右美托咪定对2型糖尿病患者上腹部手术心率变异性的影响

目的观察右美托咪定对2型糖尿病(T2MD)患者上腹部手术心率变异性的影响。方法择期上腹部手术的T2DM患者60例,随机分为右美托咪定组和对照组,每组30例。右美托咪定组麻醉开始后泵注右美托咪定0.5μg/(kg·h)直至术毕,对照组注射等量生理盐水。观察患者入室后(T0)、麻醉诱导后(T1)、气管插管后(T2)、手术开始(T3)、手术中探查(T4)和术毕拔管(T5)的心率变异性(HRV):低频功率(LF)、高频功率(HF)、LF/HF和总功率频段(TP),同时监测各时点心率(HR)及平均动脉压(MAP),拔管时间,术中知晓等。结果与T0比较,T2~T5时两组HR增快,T1~T3时MAP降低(P<0.05);右美托咪定组T2~T5时HR、MAP均明显低于对照组,差异有统计学意义(P<0.05);与T1比较,T2~T5时点两组TP、HF、LF和LF/HF均显著升高(P<0.05);右美托咪定组TP、LF和LF/HF在T2~T5均明显低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定能明显降低T2DM患者上腹部手术围术期的HRV,改善交感/迷走神经的平衡状态,维持围术期血流动力学稳定,具有心肌保护作用。     

右美托咪定对行腹腔镜恶性肿瘤根治术患者术后肾功能的影响

目的 观察右美托咪定对行腹腔镜下恶性肿瘤根治术的患者术后肾功能的影响.方法 选择择期行腹腔镜恶性肿瘤根治术的患者44例,按随机数字表法分为右美托咪定组和对照组,每组22例.两组患者麻醉诱导、麻醉维持用药相同,右美托咪定组在麻醉诱导时静脉泵注右美托咪定而对照组给予等容量的生理盐水.观察两组患者术前(T1)、术毕(T2)、术后第1天(T3)、术后第3天(T4)血肌酐(SCr)、尿素氮(BUN)、胱抑素C(Cys-C)水平.结果 两组SCr、BUN水平比较,差异无统计学意义(P>0.05);各组内各时点SCr水平比较差异无统计学意义(P均>0.05),但各组内各时点BUN水平比较,差异有统计学意义(P<0.05),其中T3时BUN水平低于其他时点.与T1时比较,T2~T4时两组的Cys-C水平明显增高(P<0.05);T2~T4时右美托咪定组Cys-C水平明显低于对照组(P<0.05).结论 麻醉时静脉泵注右美托咪定对腹腔镜恶性肿瘤根治术患者术后肾功能具有一定的保护作用.     

右美托咪定在颅内血肿清除术中的应用

目的：观察右美托咪定在颅内血肿开颅清除术中的应用效果.方法：行颅内血肿清除术的患者38例,随机分为右美托米啶（M）组和对照（N）组.M组在10 min内静脉输注1 μg/kg右美托咪定,术中右美托米啶0.2~0.5 μg/（kg·h）泵注维持至切开硬脑膜后停药,N组泵注等容量生理盐水.观察用药前（T0）、用药后（T1）、气管插管前（T2）、气管插管后（T3）、手术后即刻（T4）、手术后60 min（T5）和手术结束时（T6）各时点SBP、DBP、MAP和HR值,记录术中的丙泊酚用量和血管活性药物的用量.结果：M组T0~T6各时点间,SBP、DBP和MAP差异无统计学意义（P〉0.05）,T1~T6各时点HR差异无统计学意义（P〉0.05）,均明显低于T0时点（P〈0.01）.N组T2时点SBP、DBP、MAP和HR明显低于T3~T6各时点（P〈0.01）.右美托咪定组的丙泊酚用量和麻黄碱的使用例数显著少于对照组（P〈0.01）.结论：右美托咪定可以使颅内血肿清除术的血流动力学平稳,并节约丙泊酚的用量.     

不同剂量右美托咪定在甲状腺射频消融术中对高血压患者的影响

目的探讨不同剂量右美托咪定在甲状腺射频消融术中对高血压患者应用的有效性和安全性。方法局麻下择期行甲状腺射频消融术的高血压患者60例,随机分为3组,每组20例,分别采用右美托咪定1.0μg/kg(A组)、右美托咪定0.5μg/kg(B组)、咪达唑仑0.1 mg/kg组(C组)。观察并记录镇静给药前(T0)、给药后5 min(T1)、给药后15 min(T2)、给药后30 min(T3)、术后5 min(T4)、术后30 min(T5)的MAP、HR、RR、Ramsey镇静评分、Sp O2值及是否需要给予降压药。结果A及B组患者T1~T4时MAP、HR均明显低于T0时(P0.05);C组患者T1~T3时Ramsay评分均显著高于T0时(P0.05)。组间比较,A组、B组在T1~T4时MAP和HR明显低于C组(P0.05),T2~T4时Ramsay评分显著低于C组(P0.05);A组、C组患者在T1~T3时Sp O2明显低于B组(P0.05)。C组在使用降压药方面明显多于A、B组(P0.05)。结论小剂量右美托咪定用于局麻下甲状腺射频消融术能够维持高血压患者围术期血流动力学的稳定,且剂量0.5μg/kg优于1.0μg/kg组。     

右美托咪定对甲状腺手术麻醉苏醒期躁动的影响分析

目的探讨右美托咪定(Dex)对甲状腺手术麻醉患者苏醒期躁动的影响。方法将88例甲状腺手术患者随机分为两组,麻醉诱导后,观察组静脉泵注右美托咪定,对照组同样方式泵注生理盐水。观察患者拔管前(T0)、导管拔管时(T1)、拔管后5min(T2)、拔管后10 min(T3)的HR、SBP、DBP和SPO2的变化,记录手术结束后麻醉苏醒恢复时间。并对患者进行术后镇静—躁动评分(SAS)。记录患者拔管后10 min Ramsay镇静评分和VSA镇痛评分。结果与对照组比较,观察组T2HR明显减慢,SBP、DBP明显降低(P<0.05),观察组的Ramsay评分明显高于对照组(P<0.05),VAS、SAS评分明显低于对照组(P<0.05),苏醒时间两组比较差异无统计学意义(P>0.05)。两组均无明显的不良反应。结论右美托咪定可有效减少甲状腺手术全麻苏醒期躁动的发生,改善患者苏醒舒适度及术后生活质量,是控制苏醒期躁动的理想药物。     

不同剂量右美托咪定对腰-硬联合麻醉下高龄患者下腹部手术的影响

目的:探讨不同剂量右美托咪定对腰-硬联合麻醉下高龄患者下腹部手术的镇静效果的影响。方法:选取年龄≥65岁的腰-硬联合麻醉下行腹部手术的患者120例,随机分为右美托咪定组(D1、D2、D3组)及咪达唑仑组(M组)。分别记录患者麻醉前(T0)、用药后5 min(T1)、30 min(T2)、60 min(T3)Ramsay评分及记录术中、术后出现不良反应的例数。结果:D1、D2、D3组及M组在T1~T3时Ramsay评分显著高于同组T0时的评分,差异有统计学意义(P<0.05);在T1~T3时,D2、D3的Ramsay评分均高于M组,差异有统计学意义(P<0.05);与M组相比,D1、D2、D3组的不良反应(心动过缓、恶心呕吐)显著减少,差异有统计学意义(P<0.05)。结论:右美托咪定辅助高龄患者腰-硬联合麻醉下腹部手术时可产生理想镇静状态,其不良反应较少,其中以0.3~0.5μg/kg为初始剂量,以0.3μg/(kg·h)进行维持为宜。     

右美托咪定对脑损伤老年患者术后认知功能障碍的影响

目的探讨右美托咪定对老年脑损伤患者术后认知功能障碍的影响。方法按照随机字母表法将我院老年患者(60例)分为安慰剂组(n=30)和右美托咪定组(n=30)。安慰剂组给予生理盐水,右美托咪定组给予右美托咪定。比较两组术前1d,术后3 d、7 d、30 d简易智力状态检查表(MMSE)评分,以及麻醉诱导前至术后24 h(T1~T7)各时段血清S100β蛋白及NSE水平,记录手术及并发症发生情况。结果术前,两组MMSE评分、血清S100β蛋白及神经元特异性烯醇化酶(NSE)水平差异均无显著性(P>0.05)。术后3 d,两组MMSE评分明显降低(P<0.05),T1~T7时血浆S100β蛋白及血清NSE水平呈先升后降趋势,均在T4时达高峰。与安慰剂组比较,右美托咪定组T3~T6时血清S100β蛋白、NSE水平均明显降低(P<0.05)。此外,右美托咪定组患者苏醒和拔管期间躁动发生率、术后并发症发生率也明显低于安慰剂组(P<0.05)。结论右美托咪定可显著降低老年患者术后血清S100β蛋白、NSE水平以及认知功能障碍发生率。     

右美托咪啶对老年患者在机器人辅助腹腔镜手术麻醉苏醒期及术后认知功能的影响

目的：评估右美托咪啶对老年患者在机器人辅助腹腔镜前列腺癌根治术麻醉苏醒期及术后认知功能的影 响。方法：择期行机器人腹腔镜下前列腺癌根治术的患者100例,年龄65~80岁,美国麻醉师协会(American Society of Anesthesiologists,ASA)分级I~III级,随机双盲分为对照组和右美托咪啶组,每组50例。右美托咪啶组将右美托咪啶以 0.8 μg/(kg·h) 静脉泵注10 min,再以0.3 μg/(kg·h)恒速维持至手术结束前30 min;对照组给予生理盐水。气腹建立后, 所有患者采用40° Trendelenberg体位。观察记录患者手术结束时(T0)、苏醒时(T1)、拔管即刻(T2)、拔管10 min(T3)四 个时间点的平均动脉压、心率、脑电双频指数(bispectral index,BIS)数值;对患者进行Ramsay镇静评分、术毕舒适度 评分、术后谵妄分级量表评分和VAS评分;在术前1 d,术后第1天,术后第5天通过6个认知量表评估患者记忆、注 意、神经运动反应速度多领域的认知功能测试及术后认知功能障碍(postoperative cognitive dysfunction,POCD)判断; 患者于术前1 d,术后1 d,术后5 d采血以检查其神经元特异性烯醇化酶(neuron specific enolase,NSE)、血清肿瘤坏死 因子-α(TNF-α)、超氧化物歧化酶(SOD)和白细胞介素-6(IL-6)的含量。结果：右美托咪啶组患者在T1和T2时刻平均 动脉压、心率比对照组患者降低(P<0.05);与对照组比较,右美托咪啶组患者术后谵妄分级量表评分降低(P<0.05)、 Ramsay镇静评分升高 (P<0.05);术后1 d对照组17人,右美托咪啶组11人,术后5 d对照组12人,右美托咪啶组9人发生 POCD;在术后1 d和术后5 d右美托咪啶组血清TNF-α,NSE,IL-6较对照组明显降低(P<0.05),右美托咪啶组血清SOD 较对照组明显升高(P<0.05)。结论：右美托咪啶对老年患者在机器人辅助腹腔镜前列腺癌根治术麻醉苏醒期及术后有 神经保护作用,其作用机制可能与右美托咪啶能减轻炎症反应有关。     

右美托咪定对高血压病患者腰硬联合麻醉的镇静效应及血流动力学的影响

目的观察右美托咪定对高血压病患者腰硬联合麻醉的镇静效应及血流动力学的影响。方法将60例拟行腰硬联合麻醉的高血压病患者分为对照组、右美托咪定组和丙泊酚组,每组20例。记录麻醉前(T0)、腰硬联合麻醉开始后(T1)及用药后5(T2)、15(T3)、30(T4)、60 min(T5)时警觉/镇静(OAA/S)评分及收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸率(RR)和动脉血氧饱和度(SpO2)。结果 T0、T1时3组OAA/S评分比较差异无统计学意义(P>0.05);对照组各时点OAA/S评分比较差异无统计学意义(P>0.05)。T2～T5时右美托咪定组和丙泊酚组OAA/S评分显著低于T0时(P<0.05),右美托咪定组T3～T5时及丙泊酚组T2～T5时OAA/S评分显著低于对照组(P<0.05)。3组患者T0和T1时SBP、DBP、HR、RR及SpO2比较差异均无统计学意义(P>0.05)。丙泊酚组T3～T5时SBP和HR及T4～T5时DBP和RR显著低于T0时(P<0.05)。右美托咪定组T3～T5时HR显著低于T0时(P<0.05)。丙泊酚组T5时HR及T4～T5时RR显著低于对照组(P<0.05),T4～T5时丙泊酚组SBP显著低于对照组和右美托咪定组(P<0.05)。结论高血压病患者腰硬联合麻醉期间应用右美托咪定可获得满意的镇静效果,并能保持血流动力学平稳。     

右美托咪定对颈丛阻滞下甲状腺手术患者的镇痛效果及其安全性

目的 研究右美托咪定对颈丛阻滞下甲状腺手术患者的镇痛效果及其安全性.方法 将2013年1月至2016年5月在中山市陈星海医院和琼海市人民医院就诊的90例颈丛阻滞下甲状腺手术患者按麻醉方式分为对照组(38例)和观察组(52例).观察组术中给予右美托咪定麻醉,对照组术中给予罗哌卡因麻醉.术中记录入室时(T0)、阻滞后5 min(T1)、30 min(T2)、60 min(T3)时间点的舒张压(DBP)、收缩压(SBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2)值,同时进行Ramsay镇静评分(RSS);术后记录并发症发生情况.结果 两组患者T0时的心率及其血液动力学、呼吸指标参数和Ramsay镇静评分比较差异无统计学意义(P>0.05).对照组T1、T2、T3时的HR、SBP和DBP值均明显高于T0,差异有显著统计学意义(P<0.01).观察组在T1、T2、T3时的HR、SBP和DBP值均明显低于T0,差异有显著统计学意义(P<0.01).两组RR和SpO2在T0、T1、T2、T3时差异均无统计学意义(P>0.05).观察组并发症发生率为7.69％,低于对照组的26.3％,差异有统计学意义(P<0.05).观察组RSS值在T1、T2、T3时均明显高于T0和对照组,差异有显著统计学意义(P<0.01).结论 行颈丛阻滞下甲状腺手术中使用右美托咪定可降低患者心率和并发症并减轻疼痛.     

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.