11,12-EET对大鼠心脏缺血/再灌注损伤保护作用研究

目的观察不同质量浓度11,12-EET对心肌缺血/再灌注损伤的影响及给药后不同时间11,12-EET保护作用的变化,以期了解11,12-EET对心肌保护作用的特点。方法复制大鼠心脏缺血/再灌注模型,给予不同浓度的11,12-EET,观察不同时间点的心功能变化。结果给予6.24×10-7.5mol/L、6.24×10-8mol/L 11,12-EET均可改善心肌缺血/再灌注损伤的大鼠心功能,6.24×10-9mol/L 11,12-EET作用较弱;给药24 h后11,12-EET拮抗大鼠心肌缺血/再灌注损伤的作用也减弱。结论11,12-EET的浓度及给予11,12-EET的时间对心脏保护作用有一定的影响。     

11,12-EET心脏保护过程中NOS及ERK的交互作用

目的观察胞外信号调节激酶(extracellular signal regulated kinase 1/2,ERK1/2)抑制剂对11,12-环氧二十碳三烯酸(11,12-epoxyeicosatrienoic acid,11,12-EET)引起的结构型一氧化氮合酶(structural nitric oxide synthase,sNOS)变化的影响,了解NOS与ERK1/2在11,12-EET心脏保护中的作用方式。方法采用冠状动脉缺血60 min再灌注30 min的方法复制大鼠心肌缺血/再灌注模型。实验分为4组:缺血再灌注组(ischemia/reperfusion,I/R);假手术组(Sham);11,12-EET缺血再灌注组(EET+I/R);11,12-EET缺血再灌注加PD098059组(EET+I/R+PD)。观察缺血60 min再灌注30 min时心脏收缩期左心室内压上升的最大变化速率(+dp/dt max)及舒张期左心室内压下降的最大变化速率(-dp/dt max);采用化学比色法观察大鼠心肌组织sNOS活性。结果 I/R组的±dp/dtmax均低于Sham组及EET+I/R组(P<0.01);EET+I/R+PD组均低于EET+I/R组的±dp/dt max(P<0.01)。I/R组心肌sNOS低于Sham组(P<0.01)及EET+I/R组(P<0.01);EET+I/R组高于EET+I/R+PD组(P<0.01)。结论 11,12-EET对心功能的保护作用可能通过上调ERK进而增加sNOS的表达来实现。     

11,12-环二十碳三烯酸对心脏缺血/再灌注损伤大鼠血红素氧合酶-1的影响

目的观察11,12-环二十碳三烯酸(11,12-EET)对缺血/再灌注(I/R)损伤大鼠心肌血红素氧合酶-1(HO-1)的影响,并探讨其作用机制。方法采用健康雄性Wistar大鼠制备心肌缺血/再灌注模型,实验分为3组:1)缺血/再灌注(I/R)组,2)环氧二十碳三烯酸(EET)组及3)左旋精氨酸甲酯(L-NAME)组。观察缺血60min再灌注30min时心脏收缩期左心室内压上升的最大变化速率及舒张期左心室内压下降的最大变化速率。采用Westernblot法测定心肌HO-1表达水平。采用化学比色法观察大鼠心肌组织NOS及iNOS活性。结果收缩期左心室内压上升的最大变化速率及舒张期左心室内压下降的最大变化速率EET组高于I/R组(P<0.01);L-NAME组低于EET组(P<0.05)。心肌HO-1表达水平EET组高于I/R组(P<0.05),L-NAME组低于EET组(P<0.05)。EET组cNOS活性高于I/R组(P<0.01),L-NAME组cNOS活性低于EET组(P<0.05);EET组iNOS活性低于I/R组(P<0.01),L-NAME组iNOS活性低于EET组,但差异无统计学意义(P>0.05)。结论外源性11,12-EET能改善缺血/再灌注大鼠心功能损伤程度,增加心肌HO-1表达水平和cNOS活性,降低iNOS活性。提示11,12-EET拮抗心肌缺血/再灌注损伤的作用可能与HO-1表达增加有关,且此时HO-1的表达增加至少部分依赖于cNOS的激活。     

11,12-环二十碳三烯酸对缺血/再灌注大鼠心肌一氧化氮合酶的影响

目的观察11,12-环二十碳三烯酸(11,12-EET)对缺血/再灌注大鼠心肌一氧化氮合酶(NOS)的影响.方法采用健康雄性Wistar大鼠制备心肌缺血/再灌注模型,实验分为5组:11,12-EET缺血/再灌注组(包括EET1、EET2、EET3)组,EET对照组,缺血/再灌注组,假手术组,正常对照组.观察缺血60min及再灌注30min两个时段心脏收缩期左心室内压上升的最大变化速率及舒张期左心室内压下降的最大变化速率;采用化学比色法观察大鼠心肌组织诱导型一氧化氮合酶(iNOS)及结构型一氧化氮合酶(cNOS)活性.结果缺血/再灌注组缺血60min及再灌注30 min两个时段收缩期左心室内压上升的最大变化速率及舒张期左心室内压下降的最大变化速率均低于假手术组(P＜0.01);EET1、EET2及EET3组均高于缺血/再灌注组(P＜0.01).缺血/再灌注组心肌cNOS低于假手术组(P＜0.01),EET1、EET2及EET3组均高于假手术组(P＜0.01)及缺血/再灌注组(P＜0.01),EET2组高于EET对照组(P＜0.01).假手术组iNOS高于EET对照组(P＜0.05),缺血/再灌注组高于假手术组(P＜0.01);EET1、EET2及EET3组均低于缺血/再灌注组(P＜0.01).结论外源性11,12-EET改善缺血/再灌注心功能损伤同时出现cNOS增加及iNOS减少,提示11,12-EET拮抗缺血/再灌注损伤的作用可能与NOS同功酶改变有关.     

11,12-环氧二十碳三烯酸对缺血前和再灌注前大鼠心肌钙调节蛋白的影响

目的观察11,12-环氧二十碳三烯酸(11,12-EET)预处理与后处理对缺血/再灌注(IR)大鼠心肌钙调节蛋白的影响,探讨11,12-EET心肌保护的作用及其机制。方法采用Langendorff离体灌流装置,通过停灌40min/复灌30min复制大鼠心肌IR损伤模型。将33只雄性Sprague-Dawley大鼠随机分为对照组、IR组、EET预处理组(Pre-EET)及EET后处理组(Post-EET)。采用BL-420生物信号采集系统监测心功能,比色法检测肌浆网Ca2 -ATPase变化,半定量RT-PCR方法检测钙泵(SERCA)、磷酸受纳蛋白(PLB)、兰尼碱受体2型(RyR2)及1,4,5-三磷酸肌醇受体2型(IP3R2)表达变化。结果Pre-EET及Post-EET组与IR组相比,心功能改善、Ca2 -ATPase活性增高(P<0.05,P<0.01);IP3R2表达增强,PLB表达降低(P<0.05,P<0.01);Pre-EET组SERCA表达增强(P<0.05)。Pre-EET与Post-EET组间差异无显著性;各组RyR2表达差异无显著性。结论11,12-EET预处理与后处理具有拮抗IR损伤的作用,这与其诱导肌浆网IP3R2表达上调,PLB表达下调以及改善Ca2 -ATPase的活性有关;同时,预处理肌浆网SERCA表达上调,也可能是其抗IR损伤机制之一。     

11,12-环氧二十碳三烯酸对人脐静脉内皮细胞缺氧/复氧损伤的影响

目的通过观察11,12-环氧二十碳三烯酸(11,12-EET)对缺氧/复氧人脐静脉内皮细胞损伤程度的影响,了解EET血管保护的可能途径,并初步探讨其作用机制。方法采用原代培养人脐静脉内皮细胞,随机分为对照组、缺氧/复氧组、11,12-EET对照组、11,12-EET缺氧/复氧组、细胞外信号调节的蛋白激酶(ERK1/2)抑制组和一氧化氮合酶抑制组。通过向培养瓶内通入混合气体(2%O2,5%CO2,93%N2)3h,复氧1h复制缺氧/复氧损伤模型。采用MTT法检测细胞存活率,比色法检测培养液中乳酸脱氢酶(LDH)、超氧化物歧化酶(SOD)及丙二醛(MDA)的变化,Westernblot方法检测内皮型一氧化氮合酶(eNOS)和ERK1/2的表达。结果11,12-EET在常氧条件下可对细胞造成轻度损伤,而在缺氧/复氧条件下能显著提高内皮细胞的存活率,降低LDH的漏出率,提高SOD的活性,降低MDA的含量,并且促进eNOS、磷酸化ERK1/2的表达。结论11,12-EET具有拮抗内皮细胞缺氧/复氧损伤作用,这与其提高缺氧/复氧内皮细胞SOD活性、清除氧自由基、减少缺氧/复氧对eNOS及磷酸化ERK1/2表达的抑制有关。     

11,12-环氧二十碳三烯酸对缺氧/复氧诱导的内皮细胞损伤及细胞间黏附因子-1表达的影响

目的观察11,12-环氧二十碳三烯酸(11,12-epoxyeicosatrienoic acids,11,12-EET)对缺氧/复氧诱导的内皮细胞损伤以及黏附分子表达的影响,了解环氧二十碳三烯酸发挥血管保护作用的可能途径,初步探讨其作用机制。方法采用原代培养人脐静脉内皮细胞,用数字表法将其随机分为对照组、11,12-EET对照组、缺氧/复氧组和11,12-EET缺氧/复氧组。通过向培养瓶内通入混合气体(2%O2,5%CO2,93%N2)3h,复氧1h,复制缺氧/复氧损伤模型。采用MTT法检测细胞活力,用比色法检测培养液中超氧化物歧化酶(SOD)及丙二醛(MDA)的变化,用RT-PCR法检测细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)mRNA表达,用酶联免疫吸附实验测定细胞间黏附分子-1蛋白表达,用Western blotting方法检测蛋白激酶B(Akt)。结果11,12-EET在常氧条件下可对细胞造成轻度损伤,在缺氧/复氧条件下能显著提高内皮细胞的存活率,提高SOD的活性,降低MDA的含量,抑制细胞间黏附分子-1 mRNA和蛋白的表达,提高Akt的表达。结论11,12-EET具有减轻内皮细胞缺氧/复氧损伤作用,这可能与其能提高缺氧/复氧条件下内皮细胞SOD活性、清除氧自由基、抑制细胞间黏附分子-1 mRNA和蛋白的表达和促进Akt的表达有关。     

PD98059对11,12-EET及缺血预处置大鼠心功能保护作用的影响

为观察PD980 5 9对给予 11,12 EET或缺血预处置在体大鼠再灌注心功能的影响 ,了解磷酸化ERK1/ERK2的表达在上述心脏保护中的作用 ,使用雄性Wistar大鼠 ,通过结扎 (6 0min)和松开 (30min)冠状动脉左前降支 ,复制缺血 /再灌注模型 ;采用缺血 5min ,再灌注 5min 2次造成缺血预处置 ;6 .2 4× 10 -8mol/L 11,12 EET通过静脉给予。计算机记录再灌注过程中心功能的变化 ;实验结束时取心肌采用Western Blot法测定ERK1/ERK2的表达。结果显示 :再灌注 30min ,I/R组的 +dp/dtmax(收缩期左心室内压上升的最大变化速率 )、-dp/dtmax(舒张期左心室内压下降的最大变化速率 )和LVDP(左心室发展压 )均显著低于SI +I/R组和EET +I/R组 (P <0 .0 5 ) ;SI +I/R +PD组的 +dp/dtmax、-dp/dtmax及LVDP均明显低于SI+I/R组 (P <0 .0 5 ) ,EET +I/R +PD组的 +dp/dtmax、-dp/dtmax及LVDP明显低于EET +I/R组(P <0 .0 5 )。研究表明 :6 .2 4× 10 -8mol/L 11,12 EET及缺血预处置均有保护心功能的作用 ;这种保护作用通过激活缺血 /再灌注时ERK1/ERK2的表达而实现。     

缬沙坦对离体大鼠缺血再灌注心肌保护作用的机制

目的探讨缬沙坦对离体大鼠心肌缺血再灌注(I/R)后心功能保护作用的机制。方法采用Langendorff离体心脏灌流模型,将40只雄性SD大鼠随机等分为5组:对照组用改良Kreb-Henseleit液(K-H液持续灌注110min);I/R组(用K-H液灌流稳定20min后,停灌30min,再灌注60min);HOE140组(K-H液中含缓激肽β2受体拮抗剂HOE1401μmol/L),缬沙坦组(K-H液中含缬沙坦1μmol/L),缬沙坦+HOE140组(K-H液中含缬沙坦1μmol/L+HOE1400·1μmol/L),后3组缺血再灌注过程同I/R组。动态监测左室收缩压(LVSP)、左室压力升高速率(+dp/dtmax)、测定心脏再灌流出液肌酸激酶同工酶(CK-MB)含量变化。实验结束后计算无复流区面积。结果缺血再灌注后,I/R组无复流面积为25·8%±2·7%;与对照组比较,I/R组LVSP及+dp/dtmax降低(LVSP57mmHg±9mmHgvs107mmHg±6mmHg,+dp/dtmax679mmHg/s±177mmHg/svs1892mmHg/s±231mmHg/s,P均<0·01),心肌CK-MB水平增加(210IU/L±48IU/Lvs27IU/L±7IU/L,P<0·01)。单独应用HOE140对I/R心功能、心肌CK-MB及无复流面积无影响(P>0·05)。缬沙坦改善LVSP(85mmHg±7mmHg)和+dp/dtmax(1425mmHg/s±260mmHg/s),缩小无复流区面积(12·9%±2·5%);减少心肌CK-MB释放(103IU/L±24IU/L,与I/R组比P均<0·01);HOE140与缬沙坦合用可部分阻断缬沙坦的上述作用。结论缓激肽β2受体拮抗剂可减弱缬沙坦对离体大鼠缺血再灌注心肌的保护作用,缬沙坦对心肌I/R损伤的保护作用机制部分与缓激肽释放增多有关。     

缺血预适应对兔肢体缺血再灌注后心肌损伤的影响

1目的　观察缺血预适应 (IPC)对兔肢体缺血再灌注后心肌损伤的影响 ,以进一步探讨 IPC对肢体缺血再灌注后心肌的保护作用。 2方法　实验用纯种青紫蓝兔 2 4只 ,随机分成对照 (Control)组 ,缺血再灌注 (IR)组和缺血预适应 (IPC)组 ,每组 8只 ,用BL -4 10生理记录仪测量心功能指标 ,并测定心肌酶含量变化及丙二醛水平。 3结果　发现 IPC可以减轻肢体缺血再灌注后左室舒缩功能的降低 ,并且能降低血中心肌酶及脂质过氧化物丙二醛 (MDA)含量。 4结论　 IPC对兔肢体 IR后心肌的损伤有保护作用     

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.