塞来昔布在关节镜下膝关节手术后镇痛中的应用

【目的】通过与传统非甾体类消炎镇痛药物扶他林、阿片类镇痛药物曲马多及安慰剂的比较,评价特异性环氧化酶-2抑制剂塞来昔布在膝关节镜术后镇痛应用中的临床疗效及安全性。【方法】选取膝关节镜手术患者136例（男49例,女87例）随机分为4组,其中塞来昔布组41例、曲马多组34例、扶他林组31例,对照组30例,分别给予塞来昔布、曲马多、扶他林及安慰剂,检测术后视觉模拟评分法疼痛评分、膝关节活动度、关节肿胀、积液程度及药物不良反应。【结果】塞来昔布组、曲马多组和扶他林组术后早期疼痛评分均较对照组明显降低,关节活动度增大,四组间关节积液程度无明显差异。药物不良反应发生率分别为曲马多组20．6％、塞来昔布组2．4％、扶他林组6．5％、对照组3．3％,曲马多组药物不良反应发生率较其他组明显增高（P〈0．05）。【结论】膝关节镜术后应用塞来昔布可明显缓解患者疼痛,其不良反应低于阿片类药物曲马多和传统的NSAIDs类药物扶他林,具有良好的临床疗效和安全性。     

125I放射性粒子植入联合区域性动脉灌注化疗对 中晚期胰腺癌的作用

  【目的】 本研究旨在探讨125I放射性粒子植入联合区域性动脉灌注化疗治疗中晚期胰腺癌的临床价值｡【方法】 将23例中晚期胰腺癌患者分为两组,实验组12例采用125I放射性粒子植入联合区域性动脉灌注化疗,对照组11例采用单纯区域性动脉灌注化疗,对比两组患者治疗后疗效､疼痛缓解程度､生存期､不良反应｡【结果】 实验组(CR+PR)比例75.0%明显高于对照组27.3%;实验组患者的6个月､9个月生存率分别为83.3%､75.0%,与对照组72.7%､45.5%无统计学差异,实验组12个月生存率50.0%(中位生存期13.1个月)明显高于对照组9.1%(中位生存期8.7个月);实验组比对照组能够较大程度改善患者的疼痛症状,两组的不良反应比例除125I放射性粒子植入所致并发症外无统计学差异｡【结论】 I125放射性粒子植入联合区域性动脉灌注化疗是治疗中晚期胰腺癌有效的综合治疗方法｡     

慢加急性肝衰竭预后评分系统的建立与评估

 【目的】 建立一个简单实用的慢加急性肝衰竭预后评分系统｡【方法】 558例慢加急性乙型肝炎肝衰竭,按临床结局分为存活组和死亡组,按9 ∶ 1分成训练样本(499例)和测试样本(59例)｡首先进行单变量分析,选择对预后最有影响且临床易于评估的一些因素并按其程度分别赋予一定的分值,计算患者综合评分｡利用这些指标,采用Fisher判别分析法建立预后评分系统,求得判别方程和判别界值｡运用判别方程在训练样本中做回代判别和交互验证,在测试样本中进行组外考核,利用判别符合率评估评分系统预测预后的准确性｡【结果】 单变量分析显示:患者年龄､起病前有无肝硬化基础､天冬氨酸氨基转移酶等多项指标有统计学意义｡选择临床上易于评估且对预后最有影响的血清总胆红素水平､凝血酶原时间､肝性脑病､腹水程度､肝肾综合征及感染情况等6项指标,分别按其程度赋予一定分值,建立了慢加急性乙型肝炎肝衰竭预后评分系统｡6项指标综合评分为6､7､8､9､10分的患者其死亡率分别为34.9%､66.7%､76.7%､85.7%､91.7%;综合评分≥11分者死亡率为100%｡判别方程的回代判别符合率75.9%~88.9%,交互验证符合率为75.1%~88.9%,组外判别符合率74.3% ~ 88.0%｡【结论】评分系统对慢加急性肝衰竭的预后评估具有很好的预测准确性,且简单､方便计算｡动态评估能很好地判断慢加急性乙型肝炎肝衰竭的预后｡     

改良组织块法培养细针活检滑膜组织成纤维样滑膜细胞

 【目的】 探讨体外分离培养细针活检滑膜组织成纤维样滑膜细胞(FLS)的方法｡【方法】 滑膜组织来自接受盲式细针滑膜活检术的活动期类风湿关节炎患者,分别采用消化酶培养法､组织块培养法和改良组织块培养法分离培养FLS｡采用台盼蓝染色进行细胞计数及活性鉴定,并应用倒置相差显微镜､透射电镜､免疫细胞化学染色､流式细胞术对第3 ~ 4代FLS进行鉴定｡【结果】 3种原代分离培养的方法均可成功培养出FLS｡台盼蓝染色示FLS细胞计数约(8.30 ± 1.65) × 105/瓶,活细胞百分率 > 95%｡传代可使FLS达到形态学上的纯化要求,倒置相差显微镜､透射电镜观察均符合FLS的形态结构特征,免疫细胞化学染色示Vimentin阳性､CD68阴性､CK阳性,流式细胞术检测示CD55+ 细胞占(95.34 ± 2.47)%｡改良组织块法培养FLS成功率较高,细胞游出时间较早,所需传代时间较短｡【结论】 改良组织块法特别适合于细针滑膜活检标本FLS的培养,第3 ~ 4代细胞的数目､活性及纯度符合进一步实验的要求｡     

整合素αvβ3拮抗剂SB-273005抗小鼠胚胎着床的作用

 【目的】 探讨整合素αvβ3拮抗剂SB-273005对小鼠胚胎着床的影响&#65377;【方法】 雌雄小鼠2∶1合笼,次晨检查阴栓,阳性者定为妊娠第1天,记为D1&#65377;步骤①取D3小鼠40只,随机分为2组,每组20只,实验组连续2 d上午灌胃给SB-273005,于D4下午观察囊胚发育情况&#65377;②取D3小鼠80只,随机分为4组,每组20只,A&#65380;B&#65380;C组为实验组,连续3 d分别灌胃给SB-273005 0.3&#65380;1&#65380;3 mg·kg-1·d-1,于D8观察胚胎着床数及统计妊娠率&#65377;③取D4小鼠40只,随机分为两组,每组20只,实验组双侧宫角注射SB-273005,于D8观察胚胎着床数及统计妊娠率&#65377;④各对照组用与其相应实验组同方法给同体积二甲亚枫(DMSO)&#65377;取上述D8处死各组小鼠子宫,观察内膜组织学及D4处死小鼠内膜免疫组化变化&#65377;【结果】 步骤①中实验组与对照组囊胚发育率分别为64.7%和 84.5%(P < 0.01)&#65377;步骤②中A &#65380;B&#65380;C&#65380;D组妊娠率分别55%&#65380;40%&#65380;35%&#65380;88%(P < 0.05)&#65377;步骤③中实验组妊娠率为15%,对照组妊娠率为70%,两者相比差异有显著性(P < 0.01)&#65377;说明SB-273005能降低囊胚发育率&#65380;小鼠胚胎着床数及妊娠率&#65377;组织学及免疫组化结果表明,SB-273005能引起蜕膜细胞退化解体,抑制整合素αvβ3在蜕膜组织中的表达&#65377;【结论】 整合素αvβ3拮抗剂SB-273005对小鼠胚胎着床有抑制作用&#65377;     

IL-12P70及IFN-γ在预测肾移植术后 急性排斥反应中的应用

 【目的】 探讨血清IL-12P70&#65380;IL-4&#65380;IFN-γ在预测肾移植受者早期免疫状态的作用&#65377;【方法】 选取中山大学附属第三医院肾移植科行同种异体尸肾移植患者52例,其中男28例,女24例,平均年龄42.3岁,将患者分为正常组(n = 30)&#65380;急排组(n = 12)和感染组(n = 10)&#65377;分别于术前,术后第1&#65380;5天检测其血清IL-12P70&#65380;IL-4&#65380;IFN-γ这3种细胞因子浓度&#65377;数据统计使用SPSS 15.0,P < 0.05被认为有统计学意义,使用方差分析并加行LSD-t和SNK-q检验以检验3组患者3种细胞因子浓度的组间差异,作 ROC曲线&#65380;计算机处理ROC曲线下面积(Az),以评价这3种细胞因子对急性排斥反应的诊断价值&#65377;【结果】 三组患者术前及术后第1天血清IL-12P70&#65380;IFN-γ&#65380;IL-4浓度和IFN-γ/IL-4均无统计学差异;术后第5天各组患者血清IL-4浓度无统计学差异;急排组血清IL-12P70&#65380; IFN-γ浓度和IFN-γ/IL-4均显著高于正常组和感染组;急排组术后第5天血清IL-12P70&#65380;IFN-γ水平较术前和术后第1天明显上升(9.012 ± 0.736 vs 6.613 ± 0.598;40.402 ± 13.414 vs 31.539 ± 13.323,P < 0.05); IL-12P70&#65380;IFN-γ&#65380;IL-4&#65380;IFN-γ/IL-4在术后第5天的ROC曲线下面积分别为0.975,0.808,0.492,0.708;当IL-12P70浓度取值7.40 pg/mL时或IL-γ取值31.48 pg/mL时,对急性排斥反应预测的敏感度和特异度分别达到100%&#65380;85%或83.3%&#65380;85%&#65377;【结论】 血清IL-12P70&#65380;IFN-γ水平对肾移植受者移植术后早期的免疫状态有较好的预测价值;当血清IL-P70浓度高于7.40 pg/mL或IFN-γ浓度高于31.48 pg/mL时须高度怀疑急性排斥反应发生的可能性&#65377;     

侵袭性T细胞性非霍奇金淋巴瘤自体造血干细胞 移植后长期随访结果

 【目的】 评价自体造血干细胞移植(AHSCT)治疗侵袭性T细胞性非霍奇金淋巴瘤(T-NHL)的临床疗效及安全性&#65377;【方法】 本文回顾性分析1994 ~ 2008年间,我院收治的AHSCT治疗后长期随访的侵袭性T-NHL 36例,初治11例(30.6%),复发11例(30.6%)和难治性病例14例(38.9%)&#65377;病理类型包括T淋巴母细胞淋巴瘤16例(44.4%)&#65380;间变大细胞性淋巴瘤8例(22.2%)和外周T非特异型淋巴瘤5例(13.9%)&#65377; 【结果】 35例患者可评价疗效&#65377;中位无进展生存时间(PFS)38.7个月,预计1年&#65380;3年和5年无进展生存率分别为56%,46%和46%&#65377;预计中位总生存时间54月,1年&#65380;3年和5年总生存率分别为69%,58%,49%&#65377;移植后17例(48.6%)患者复发,4例患者仍带瘤生存&#65377;移植前为难治性病例和骨髓侵犯是本组患者不良预后相关的因素&#65377;主要Ⅲ ~ Ⅳ度不良反应为发热&#65380;口腔溃疡;1例治疗相关死亡&#65377; 【结论】 AHSCT常规化疗后治疗T细胞淋巴瘤安全有效,但复发率仍偏高,值得开展大规模的临床试验进一步深入研究&#65377;     

抗病毒治疗对不同分期的乙型肝炎相关慢加急性 肝衰竭患者短期生存率的影响

 【目的】 探讨抗病毒治疗对不同分期的乙型肝炎相关慢加急性肝衰竭患者转归的影响&#65377;【方法】 352例乙型肝炎相关慢加急性肝衰竭患者,其中早期患者120例&#65380;中期患者149例&#65380;晚期患者83例,各期患者分为常规治疗组及抗病毒治疗组,抗病毒治疗组在常规内科治疗基础上加用抗病毒药物治疗(拉米夫定&#65380;恩替卡韦&#65380;替比夫定),比较各期患者临床特征&#65380;生存率及抗病毒治疗短期疗效差异&#65377;【结果】 观察24周,乙型肝炎相关慢加急性肝衰竭早&#65380;中&#65380;晚期患者的生存率明显不同(P < 0.05),随着病情的加重,生存率明显下降&#65377;不同分期分析,早&#65380;晚期患者常规治疗组及抗病毒治疗组生存率无明显差异(P > 0.05),而中期患者抗病毒治疗组生存率明显高于常规治疗组(P < 0.05)&#65377; 【结论】 及早治疗可提高乙型肝炎相关慢加急性肝衰竭患者的生存率,抗病毒治疗可明显提高中期患者的生存率&#65377;     

硬膜外罗哌卡因和左旋布比卡因运动阻滞效能的比较

  【目的】 在分娩第一产程时测定左旋布比卡因和罗哌卡因的最小运动阻滞浓度(EC50)并对其运动阻滞效能进行比较&#65377;【方法】 60例产妇随机分为两组,每组30例,在宫口开至2 ～ 5 cm时行硬膜外穿刺置管注入左旋布比卡因或罗哌卡因溶液10 mL&#65377;注药前和注药后30 min进行Bromage运动评分,运动阻滞的标准为注药后30 min任何一侧下肢出现Bromage评分 < 4分&#65377;各组产妇硬膜外起始用药浓度均设定0.5%,按照序贯法来调整每组下一例产妇用药的浓度&#65377;记录临床效果及不良反应&#65377;【结果】 所有产妇均顺利产婴,母婴安全,无明显不良反应&#65377;硬膜外罗哌卡因运动阻滞EC50为0.674%;左旋布比卡因运动阻滞EC50为0.562%&#65377;罗哌卡因运动阻滞的效能为左旋布比卡因的0.83,95%的置信区间为0.80 ～ 0.87&#65377;【结论】 硬膜外罗哌卡因的运动阻滞效能小于左旋布比卡因,仅为左旋布比卡因运动阻滞效能的83%&#65377;     

高容量血液滤过在肝移植术后多器官功能障碍 综合征病人中的应用

 【目的】 探讨高容量血液滤过(HVHF)在肝移植术后因严重感染引起多器官功能障碍综合征(MODS)患者中的应用&#65377; 【方法】 分析2003年12月至2008年12月肝移植术后因感染引起MODS进行连续性血液净化治疗74例患者的临床资料,根据超滤率是否大于35 mL/kg/h分为HVHF组(49例)和连续性静脉-静脉血液滤过(CVVH)组(25例)&#65377;记录治疗前和治疗后24 h&#65380;48 h&#65380;72 h APACHⅡ评分&#65380;电解质&#65380;血流动力学和呼吸功能各项指标,以及临床转归&#65377;分别对组内治疗后各时间点与治疗前以及两组间各时间点之间的观察指标进行比较&#65377; 【结果】 HVHF组患者,APACHⅡ评分&#65380;乳酸&#65380;肌酐&#65380;心率&#65380;多巴胺用量&#65380;气道平均压和气道峰压&#65380;氧合指数等指标在治疗后24 h&#65380;48 h&#65380;72 h较治疗前明显下降(P < 0.05)&#65377;CVVH组患者,APACHⅡ评分&#65380;乳酸&#65380;气道平均压和气道峰压值治疗前后无明显变化(P > 0.05),心率&#65380;多巴胺用量和氧合指数虽较前有所改善,但程度均不如HVHF组(P < 0.05)&#65377;HVHF组死亡率为59.2%(29/49),CVVH组为84.0%(21/25),两者具有统计学差异(χ2 = 4.652,P = 0.031)&#65377;【结论】 HVHF通过维持机体内环境的稳定,为其他治疗创造有利条件,有助于提高肝移植术后危重患者的生存率&#65377;     

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.