素(β-catenin)和Axin(axis inhibition protein)在癌旁正常胃黏膜及胃癌组织中的表达及其与胃癌各临床病理因素的关系。方法采用免疫组织化学方法(SP法)检测15例癌旁胃黏膜及60例胃癌石蜡切片中Axin和β-catenin的表达情况;分析癌旁及胃癌组织中二者的表达;二者表达分别与胃癌患者年龄、临床分期、肿瘤分型、分化程度和淋巴结转移的关系及二者表达的关系。以磷酸盐缓冲液(PBS)代替一抗作为阴性对照,以正常大肠黏膜组织作为阳性对照。结果β-catenin在癌旁胃黏膜组织中的表达率为93%,胃癌组织的表达率仅为28%(17/60),二者差异有统计学意义(P<0.01)。癌旁胃黏膜组织中Axin的阳性表达率为87%,胃癌组织中Axin的表达率为55%(33/60),二者差异有统计学意义(P<0.01)。72%(43/60)的胃癌组织中检测出β-catenin的细胞质和(或)核表达,视为细胞膜表达降低。高、中、低分化胃癌中,β-catenin的表达降低率分别为60%(12/20)、65%(13/20)和90%(18/20),差异有统计学意义(P<0.01)。低分化胃癌β-catenin的表达降低率显著高于高、中分化胃癌。有淋巴结转移和无淋巴结转移的胃癌中β-catenin表达降低率分别为81%(21/26)和65%(22/34),差异有统计学意义(P<0.05)。本实验中Axin的阳性表达率为55%(33/60)。Ⅰ、Ⅱ期和Ⅲ、Ⅳ期胃癌中,Axin的阳性表达率为80%(12/15)、53%(10/19)和42%(11/26),差异有统计学意义(P<0.05)。中晚期胃癌中Axin的阳性表达率显著低于早期胃癌。有淋巴结转移和无淋巴结转移的胃癌中Axin的阳性表达率分别为42%(11/26)和65%(22/34),差异有统计学意义(P<0.05)。β-catenin细胞核表达率为27%(16/60)。在β-catenin核表达阳性的病例中,Axin阳性表达率为20%(3/15),显著低于β-catenin核表达阴性病例的67%(30/45)(P<0.01)。结论β-catenin的膜表达降低与胃癌的低分化和淋巴结转移相关,Axin的表达与胃癌的临床分期和淋巴结转移相关,Axin的表达和β-catenin的细胞核蓄积呈负相关。     

Claudin-3在胃腺癌的表达及预后意义

目的探讨Claudin-3在胃腺癌组织中的表达及其临床病理学意义以及和预后的关系。方法应用组织芯片和免疫组化S-P法检测139例胃腺癌患者正常胃黏膜腺上皮/肠化生的胃腺上皮、黏膜层、肿瘤中心、侵袭前沿区及淋巴结转移灶纵向侵袭胃癌组织Claudin-3表达的动态变化,分析Claudin-3的定位及表达水平与胃癌的临床病理学特征、侵袭转移及预后关系。结果肠化生上皮Claudin-3中-强阳性表达率为100%(36/36),高于正常胃黏膜腺上皮(17.5%,18/103,χ2=78.12,P<0.05)。在胃癌组织中,Claudin-3的表达呈2种染色模式,肠型胃癌细胞Claudin-3定位于细胞膜,弥漫型胃癌细胞Claudin-3定位于细胞质,混合型胃癌细胞呈细胞膜和细胞质表达。从黏膜层、肿瘤中心、侵袭前沿及淋巴结转移灶胃癌组织,膜型染色的Claudin-3中-强阳性表达率分别为59.4%(61/88)、85.3%(75/88)、36.4%(32/88)、23.9%(21/88),呈先升后降的抛物线趋势,肿瘤中心区表达最高,淋巴结转移灶表达最低(χ2=110.83,P<0.05),而浆型染色的Claudin-3中-强阳性表达率分别为11.8%(6/51)、33.3%(17/51)、51.0%(26/51)、15.7%(8/51),呈逐渐升高的趋势,侵袭前沿区表达最高(χ2=31.32,P<0.05)。黏膜层胃癌细胞膜型Claudin-3高表达者的术后中位生存时间高于弱表达者(χ2=9.36,P<0.05)。结论胃腺癌Claudin-3的表达可能与胃癌细胞的组织学分型有关,在胃癌侵袭转移的不同部位呈异质性表达,黏膜层胃腺癌膜型Claudin-3的表达可作为胃癌患者潜在预后指标。     

胃癌组织中TGF-β1、Smad2与CyclinD1的表达及其相关性的研究

目的：探讨胃癌组织中转化生长因子β1（TGF‐β1）、Smad2与细胞周期蛋白D1（CyclinD1）的表达及三者之间的相关性。方法选择2007年1月至2012年1月腔镜活检正常胃黏膜20份（正常胃组织）作为对照组,手术切除胃癌标本60份（高‐中分化、低分化）作为胃癌组,用免疫组化法检测TGF‐β1、Smad2、CyclinD1正常胃组织及胃癌组织中的表达。结果TGF‐β1及CyclinD1在胃癌组织中的表达高于对照组,Smad2在胃癌组中的表达低于对照组;TGF‐β1及CyclinD1在低分化胃癌组中的表达高于高‐中分化胃癌组;TGF‐β1及CyclinD1在无淋巴结转移的胃癌组中的表达低于有淋巴结转移的胃癌组;TGF‐β1、CyclinD1在胃癌组中的表达随着TNM分期的提高而升高,高‐中分化胃癌组Smad2较低分化胃癌组表达升高,Smad2的表达在无淋巴结转移的胃癌组中的表达高于有淋巴结转移的胃癌组;Smad2在胃癌中的表达随TNM分期的提高而降低,TGF‐β1、Smad2及Cy‐clinD1的表达与患病年龄、性别无关;TGF‐β1与Smad2呈负相关,TGF‐β1与CyclinD1呈正相关,CyclinD1与Smad2呈负相关。结论TGF‐β1、Smad2与CyclinD1的表达与胃癌的发病有关。     

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.