Hp与冠心病患者冠脉病变程度的相关性及机制

【摘要】目的 研究冠心病（CHD）患者血清白介素 6（IL 6）、白介素 17（IL 17）及可溶性细胞间黏附因子 1（sICAM 1）水平与幽门螺旋杆菌（Hp）检测结果间的相关性,并探讨其可能机制。 方法 纳入2016年1月~2019年1月我院收治的74例CHD患者为研究对象,另选取同期于我院行健康体检的50例同龄体检者作为健康对照组。观察Hp感染与患者病变支数、斑块性质间的关系,并比较Hp阳性与阴性CHD患者血清IL 6、IL 17、sICAM 1水平。结果 冠心病患者Hp感染率显著高于健康对照组（P＜005）,动脉狭窄支数以及颈动脉斑块性质与健康对照组比较差异具有统计学意义（P＜005）,血清IL 6、IL 17及sICAM 1水平显著高于健康对照组（P＜005）。随着狭窄支数的增多,冠心病患者Hp阳性率显著上升（P＜005）,且血清IL 6、IL 17及sICAM 1水平也呈依次上升趋势,组间比较差异具有统计学意义（P＜005）。存在颈动脉斑块的冠心病患者Hp阳性率显著高于无斑块者（P＜005）,不稳定斑块者Hp阳性率显著高于稳定斑块者（P＜005）。无斑块、稳定斑块及不稳定斑块冠心病患者血清IL 6、IL 17及sICAM 1水平呈依次上升趋势（P＜005）比较Hp阳性组冠心病患者血清IL 6、IL17及sICAM 1水平显著高于Hp阴性组（P＜005）。结论 Hp感染可能通过加剧机体炎症反应参与CHD进程,其与CHD患者动脉狭窄支数及斑块稳定性存在密切关系。     

IL-23在慢性鼻窦炎中的表达和作用

目的 探讨IL-23因子在慢性鼻窦炎中的表达和对辅助性T细胞17（T helper cell 17,Th17）免疫反应的调节作用。方法 募集15例受试者（正常对照组）,14例慢性鼻窦炎不合并鼻息肉（chronic rhinosinusitis without nasal polyps,CRSsNP）患者（CRSsNP组）和37例慢性鼻窦炎合并鼻息肉（chronic rhinosinusitis with nasal polyps,CRSwNP）患者（CRSwNP组）。取正常对照组受试者的下鼻甲,CRSsNP组患者的筛窦黏膜和CRSwNP组患者的鼻息肉（nasal polyps,NP）组织制备组织匀浆,检测组织匀浆中白细胞介素-23（interleukin-23,IL-23）、髓过氧化物酶（myelo-peroxidase,MPO）和IL-17蛋白的浓度;计数组织中性粒细胞数目和外周血中性粒细胞数目和百分比。取NP组织消化成单个细胞悬液,IL-23体外刺激24 h,然后检测NP组织单个细胞悬液中Th17相关因子的浓度。结果 与正常对照组相比,IL-23因子在CRSsNP和CRSwNP组患者中的表达均没有差别。但是,IL-17+CRSwNP亚组中IL-23的表达显著高于正常对照组和IL-17-CRSwNP亚组。鼻黏膜组织IL-23浓度与鼻黏膜组织MPO浓度正相关,但是与外周血和组织中的中性粒细胞数目不相关。IL-23体外刺激NP组织单个细胞悬液能够促进Th17相关因子IL-17和IL-1β的生成,但是对Th17相关因子IL-8和粒细胞集落刺激因子（granulocyte-colony stimulating factor,G-CSF）生成没有影响。结论 IL-23因子在IL-17+CRSwNP中通过增强Th17反应发挥作用。     

分泌性中耳炎伴腺样体肥大患儿相关细胞因子的表达水平及临床意义

【摘要】 目的 研究分泌性中耳炎(OME)伴腺样体肥大（AH）患儿IL 5因子的表达水平及临床意义。方法 选择2015年1月~2017年月诊治的25例OME伴AH患儿（OME伴AH组）、30例单纯OME患儿（单纯OME组）、30例单纯AH患儿（单纯H组）以及25例正常儿童（对照组）。采用酶联免疫吸附试验（ELISA）检测相关腺样体、血清白细胞介素5、6、8（IL 5、IL 6、IL 8）水平。结果 OME伴AH组腺样体IL 5、IL 6水平高于单纯AH组,差异具有统计学意义（P＜005）; OME伴AH组与单纯OME组血清IL 5、IL 6水平高于单纯OME组与对照组（P＜005）;OME伴AH组与单纯OME组、单纯OME组与对照组IL 5、IL 6水平差异无统计学意义（P＞005）;OME伴AH组、单纯OME组腺样体、血清IL 8水平差异无统计学意义（P＞005）;三组血清IL 8水平差异无统计学意义（P＞005）,但均高于对照组（P＜005）。结论 IL 5、IL 6在OME伴AH、单纯AH患儿腺样体表达明显增高,提示其在OME的发生及发展中具有重要作用。     

新生儿呼吸窘迫综合征与感染性肺炎患儿血清炎症因子和甲状腺激素的变化及相关性分析

【摘要】 目的 探讨新生儿呼吸窘迫综合征（neonatal respiratory distresssyndrome, NRDS）、感染性肺炎患儿血清炎症因子和甲状腺激素的变化情况及相关性。方法 选取NRDS患儿（NRDS组）、感染性肺炎患儿（感染性肺炎组）及正常新生儿（对照组）,每组各35例,三组均做炎症因子白细胞介素 6（IL 6）、肿瘤坏死因子 α（TNF α）及甲状腺激素检测,同时疾病患儿给予对症治疗,对比其不同阶段检测结果差异并做相关性分析。结果 NRDS组治疗前T3、T4、FT3、FT4、γT3、IL 6、TNF α与对照组比均有明显差异（P＜005）;组内比较,治疗后患儿T3、T4、FT3、FT4明显升高,IL 6明显降低（P＜005）;治疗后NRDS仅γT3明显低于对照组（P＜005）,其他指标无明显差异（P＞005）。感染性肺炎组患儿较对照组T3明显降低（P＜005）,TSH、IL 6、TNF α明显升高（P＜005）,治疗后T3与治疗前相比明显升高,TSH、IL 6、TNF α明显降低（P＜005）,且治疗后患儿各指标与对照组比无明显差异（P＞005）;相关性分析显示,新生儿呼吸窘迫组血清IL 6和T3、T4、FT3、FT4等甲状腺激素为负相关（r依次为 0794、 0572、 0369、 0517,P依次为0000、0000、0029、0001）;感染性肺炎组患儿血清IL 6、TNF α和T3为负相关（r依次为 0887、 0783,P依次为0000、0000）。结论 新生儿呼吸窘迫组血清IL 6和T3、T4、FT3、FT4等甲状腺激素为负相关,感染性肺炎组患儿血清IL 6、TNF α和T3为负相关,测定甲状腺素水平在监测病情轻重中具有一定的临床参考价值。     

丙戊酸钠联合拉莫三嗪对原发性癫痫患者 外周血细胞因子与疗效的影响

【摘要】 目的 探讨丙戊酸钠与拉莫三嗪联用对原发性癫痫患者疗效、安全性及对外周血TNF α、IL 2水平的影响。方法 纳入2014年3月～2016年3月就诊于本院的确诊为原发性癫痫的患者150例,随机分为对照组和观察组,每组各75例,对照组采用丙戊酸钠单独给药,观察组予以丙戊酸钠联合拉莫三嗪给药。进行随访,比较两组脑电图结果好转时间及异常放电率、治疗后发作频次、自尊量表SES评价分数、外周血TNF α、IL 2水平、总有效率及不良反应情况。结果 观察组脑电图好转时间及异常放电率结果显著低于对照组（P＜005）;观察组3个月及6个月发作频次明显少于对照组（P＜005）;观察组的SES自尊评价平均分数显著高于对照组（P＜005）;两组患者治疗6个月后 TNF α、IFN γ、IL 2、IL 6、 IL 17A水平均比治疗前显著降低（P均＜005）,且观察组的 TNF α、IFN γ、IL 2、IL 6、 IL 17A水平均显著低于对照组（P均＜005）,但两组IL 10、IL 4、IL 23和IL 1β治疗前后无显著差异（P＞005）;观察组总有效率显著高于对照组（P＜005）;观察组不良反应出现率显著低于对照组（P＜005）。结论 丙戊酸钠与拉莫三嗪联合治疗原发性癫痫疗效确切,能更好地降低血TNF α、IL 2水平,副作用较小,可在临床推广。     

白介素17在原发性膜性肾病患者血清和尿液中的表达

【摘要】目的 探讨IL 17在原发性膜性肾病中的作用。方法 选取2016年6月~2018年2月哈尔滨医科大学附属第一医院43例原发性膜性肾病的患者,按照病理分期分为Ⅰ、Ⅱ、Ⅲ期3组,对所有患者的一般情况、实验室检查以及肾活检病理结果进行统计分析;另将43例患者按照有无肾小管及间质损伤分组,分析IL 17与原发性膜性肾病患者肾小管及间质损伤的关系。结果 Ⅱ期和Ⅲ期血清IL 17水平高于Ⅰ期（P＜005）,Ⅲ期尿液IL 17水平高于Ⅱ期（P＜005）,Ⅲ期高于Ⅰ期和Ⅱ期（P＜005）;不同肾小管间质损伤程度的患者血清和尿液IL 17表达水平比较差异均有统计学意义（P＜005）。结论 IL 17与原发性膜性肾病患者肾小管及间质损伤有关。     

流式细胞术微球阵列法在慢性鼻-鼻窦炎细胞因子临床检测中的应用

目的 检测慢性鼻-鼻窦炎伴有鼻息肉(CRSwNP)和不伴鼻息肉(CRSsNP)患者细胞因子的表达,探讨免疫因素在其发病中的作用.方法 采用流式细胞术微球阵列法(CBA)检测20例CRSwNP患者、17例CRSsNP患者及13例正常对照组织样本及血清中IL-2、IL-4、IL-5、IL-10、TNF、IFN-γ六种细胞因子水平.结果 CRSwNP组织中IL-4、IL-5、IL-10、IFN-γ,CRSsNP组织中IL-2、IL-4、IL-10、IFN-γ表达显著高于血清；CRSwNP组织中IL-5、IL-10的表达明显高于对照且IL-5明显高于CRSsNP; CRSsNP组织中IFN-γ、IL-10的表达明显高于对照和CRSwNP.结论 CRSsNP以高表达IFN-γ为代表的Th1细胞因子为主,而CRSwNP主要表现为以高水平的IL-5为代表的Th2细胞因子,CBA技术具有一定优势,能够比较全面反应免疫因素在此两型慢性鼻-鼻窦炎(CRS)中的差异,从而为应用细胞因子抗体等治疗CRS提供科学依据.     

利拉鲁肽对Ⅱ型糖尿病伴肥胖患者胰岛β细胞功能和微炎症状态的影响

【摘要】 目的 探讨利拉鲁肽对初发Ⅱ型糖尿病（T2DM）伴肥胖患者胰岛β细胞功能和微炎症状态的影响及疗效。方法 选取本院2012年1月~2014年6月收治的T2DM伴肥胖患者134例,随机分为对照组（口服二甲双胍）和观察组（皮下注射利拉鲁肽）各67例。比较治疗前后血糖指标、体重指数、微炎症状态和胰岛β细胞功能变化。结果 观察组治疗后FBG、2hPBG和HbAlc水平显著低于对照组（均P＜005）; IL 6、TNF α和ASAA水平布显著低于对照组水平（P＜005）;HOMA IR水平显著低于对照组（P＜005）,而HOMA β水平显著高于对照组（P＜005）。结论〓利拉鲁肽通过增强胰岛β细胞功能,改善微炎症状态来控制T2DM伴肥胖患者血糖浓度和体质量,综合疗效优于单纯二甲双胍治疗。     

两种血液净化方式对维持性血液透析伴高血压患者血压的影响

【摘要】 目的 探讨血液灌流与透析对维持性血液透析伴高血压患者的血压、血浆内皮素 1（ET 1）及瘦素（Lep）的影响,并对其机制作初步分析。方法 选取陕西省人民医院2016年3月~2017年2月行维持性血液透析伴高血压患者94例作为研究对象,根据血液透析方式不同将患者分为观察组与对照组,每组各47例,观察组采用血液灌流联合常规透析,对照组采用常规血液透析。比较两组患者血压水平、实验室血液指标、机体矿物质、骨代谢指标水平及生活质量变化情况。结果 对照组收缩压、舒张压治疗4、8、12周后稍低于治疗前（P＞005）,但观察组明显低于治疗前（P＜005）;治疗后同一时期,观察组收缩压、舒张压明显低于对照组（P＜005）;对照组治疗12周后 ET 1 、Lep 水平明显高于治疗前（P＜005）,观察组治疗12周后ET 1、Lep水平明显低于治疗前（P＜005）;治疗后同一时期,观察组ET 1、Lep水平明显优于对照组（P＜005）。治疗后,观察组患者C反应蛋白（CRP）、白介素 6（IL 6）指标水平下降幅度明显大于对照组（P＜005）;观察组患者治疗后Ca明显下降,P、PINP明显上升（P＜005）;观察组患者治疗后FGF 23、iPTH、Ca、P、β CTX、PINP指标水平较治疗前均明显下降（P＜005）;观察组治疗后患者躯体功能、角色功能、情绪功能、认知功能、社会功能评分均明显高于对照组（P＜005）。结论 血液灌流联合常规透析相对于常规血液透析更能有效降低维持性血液透析伴高血压患者的血压水平,并改善血浆ET 1及Lep水平,但血液灌流联合常规透析对患者机体矿物质、骨代谢指标存在一定影响,在治疗过程中需要对患者采取相应预防措施。     

慢性鼻-鼻窦炎术后应用曲安奈德喷鼻治疗疗效及对鼻黏膜IL 17及Eos浸润的影响

【摘要】 目的 观察慢性鼻 鼻窦炎（CRS）术后应用曲安奈德喷鼻治疗疗效及对鼻黏膜白介素17（IL 17）及嗜酸性粒细胞（Eos）浸润的影响。方法 选取2013年2月～2017年2月我院收治的接受鼻内镜手术治疗CRS患者380例,按照随机抽签法分为对照组和观察组各190例。对照组术后使用生理盐水灌洗患者鼻腔,观察组术后使用曲安奈德进行喷鼻治疗。比较两组术后7d与治疗1疗程后视觉模拟（VAS）各症状评分、鼻腔鼻窦结局测试 20（SNOT 20）评分、鼻黏膜纤毛传送率（MTR）、鼻黏膜白介素6（IL 6）、白介素8（IL 8）、白介素17（IL 17）表达水平和Eos计数及不良反应率。结果 1疗程后,观察组鼻黏膜IL 6、IL 8、IL 17阳性细胞率、Eos计数均明显低于对照组(P＜005),鼻黏膜MTR明显大于对照组(P＜005);观察组VAS各症状评分及SNOT 20各项内容评分均明显低于对照组(P＜005);两组不良反应率差异无统计学意义(P＞005)。结论 CRS术后应用曲安奈德进行治疗,可有效降低患者鼻黏膜炎性因子水平,减小Eos浸润程度,提高鼻黏膜MTR,改善其临床症状及生活质量,且不良反应少。     

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.