卡维地洛对乳鼠心肌细胞缺氧/复氧损伤的保护作用

目的研究卡维地洛对缺氧／复氧损伤心肌细胞的保护作用,并探讨其可能的作用机制。方法新生1-3 d的Sprague-Dawley鼠,原代分离,培养其心肌细胞72 h后,随机分为正常对照组、单纯缺氧／复氧组及卡维地洛 缺氧／复氧组。先将培养板中的心肌细胞缺氧(氧浓度<1％)120 min,再复氧30 min,造成缺氧／复氧损伤模型,测定细胞存活率;抽取细胞培养上清液测定乳酸脱氢酶(LDH)、磷酸肌酸激酶同工酶(CK-MB);并破碎细胞,测定丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性。结果卡维地洛 缺氧／复氧组的细胞培养液中LDH和CK-MB漏出量分别为(32．32±1．46)和(28．33±2．12)U／L,均显著低于缺氧／复氧组[(50．28±1．22)和(42．45±3．22)U／L,P值均<0．05];卡维地洛 缺氧／复氧组的细胞存活率为(70．21±2．12)％,显著高于缺氧／复氧组[(58．39±3．22)%,P<0．05]。卡维地洛 缺氧／复氧组的细胞内MDA含量为(5．32±0．32)nmol／mL,显著低于缺氧／复氧组[(8．32±0．42)nmol／mL,P<0．05];SOD活性为(10．32±0．42)U／mL,显著高于缺氧／复氧组[(7．42±0．20)U／mL,P<0．05]。结论卡维地洛对心肌细胞缺氧／复氧损伤具有保护作用,能清除氧自由基,提高心肌细胞抗氧化能力。     

TRPV1对H9c2心肌细胞缺氧复氧后凋亡的影响及机制

目的 探讨瞬时受体电位阳离子通道V亚族成员1(TRPV1)对H9c2心肌细胞缺氧复氧后凋亡的保护作用及可能机制。 方法 将H9c2心肌细胞随机分为对照组、模型组(缺氧/复氧组)、辣椒素(TRPV1激活剂)组(缺氧/复氧+辣椒素组)、辣椒素+LY组[缺氧/复氧+辣椒素+LY294002(PI3k抑制剂)组]。采用CCK-8法测定心肌细胞存活率，采用流式细胞仪测定各组心肌细胞凋亡率，采用Western blot法和逆转录-聚合酶链反应(RT-PCR)法测定各组细胞caspase-3、B淋巴细胞瘤-2基因(Bcl-2)、Bcl-2相关X蛋白(Bax)、磷酸化-蛋白激酶B(p-Akt)、蛋白激酶B(Akt)水平。 结果 与对照组比较，模型组、辣椒素组、辣椒素+LY组心肌细胞存活率和Bcl-2水平降低(均P<0.05)，细胞凋亡率和caspase-3、Bax、p-Akt水平升高(均P<0.05)；与模型组比较，辣椒素组心肌细胞存活率和Bcl-2、p-Akt水平升高(均P<0.05)，细胞凋亡率和caspase-3、Bax水平降低(均P<0.05)；模型组与辣椒素+LY组各指标比较差异均无统计学意义(均P>0.05)。 结论 TRPV1可抑制缺氧复氧后H9c2心肌细胞凋亡，其机制可能与TRPV1激活磷脂酰肌醇3-激酶(PI3k)/Akt信号通路有关。      

Ghrelin 预处理对 H9C2心肌细胞缺氧/复氧损伤的影响

目的：探讨 Ghrelin 预处理对 H9C2心肌细胞缺氧/复氧损伤的影响。方法培养 H9C2心肌细胞并建立心肌细胞缺氧(21 h)/复氧(6 h)模型。细胞随机分成4组：对照组,缺氧/复氧组(H/ R 组),缺氧/复氧+ Ghrelin 组(H/ R +G 组),缺氧/复氧+ Ghrelin +生长激素促分泌素受体(GH-SR)-siRNA 组(H/ R + G + G-siRNA 组);采用 siRNA 干扰技术阻断 Ghrelin 受体 GHSR 的表达以及 Hoechst 33258染色剂和流式细胞术检测各组细胞凋亡率,Western blot 法检测各组凋亡相关蛋白表达情况。结果 GHSR 存在于正常H9C2心肌细胞中,GHSR-siRNA 可以显著抑制 H9C2心肌细胞中 GHSR 的表达。与 H/ R 组相比,在 H/ R + G 组中缺氧/复氧损伤所导致心肌细胞的凋亡率明显下降(P <0．05),B淋巴细胞瘤-2蛋白/ Bcl-2相关 X 蛋白(Bcl-2/ Bax)比率明显上调(P <0．05),含半胱氨酸的天冬氨酸蛋白水解酶-3(caspase-3)表达水平被显著抑制(P <0．05)。而与 H/ R + G组相比,H/ R + G + G-siRNA 组心肌细胞凋亡率增加( P <0．05),Bcl-2/ Bax 比率显著下降(P <0．05),caspase-3表达上调(P <0．05)。结论 Ghrelin 具有减轻缺氧/复氧所引起的心肌细胞损伤、抑制心肌细胞凋亡的作用。     

EPO预处理在心肌细胞缺氧复氧损伤中的抗凋亡作用研究

目的 观察促红细胞生成素(EPO)预处理在培养心肌细胞缺氧复氧损伤中的抗凋亡效应,进一步研究其可能机制.方法 建立大鼠乳鼠心肌细胞缺氧复氧损伤模型,将细胞分为对照组、EPO组[缺氧复氧前24h培养液中加入终浓度10u/mL重组人EPO(rhEPO)]、EPO+吡咯烷二硫氨基甲酸盐(PDTC)组(缺氧复氧前24h加入终浓度10u/mL rhEPO和5μg/mL PDTC)及PDTC组(缺氧复氧前24h加入终浓度5μg/mLPDTC).于缺氧复氧损伤前后观察各组心肌细胞存活率(MTT法),用流式细胞仪检测心肌细胞凋亡,EMSA检测缺氧复氧损伤前后各组心肌细胞NF-κB活性变化,RT-PCR检测损伤前后各组心肌细胞bcl-2 mRNA表达变化.结果 缺氧复氧损伤后各组细胞存活率较损伤前对照组显著降低(P<0.01),EPO组高于其余各组(P<0.01);损伤后各组心肌细胞凋亡率较损伤前显著升高(P<0.01),EPO组凋亡率低于其余各组(P<0.01);损伤前EPO组心肌细胞NF-κB活性显著高于其余各组(P<0.01),损伤后各组NF-κB活性较损伤前显著升高(P<0.01),EPO组低于其余各组(P<0.05);损伤前EPO组bcl-2mRNA表达水平显著高于其余各组(P<0.01),损伤后各组心肌细胞bcl-2mRNA表达水平均较损伤前显著升高(P<0.01),EPO组仍高于其余各组(P<0.01).结论 EPO预处理在培养心肌细胞缺氧复氧损伤中具有显著抗凋亡效应;EPO预处理心肌细胞抗凋亡保护作用与预处理过程中NF-κB活化有关;EPO预处理过程中NF-κB活化,通过上调抗凋亡基因bcl-2表达,产生抗凋亡效应.     

氧化应激介导的DNA损伤在大鼠心肌H9C2细胞缺氧/复氧损伤中的作用

目的 探讨氧化应激介导的DNA损伤在大鼠心肌H 9 C2细胞缺氧/复氧损伤中的作用.方法 采用大鼠心肌H9C2细胞制备缺氧/复氧损伤模型.实验分为对照组(Con组)、缺氧/复氧模型组(H/R组)、抗氧化剂NAC组(NAC组)、抗氧化剂+模型组(NAC+H/R组).Western blot检测细胞凋亡相关蛋白(Bax、Bcl-2)表达;细胞免疫荧光法检测活性氧(ROS)水平,DNA损伤相关蛋白(p-γH2ax、8-OHdG)、细胞损伤指标[细胞色素c(Cytochrome c)]表达.结果 与Con组比较,H/R组细胞内ROS水平升高,p-γH2ax、8-OHdG、Cytochrome c、Bax/Bcl-2表达增加,差异有统计学意义(P<0.05);与H/R组比较,NAC+H/R组ROS水平降低,p-γH2ax、8-OHdG、Cytochrome c、Bax/Bcl-2表达降低,差异有统计学意义(P<0.05).结论 抑制心肌细胞氧化应激,可明显改善心肌细胞DNA损伤和凋亡.     

活性氧对缺氧大鼠肺动脉平滑肌细胞凋亡的影响及其机制

目的 研究和探讨缺氧状态下大鼠肺动脉平滑肌细胞(pulmonary arterial smooth muscle cells,PASMCs)内活性氧(reactive oxygen species,ROs)对细胞凋亡的影响及其调控机制.方法 原代培养正常大鼠PASMCs,选用第2～4代用于实验.分别在常氧及低氧条件下使用ROS清除剂Tiron进行分组干预.通过四唑硝基蓝(NBT)还原法、2,7-二氢二氯荧光黄双乙酸钠(DCFH-DA)荧光探针检测细胞内ROS水平,原位细胞凋亡检测法(TUNEL)检测细胞凋亡,免疫细胞化学法检测Bcl-2和Bax蛋白表达.结果 ①缺氧组细胞ROS水平[NBT:(0.214±0.024),DCFH-DA:(39.33±3.27)]明显高于对照组[NBT:(0.114±0.017),DCFH-DA:(15.84±2.86)](均P<0.01);②缺氧组细胞凋亡指数(2.42±0.74)显著低于对照组(4.50±0.45)(P<0.01),Tiron+缺氧组细胞的凋亡指数(5.75±0.94)与缺氧组比较则明显升高(P<0.01);③与对照组[Bcl-2:(0.098±0.017),Bax:(0.210±0.031),Bcl-2/Bax:(0.465±0.021)]相比较,缺氧组Bcl-2蛋白表达(0.141±0.024)增强(P<0.05),Bax蛋白表达(0.074±0.020)减弱(P<0.05),Bcl-2/Bax比值(1.973±0.283)升高(P<0.01);④和缺氧组比较,缺氧+Tiron组Bcl-2蛋白表达(0.124±0.018)降低(P<0.05),同时Bax蛋白表达(0.182±0.019)增强(P<0.05),Bcl-2/Bax比值降低(0.678±0.071)(P<0.01).结论 缺氧状态时大鼠PAsMCs内ROS生成增多,ROS可通过促进Bcl-2/Bax蛋白表达比值升高来抑制PASMCs凋亡,从而在缺氧性肺动脉重建的发病机制中发挥重要作用.     

姜黄素对缺氧复氧损伤PC12细胞的影响

目的:观察姜黄素对缺氧复氧致PC12细胞损伤的保护作用,并探讨其可能的机制.方法:实验分为对照组、缺氧复氧组(IR组)和低、中、高剂量姜黄素组(C1、C2和C3组).C1、C2和C3组分别应用20、40、100μmol/L的姜黄素预处理.IR组、C1、C2和C3组均给予缺氧复氧损伤处理.通过MTT比色法检测细胞存活率,并应用Western blotting方法检测细胞内Bc1-2、Bax、Caspase-3蛋白含量的变化.结果:与对照组相比,IR组细胞存活率降低(P<0.05);与IR组比较,C2、C3组细胞存活率升高(P<0.05).姜黄素可促进缺氧复氧诱导的PC12细胞Bcl-2表达增加,抑制Bax和Caspasc-3蛋白的表达,其作用呈剂量依赖性.结论:姜黄素对缺氧复氧导致的PC12细胞损伤有保护作用,这一作用与其抗凋亡特性有关.     

黄连素对缺氧复氧心肌细胞Bcl-2和Bax基因表达变化的免疫组织化学研究

目的 研究黄连素对心肌细胞缺氧复氧损伤后的保护作用.方法 把培养3d的心肌细胞分为对照组和黄连素浓度组,同时于缺氧环境(95%N2 5%CO2)中培养24h后,再置常氧培养箱内培养1h.于不同时间取出,分别用抗Bcl-2、Bax的抗血清进行免疫组织化学染色,观察缺氧复氧后心肌细胞中Bcl-2、Bax的表达情况.结果 与缺氧前相比,缺氧24h和复氧1h,心肌细胞Bcl-2表达明显减弱,Bax表达明显增强;经黄连素预处理的心肌细胞与对照组相比,缺氧24h、复氧1h,Bcl-2表达明显增强,Bax表达明显减弱.结论 黄连素对心肌细胞缺氧复氧损伤有一定的保护作用.     

PI3K/Akt通路在硫化氢后处理保护心肌细胞缺氧复氧损伤中的作用

目的探讨硫化氢后处理对原代培养的新生大鼠心肌细胞缺氧复氧损伤的保护作用及可能机制。方法以硫氢化钠(NaHS)作为外源性硫化氢供体。原代培养新生大鼠的心肌细胞随机分为5组:①正常对照组;②缺氧复氧组(hypoxia-reoxygenation,HR组);③二甲基亚砜组(dimethyl sulfoxide,DMSO组);④硫化氢后处理组(hydrogen sulfide post-con-ditioning,H2S组);⑤LY294002+H2S后处理组(LY+H2S组)。分别于缺氧前和复氧2 h检测各组的心肌细胞存活率、培养液中CK和LDH的活性;复氧末,用流式细胞学技术检测各组心肌细胞凋亡情况;Western blot检测HIF-1α、p-Akt与Akt蛋白的表达情况。结果通过比较可知,复氧2 h时,H2S组心肌细胞存活率较HR组升高显著[(71.55±1.46)%vs(62.03±1.29)%,P<0.01],CK、LDH活性以及心肌细胞凋亡率明显降低[(244.99±21.38)U/L vs(329.53±26.14)U/L,(371.64±18.62)U/L vs(427.69±13.25)U/L,(...     

蒺藜皂苷对NaCN诱导大鼠乳鼠心肌细胞凋亡的抑制作用及机制

目的：探讨蒺藜皂苷（GSTT）对NaCN诱导大鼠乳鼠心肌细胞凋亡的影响。 方法：采用NaCN建立心肌细胞内缺氧模型,GSTT干预后流式细胞术检测凋亡百分率及线粒体膜电位,激光共聚焦显微系统检测细胞内钙水平,Western blotting检测Bcl-2/Bax的蛋白表达。 结果：NaCN诱导的心肌细胞凋亡百分率GSTT组［（3.31±0.24）%］与模型组［(16.65±0.18)%］比较明显降低（P<0.01）;心肌细胞膜电位(mV)GSTT组(158.29±0.40)高于缺氧模型组(121.71±0.80)(P<0.01),低于正常对照组(167.10±0.70)(P<0.01);细胞内钙水平(色密度)GSTT组(323.73±68.19)低于缺氧模型组(496.65±80.10),高于正常对照组(280.18±48.10)(P<0.01)。Bcl-2蛋白表达强度上调, Bax蛋白表达强度下调。 结论：GSTT对NaCN诱导心肌细胞凋亡具有抑制作用,该作用与其调节Bcl-2/Bax蛋白表达、稳定线粒体膜电位以及改善细胞内钙超载有关。     

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.