Semaphorins-3A蛋白在发育期大鼠脑内的分布与表达

目的 了解Semaphorins-3A蛋白在生后发育期大鼠脑中的分布特征和表达变化.方法 随机选择生后0d、7d、14d、21d和28d日龄SD大鼠,通过免疫组化法观察Semaphorins-3A阳性细胞在大脑皮层、海马、齿状回和内嗅皮层内的分布和表达量.结果 出生后大鼠Semaphorins-3A阳性细胞广泛密集的分布于顶、枕、额、颞、岛叶、扣带皮质、梨状前皮质和杏仁周皮质中除分子层(Ⅰ)以外的颗粒细胞层(Ⅱ)、外椎体细胞层(Ⅲ)、内颗粒细胞层(Ⅳ)、内椎体细胞层(Ⅴ)和多行层(Ⅵ).Semaphorins-3A蛋白在0d、7d、14d、21d和28d日龄大鼠的内嗅皮层中表达量分别为84916.23±3266.34、77711.41±2634.26、74124.25±3989.09、65887.63±3406.57和57705.96±3136.35(IOD),表达区域缩小在Ⅱ～Ⅵ层的部分层次.Semaphorins-3A阳性细胞也分布于各日龄大鼠的齿状回、CA1、CA3区颗粒细胞层,少数散在分布于多行层,齿状回、CA1、CA3区内Semaphorins-3A表达量在各日龄之间具有明显差异(P＜0.01).结论 Semaphorins-3A阳性细胞广泛分布于发育期大鼠脑各脑叶及海马CA1、CA3、DG区内,并随年龄的增长分布范围逐渐缩小.     

戊四氮点燃致发育期癫(疒间)大鼠海马神经元突触结构的改变

目的 观察戊四氮(PTZ)点燃后发育期癫(疒间)大鼠海马神经元海马突触素(P38)和突触后致密物质(PSD95)及电镜超微结构的变化.方法 21日龄SD大鼠随机分为生理盐水组(NS)和实验组(PTZ),用戊四氮建立点燃模型,免疫组化检测大鼠P38及 PSD95阳性细胞的数量及分布,电镜观察海马CA3区超微结构的变化.结果 PTZ组大鼠海马区P38及PSD95免疫反应产物表达量较NS组明显减少(P<0.05);电镜下NS组海马CA3区神经元形态及突触结构未见明显异常,PTZ组大鼠神经元细胞及突触结构均有改变.结论 戊四氮点燃所致癫(疒间)对发育期大鼠海马神经元的突触结构有明显损害.     

氯胺酮对SD幼鼠海马神经元细胞凋亡和突触素表达的影响

目的观察氯胺酮对7d龄SD幼鼠海马神经元细胞凋亡和突触素(P38)表达的影响。方法7d龄SD幼鼠共30只,随机分成3组,分别注射氯胺酮25mg/kg(K1组)、50mg/kg(K2组),对照组注射生理盐水50ml/kg(K0组),24h后取材,采用Tunel法检测神经元细胞凋亡,免疫组化染色和Westernblot技术检测SD幼鼠海马突触素的表达,进行图像分析。结果注射氯胺酮后24h,海马神经元细胞凋亡计数K0组(5.3±1.7)、K1组(9.5±4.2)、K2组(23.4±7.6),免疫组化染色突触素灰度值:K0组为(174.11±4.68),K1组为(181.36±4.17),K2组为(198.25±3.06)。Westernblot突触素蛋白电泳条带积分光密度值K0组为(4007±758),K1组为(2621±465),K2组为(987±183)。结论注射氯胺酮后24h,SD大鼠海马神经元细胞大量凋亡,突触素表达减少可能和氯胺酮神经毒性有关。     

电迷宫训练对全脑缺血大鼠学习记忆能力的影响

目的:探讨Y型电迷宫训练对全脑缺血大鼠学习记忆能力和海马组织CA1区突触素表达的影响.方法:90只SD大鼠随机等分为假手术组、对照组和训练组.对照组和训练组均采用改良Pulsinelli's 4血管闭塞法建立全脑缺血大鼠模型,假手术组除不电凝双侧椎动脉、不夹闭双侧颈总动脉外,其余操作与对照组和训练组相同.术后7 d以Y型电迷宫训练大鼠,分别在训练的7 d、14 d、21 d应用Y型电迷宫检测大鼠的学习记忆能力;HE染色观察3组大鼠海马组织CA1区神经元形态学变化并计数正常神经元;免疫组织化学方法染色观察海马组织CA1区突触素的表达.结果:训练后7 d、14 d、21 d,对照组大鼠错误反应次数、全天总反应时间、潜伏期与假手术组比较,差异有统计学意义(P均＜0.05);训练组大鼠与对照组比较,3个指标间差异亦有统计学意义(P均＜0.05).训练组、对照组各时点大鼠海马组织CA1区正常神经元数目均低于假手术组(P均＜0.05),且训练组21 d高于对照组(P<0.05).对照组大鼠各时点海马组织CA1区突触素表达与假手术组比较,差异有统计学意义(P均＜0.05);且训练组大鼠14 d、21 d海马组织CA1区突触素的表达较对照组增多(P均＜0.05).结论:Y型电迷宫训练可以改善全脑缺血大鼠的学习记忆能力,其机制可能与促进海马组织CA1区突触素的表达有关.     

新生Wistar鼠海马CA1区GFAP和Syp的表达

目的动态观察Wistar鼠生后7～21d海马CA1区胶原纤维酸性蛋白(GFAP)和突触素(Syp)的表达并探讨其意义.方法应用免疫组化的方法动态观察Wistar大鼠生后7d、8d、10d、14d、21d海马CA1区GFAP和Syp的表达.结果海马CA1区Syp和GFAP的表达随日龄增加而增加.结论 Wistar大鼠海马CA1区GFAP和Syp的表达随日龄增加而增加,表明新生Wistar大鼠脑于生后大脑处于不断生长发育阶段,测定GFAP和Syp是研究新生鼠脑发育的有效指标之一.     

木犀草素对癫痫持续状态幼鼠海马组织神经细胞保护作用的机制研究

目的探讨木犀草素对癫痫持续状态（SE）幼年大鼠（下称幼鼠）海马组织神经细胞保护作用的机制。方法将156只21日龄雄性SD幼鼠按随机数字表法分为对照组12只、模型组48只、木犀草素1组（低剂量20mg/kg）48只和木犀草素2组（高剂量50mg/kg）48只,其中模型组、木犀草素1组和木犀草素2组在癫痫发作后的1、2、3和7d分别处死12只幼鼠。采用氯化锂-匹罗卡品法制作幼鼠SE模型,木犀草素1组和木犀草素2组在造模成功后,腹腔注射相应剂量的木犀草素,此后每天重复注射1次,直至处死。采用qRT-PCR法检测幼鼠海马组织中NF-κB、Toll样受体4（TLR4）、半胱氨酸门冬氨酸特异性蛋白酶3（Caspase-3）、TNF-αmRNA表达水平,Westernblot法检测幼鼠海马组织中TLR4蛋白表达水平,TUNEL法观察幼鼠海马CA1区神经细胞凋亡情况。结果与对照组比较,癫痫发作后1、2、3和7d模型组幼鼠海马组织中TLR4、NF-κB、Caspase-3、TNF-αmRNA及TLR4蛋白表达水平均升高（均P＜0.01）;与模型组比较,癫痫发作后1、2、3和7d木犀草素2组幼鼠海马组织中TLR4、NF-κB、Caspase-3、TNF-αmRNA及TLR4蛋白表达水平均降低（均P＜0.05）,癫痫发作后3和7d木犀草素1组幼鼠海马组织中TLR4mRNA表达水平均降低（均P＜0.05）,癫痫发作后1和3d木犀草素1组幼鼠海马组织中Caspase-3mRNA表达水平均降低（均P＜0.05）,癫痫发作后3d木犀草素1组幼鼠海马组织中TNF-αmRNA表达水平降低（P＜0.01）,癫痫发作后7d木犀草素1组幼鼠海马组织中TLR4蛋白表达水平降低（P＜0.05）。与对照组比较,癫痫发作后1、2、3和7d模型组大鼠海马组织中神经细胞凋亡率均升高（均P＜0.01）;与模型组比较,癫痫发作后1、2、3和7d木犀草素2组幼鼠海马组织神经细胞凋亡率均降低（均P＜0.01）,癫痫发作后2、3和7d木犀草素1组幼鼠海马组织神经细胞凋亡率均降低（均P＜0.05）。结论木犀草素可减轻SE幼鼠海马组织的炎症反应和细胞凋亡,其机制可能是通过调控TLR4/NF-κB通路来达到神经保护作用。     

利拉鲁肽对匹罗卡品致痫大鼠海马各区神经元凋亡的影响

目的探讨利拉鲁肽对大鼠癫痫持续状态后海马各区神经元凋亡的影响。方法将雄性SD大鼠(n=54)随机分为空白对照组(n=6)、匹罗卡品模型组(SE组,n=24)、利拉鲁肽干预组(Liraglutide组,n=24);并根据发作终止后的时间点(12 h,1 d,3 d,7 d)将SE组和Liraglutide组各分为4个亚组(n=6)。采用免疫组化技术检测海马CA3和DG区BCL2和BAX蛋白的表达。结果与SE组相比,Liraglutide组在SE后12 h、1 d、3 d时CA3区BCL2表达水平升高(P0.05),而在SE后7 d时BCL2水平与SE组无差异(P0.05);在DG区,Liraglutide组在SE后1 d BCL2表达升高(P0.05),在SE后3 d时表达无差异(P0.05)。Liraglutide组相较SE组,在SE后12 h,DG区BAX表达开始明显降低(P0.01);在SE后1 d,CA3区BAX表达降低(P0.01);且在SE后3 d,Liraglutide组DG区和CA3区BAX表达都高于空白对照组(P0.05)。结论利拉鲁肽通过抑制癫痫持续状态后海马CA3区和DG区神经元凋亡发挥神经保护作用。     

颞叶癫痫大鼠认知功能与海马区NR2B表达的关系

目的〓〖HTK〗研究颞叶癫痫大鼠在Morris水迷宫(MWM)中学习、记忆能力与大鼠海马区N-甲基-D-天门冬氨酸受体2亚基B（NR2B）表达变化的关系，探讨颞叶癫痫学习、记忆等认知功能障碍的可能机制。〖HTW〗方法〓〖HTK〗随机将60只Wistar大鼠分为癫痫组（48只）和对照组（12只）。癫痫组采用海人酸（K A）右侧海马立体定向注射制作颞叶癫痫大鼠模型，又分为：癫痫迷宫训练组（A组），癫痫迷宫未训练组（B组）；对照组即NS迷宫训练组（C组），注射生理盐水。通过MWM测验观察A、C组大鼠在7、14、28、42d时各亚组的学习、记忆能力。采用免疫组化法检测大鼠在7、14、28、42d时各亚组海马CA1、CA3区NR2B的表达。〖HTW〗结果〓〖HTK〗与C组相比，在28、42d时A组学习、记忆功能明显下降，相应海马CA1、CA3区NR2B表达均明显降低(P＜0.05，P＜0.01) ，B组在28、42d时海马CA1、CA3区NR2B表达均明显降低(P＜0.01)；与B组相比，A、C组在28、42d时海马CA1、CA3区NR2B表达均增高(P＜0.05，P＜0.01)。与A7、A14d亚组相比，A28、A42d亚组学习、记忆功能逐渐下降(P＜0.05，P＜0.01)，NR2B的表达逐渐降低(P＜0.05，P＜0.01) ，且A组28d与A组42d亚组相比差异有统计学意义(P＜0.05，P＜0.01)。B组各亚组NR2B表达与A组一致。〖HTW〗结论〓〖HTK〗颞叶癫痫长期反复发作时海马区NR2B表达减少，可能是导致颞叶癫痫学习、记忆等认知功能障碍的机制之一。     

褪黑素对颞叶癫痫大鼠海马BDNF表达的影响及意义

目的探讨褪黑素(melatonin,Mel)在匹罗卡品(pilocarpine,PILO)致痫大鼠模型中的抗癫痫作用机制。方法采用匹罗卡品诱导大鼠慢性颞叶癫痫模型,用原位杂交、免疫组化技术检测海马脑源性神经营养因子(BDNF)基因和蛋白表达水平;用Ti mms染色评价苔藓纤维发芽(mossy fiber sprouting,MFS),动态观察了Mel对癫痫大鼠海马BDNF基因、蛋白表达水平的影响及其与MFS的关系。结果(1)PILO诱导大鼠癫痫持续状态(SE)后6h,海马BDNF基因和蛋白表达水平均明显增强;SE后7~14d,BDNF蛋白表达仍维持较高水平,尤其在齿状回处BDNF蛋白高表达可持续至SE后28d。PILO Mel组大鼠海马BDNF基因和蛋白表达与PILO组有着类似变化趋势,但在SE后各时相点BDNF基因和蛋白表达水平均低于PILO组,尤其在SE后6h~7 d表现最为明显(P<0.05)。(2)SE后14 d,PILO组大鼠Ti mms染色密度开始增强,至SE后28 d Ti mms染色密度进一步增强,与PILO Mel组比较差异有统计学意义(P<0.05)。结论Mel对癫痫发作大鼠海马BDNF基因和蛋白表达具有一定的调节作用,这可能是其抑制MFS而发挥抗癫痫作用的机制之一。     

外源性碱性成纤维细胞生长因子对癫痫持续状态大鼠海马c-fos表达的影响

目的：通过戊四氮癫痫持续状态大鼠模型,观察外源性碱性成纤维细胞生长因子（bFGF）对癫痫大鼠海马组织内c—fos表达的影响。方法：建立SD大鼠戊四氮（PTZ）诱导癫痫持续状态模型,生理盐水（NS）注射作为对照,皮下注射bFGF进行干预,分4组：即NS组、NS＋bFGF组、PTz组、Frrz十bFGF组。选择处理后第3、7、14天3个时间点进行观察,采用免疫组化SABC法检测c-fos。结果：发作后3、7、14dPTZ组海马组织c—fos较NS组有显著升高（P〈0．01）,以发作后14d升高更为明显,眦＋bFGF组各时间点c-fos较PTZ组下降（P〈0．05）;c-fos含量在P1lZ组各时间点亦大于NS组（P〈0．05）,以发作后14d升高较为显著;NS＋bFGF组发作后各时间点c-fos较PTZ组差异无统计学意义（P〉0．05）。结论：大鼠癫痫持续状态后一定时间内c—fos表达增加,bFGF能够降低大鼠癫痫发作后c—fos表达,减少神经元的损害。     

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.