老年小鼠心脏左室重塑和存活相关蛋白的表达变化

【目的】 探讨老年小鼠心脏左室重塑以及左室心肌蛋白激酶B(Akt)、磷酸化Akt、B细胞淋巴瘤-2蛋白(Bcl-2)和存活素(Survivin)的蛋白表达变化。【方法】 8只成年(5 ~ 5.5 月龄)雄性 C57bl/6小鼠作为对照组,8只老年(21.5 ~ 24 月龄)雄性 C57bl/6小鼠作为老年组(n = 8),计算心脏质量指数和左室质量指数,并利用Western-blot方法检测小鼠左室心肌β-肌动蛋白(β-actin)、Akt、磷酸化Akt (Ser473)、Bcl-2和Survivin的蛋白表达。【结果】 与成年对照组小鼠相比,老年组小鼠心脏质量指数、左室质量指数、左室心肌β-actin表达显著增加(P = 0.003, P = 0.001,P < 0.001),左室心肌Akt、磷酸化Akt (Ser473)、Survivin表达显著下降(P < 0.001, P = 0.028, P = 0.002),而Bcl-2表达却显著增加(P < 0.001)。【结论】这些研究结果表明,小鼠老年化过程中心脏发生左室重塑,同时左室心肌Akt、磷酸化Akt (Ser473)和Survivin表达下降,而Bcl-2表达增加,这些改变可能与老年心脏耐受缺血损伤能力下降有关。     

Apocynin改善1型糖尿病小鼠心脏功能的实验研究

目的 探讨NADPH氧化酶选择性抑制剂Apocynin对1型糖尿病小鼠心脏功能的影响及其作用机制.方法 44只8周龄雄性C57小鼠随机分为正常对照组(n=6)、Apocynin对照组(n=6)、1型糖尿病组(n=16)及1型糖尿病Apocynin治疗组(n=16).小鼠腹腔注射链脲佐菌素(STZ)建立1型糖尿病动物模型.实验于8周末结束,记录实验小鼠生存率、测量小鼠体质量及左室质量,并计算左室质量指数.运用超声心动图技术与Langendorff灌注系统检测小鼠心脏功能;Real-time RT-PCR技术测定心肌组织α-肌球蛋白重链(α-MHC)、β-肌球蛋白重链(β-MHC)、心房钠尿肽(ANP)以及Ⅰ型(Col Ⅰ)和Ⅲ型(Col Ⅲ)胶原的表达.结果 ①Apocynin能提高糖尿病小鼠生存率,降低糖尿病小鼠左室质量指数(P<0.01);②Apocynin能明显改善糖尿病小鼠心脏功能,增加心脏左室射血分数、左室短轴缩短率和+dp/dt、-dp/dt(P<0.01);③Apocynin能显著降低糖尿病小鼠心肌ANP mRNA表达和β/α-MHC比值(P<0.01);④Apocynin能降低糖尿病小鼠心肌组织Col Ⅰ和Col Ⅲ胶原的表达(P<0.01).结论 Apocynin能显著改善1型糖尿病小鼠的心脏功能,其机制与降低心肌肥大特征性基因ANP表达和β/α-MHC比值以及减少心肌Col Ⅰ、Col Ⅲ胶原表达密切相关.     

大鼠压力超负荷心肌糖蛋白130表达及贝那普利干预研究

目的 研究糖蛋白130(GP130)在腹主动脉缩窄所致大鼠压力超负荷性心肌肥大模型中的表达变化与心肌肥大的关系,以及贝那普利(Benazepril,Ben)对GP130蛋白表达及心肌肥大的影响.方法 用腹主动脉缩窄术建立大鼠压力超负荷性心肌肥厚模型,随机分为左室肥厚组(LVH,n=7)、贝那普利干预组(n=7,贝那普利1 mg·kg-1·d-1,灌胃3周),另设一假手术组(n=7)为对照.干预3周后测定血流动力学指标、左心室质量指数,应用放射免疫分析法测定心肌血管紧张素Ⅱ(AngⅡ)水平,免疫组化法检测心肌中GP130 蛋白水平表达.结果与假手术组比较,左室肥厚组动物的血压与左心室质量指数显著升高(P＜0.05);心肌组织AngⅡ含量(P＜0.01)和GP130蛋白表达水平明显增加(P＜0.05).贝那普利干预可显著降低血压和左心室质量指数(P＜0.05),同时降低肥厚心肌组织AngⅡ浓度(P＜0.01)与GP130蛋白表达水平(P＜0.05).结论 GP130蛋白的过度表达参与了压力超负荷性大鼠心肌肥大的发病过程;贝那普利对GP130蛋白表达及心肌肥大有抑制作用.     

脂联素受体1结合蛋白表达抑制对脂联素抗小鼠心肌缺血/再灌注损伤作用的影响

目的观察脂联素(APN)受体1结合蛋白(APPL1)表达抑制对APN抗小鼠心肌缺血/再灌注(MI/R)保护作用的影响。方法采用小鼠在体MI/R动物模型,APPL1表达抑制采用心肌内注射特异性小干扰RNA(APPL1 SiRNA)1μg/g体重方法实现,再灌注前10 min经腹腔注射给予APN蛋白球状片段(gAPN)2μg/g体重或等量生理盐水。70只实验小鼠随机分为5组:假手术组(Control),MI/R+Scramble SiRNA(无关对照SiRNA)组,MI/R+APPL1 SiRNA组,MI/R+Scramble SiRNA+gAPN组,MI/R+APPL1 SiRNA+gAPN组。再灌注3 h后(n=6),取心肌组织进行Western Blot分析APPL1含量,再灌注24 h后(n=8)对小鼠进行超声心动图心功能检测和心肌梗死面积测定。结果再灌注3 h后,APPL1 SiRNA注射小鼠的心肌组织中APLL1表达量较Control组及无关对照SiRNA组注射小鼠明显降低(P0.01)。MI/R+APPL1 SiRNA组与MI/R+Scramble SiRNA组比较,左室射血分数和心肌梗死面积无显著差异。与MI/R+Scramble SiRNA组相比,MI/R+Scramble SiRNA+gAPN组和MI/R+APPL1 SiRNA+gAPN组的左室射血分数明显升高(P0.01),心肌梗死面积明显降低(P0.01)。与MI/R+Scramble SiRNA+gAPN组相比,MI/R+APPL1 SiRNA+gAPN组的左室射血分数明显降低(P0.01),心肌梗死面积明显增加(P0.01)。结论 APPL1表达抑制可导致APN抗小鼠MI/R损伤保护作用的明显减弱。     

阿托伐他汀对自发性高血压大鼠心肌组织GLUT4表达的影响及意义

目的:探讨阿托伐他汀对自发性高血压大鼠(spontaneously hypertensive rats,SHR)心肌组织葡萄糖转运蛋白4(glu-cose transporter-4,GLUT4)表达的影响及其对心肌肥厚的逆转作用与可能机制。方法:将16只8周龄SHR随机分为:阿托伐他汀药物干预组(ATV组,n=8)与SHR模型对照组(SHR组,n=8),以8只同周龄Wistar-Kyoto大鼠作为正常对照(WKY组)。观察阿托伐他汀灌胃10周后大鼠血脂、心肌肥厚指标、GLUT4 mRNA及其蛋白表达的改变。结果:经过10周治疗,ATV组及SHR组血脂水平差异无统计学意义(P>0.05)。ATV组左室重量指数低于SHR组(P<0.05)。在ATV组,GLUT4表达高于SHR组(P<0.05)。结论:阿托伐他汀可上调SHR肥厚心肌组织中GLUT4的表达,有效逆转左室肥厚。     

丹参酮ⅡA磺酸钠对大鼠肥厚心肌血管紧张素受体STAT3的影响

目的 观察丹参酮ⅡA磺酸钠盐对腹主动脉缩窄致高血压大鼠肥厚心肌血管紧张素Ⅱ受体 (AT1R) 基因、蛋白表达以及对 STAT3 蛋白表达的影响,探讨其延缓心肌肥厚的机制。方法 取 24 只9周龄 SD 大鼠,环扎其腹主动脉,制成高血压大鼠模型,随机分为模型组(n=8)、丹参酮ⅡA 磺酸钠组 (n=8)、缬沙坦组 (n=8);另取8只行假手术,作为假手术组。给药8周后测量大鼠的尾动脉收缩压 (SBP) 及左室质量指数 (LVMI),应用 HE 染色、VG 染色,检测心肌纤维直径 (MFD),采用 RT-PCR、Western blotting 方法分别检测 AT1 R 的 mRNA 和蛋白的表达水平以及 STAT3 蛋白的表达水平。结果：与假手术组比较,模型组的 SBP、LVMI、MFD 均显著增加;AT1R mRNA 和蛋白的表达水平明显增高,STAT3 的表达也明显升高 (P＜0.05)。与模型组相比,丹参酮ⅡA磺酸钠组大鼠 LVMI、MFD 均显著降低;AT1R mRNA、蛋白表达和 STAT3 的表达均受到一定程度的抑制,但作用不如缬沙坦明显 (P ＜0.05)。结论 丹参酮ⅡA磺酸钠有延缓心肌肥厚的作用,可能与一定程度上抑制 AT1R 以及 STAT3 的表达有关。     

抗心肌肌球蛋白抗体在慢性病毒性心肌炎小鼠中的表达及卡托普利、氧化苦参碱的干预效果

目的 观察抗心肌肌球蛋白抗体(AMA)在慢性病毒性心肌炎(VMC)小鼠中的表达,比较卡托普利和氧化苦参碱的干预效果.方法 以柯萨奇病毒B_3株(CVB_3)重复增量感染(第0、14、28天,剂量分别为0.20、0.25、0.30mL)BALB/c小鼠建立慢性VMC(n=60)模型,正常对照组(n=8)同期腹腔注射等体积生理盐水.42d将慢性VMC模型组存活小鼠随机分为慢性VMC对照组(n=8)、卡托普利干预组(n=8)及氧化苦参碱干预组(n=8),干预28d后,即实验第70天杀死各组小鼠.称取小鼠心脏质量,计算心脏与体质量比值;分别以苏木素-伊红(HE)、苦味酸天狼猩红行心肌组织及心肌胶原组织特异性染色,运用图像分析软件计算心肌组织中胶原容积积分(CVF,%);酶联免疫法(ELISA)检测实验小鼠血清中AMA的表达,以光密度值(OD值)>(x-)+2s为阳性组,<(x-)+2s为阴性组.结果 慢性VMC组小鼠在实验第70天心脏与体质量比值、CVF及血清中AMA OD值均较正常对照组增高(P均<0.01).卡托普利及氧化苦参碱干预后心脏与体质量比值、CVF较慢性VMC组降低(P均<0.01),血清中AMA OD值较慢性VMC组降低(P<0.05).AMA阳性组心脏与体质量比值、CVF及OD值均较阴性组增高(P均<0.01).结论 慢性VMC小鼠血清中AMA表达增高,卡托普利及氧化苦参碱可下调AMA的表达,抑制慢性VMC小鼠的心肌重构.     

替米沙坦对高血压大鼠心室重构及AT1R表达的影响

目的探讨血管紧张素Ⅱ受体拮抗剂替米沙坦对高血压大鼠心室重构及AT1R表达的影响。方法腹主动脉部分缩窄构建高血压大鼠模型,随机分成高血压组(EH,n=8)和替米沙坦组[Tel,n=8,3mg(/kg·d)]6周,另设8只作为假手术组(Sham,n=8)。测定血流动力学指标和心室质量指数,放免疫法测定心肌和血浆的血管紧张素Ⅱ(AngⅡ)含量,免疫组化法测定心肌组织中血管紧张素Ⅱ1型受体(AT1R)蛋白的表达。结果与假手术组比较,高血压组SBP、DBP和MABP显著升高(P<0.05),左室质量指数(LVMI)和右室质量指数(RV-MI)亦显著升高(P<0.05);血浆与心肌组织AngⅡ含量和AT1R表达水平明显增加(P<0.05～0.01)。相关分析显示AngⅡ、AT1R和LVMI互为显著正相关(P<0.01～0.001)。替米沙坦能显著改善血流动力学指标,降低LVMI和RVM(IP<0.05);心肌组织中AngⅡ含量显著降低(P<0.01),AT1R的表达明显减少(P<0.05),血浆AngⅡ含量显著升高(P<0.01)。结论过度表达的AT1R在高血压大鼠心室重构中起到了重要作用,替米沙坦通过抑制AT1R的表达从而逆转心室重构。     

压力超负荷左室肥厚大鼠心肌组织血管紧张素Ⅱ受体的表达

目的:本研究观察压力超负荷左室肥厚(Left ventricular hypearophy,LVH)大鼠心肌组织AT1和AT2的表达,进一步探讨血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)受体在左室肥厚中的作用及可能机制.方法:采用腹主动脉缩窄法建立LVH模型,14只Sprague-Dawley(SD)大鼠随机分为:(1)假手术组(n=7);(2)手术组(手术组n=7);用免疫组化法及RT-PCR检测血管紧张素Ⅱ受体(AT)的表达,同时检测LVH的指标:心肌纤维化、左室质量指数(LVMI)、心肌细胞横切面积(CSA)、心肌细胞凋亡指数.结果:与假手术组比较,手术组SBP、DBP、MBP、LVMI、心肌细胞CSA、心肌细胞凋亡指数(Apoptosis index,APOI)、血浆AngⅡ水平及AT1和AT2蛋白和mRNA的表达水平均显著升高.结论:左室肥厚大鼠心肌组织AT1和AT2从蛋白和mRNA表达水平均明显升高;AT1和AT2均参与左室肥厚过程,但二者可能发挥相互拮抗的作用.     

半乳糖凝集素-3在心衰小鼠心室重构发生发展中的变化规律

目的 研究压力超负荷心衰小鼠心肌组织中半乳糖凝集素-3(Galectin-3)在心室重构中的作用.方法 选取40只成年雄性昆明小鼠,其中30只采用人工微创主动脉弓缩窄的方法建立压力超负荷心衰小鼠模型(弓缩窄组);10只行假手术作为对照组(假手术组),对两组小鼠心肌重构情况进行评价,同时应用实时荧光定量PCR法检测小鼠心肌组织Galectin-3表达的情况,并探讨Galectin-3在心衰时心室重构发生发展中的作用.结果 术后8周,与假手术组比较,弓缩窄组左心室舒张末期压(LVEDP)明显增加,差异有统计学意义(P=0.001)[1],而左心室收缩压(LVSP)和左心室压力变化最大速率(±dp/dtmax)明显下降,差异有统计学意义(P=0.001),说明模型制备成功;实时荧光定量PCR法结果显示,弓缩窄组小鼠心肌组织Galectin-3的表达较假手术组明显增强,差异有统计学意义(P=0.001).结论 Galectin-3可能在压力超负荷状态所诱发的心衰中参与心室重构,引起心肌间质胶原沉积和心肌肥厚,进而导致心力衰竭的发生和发展.     

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.