脑梗死患者同型半胱氨酸和C反应蛋白与颈动脉硬化的关系

目的 探讨血清同型半胱氨酸（Hcy）和超敏C反应蛋白（hs-CRP）及颈动脉粥样硬化在脑梗死中的相互关系.方法 对65例脑梗死患者及30例健康对照者进行Hcy、hs-CRP测定,应用彩色多普勒超声检查颈动脉硬化程度,并测定颈动脉内膜中层厚度（IMT）,将脑梗死组患者分为斑块组和无斑块组进行对比.结果 脑梗死组患者血浆Hcy、hs-CRP及IMT均较对照组增高,差异有统计学意义（P＜0.01）;不稳定斑块组Hcy、hs-CRP、IMT高于稳定斑块组,差异有统计学意义（P＜0.01）.直线相关分析显示Hcy与hs-CRP、IMT呈正相关（P＜0.01）.结论 血浆Hcy、hs-CRP与颈动脉硬化及斑块形成有关,均为脑梗死的危险因素.     

高龄急性脑梗死患者同型半胱氨酸与颈动脉硬化的相关性

目的探讨高龄急性脑梗死(acute cerebral infarction,ACI)患者同型半胱氨酸(homocysteine,Hcy)与颈动脉硬化及预后的相关性。方法选取初发性高龄ACI患者118例和同期健康体检者118例,观察其临床特征、血清Hcy水平的变化及颈动脉粥样硬化情况。将高龄ACI患者又分为不稳定性斑块、稳定性斑块和无斑块组;根据血清Hcy水平,分为Hcy10μmol/L组和Hcy≤10μmol/L组;以改良Rankin量表(modified Rankin scale,m RS)评分,将患者分为预后不良和预后良好组。应用Logistic回归分析脑梗死不良预后的危险因素,Spearman相关分析血清Hcy与美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)、m RS及颈动脉内-中膜厚度(intima-media thickness,IMT)的相关性。结果脑梗死组血清Hcy水平及IMT均高于对照组[(19.24±7.86)μmol/L vs(9.12±3.60)μmol/L;(1.27±0.23)mm vs(0.68±0.14)mm,P0.01]。不稳定性斑块组[(24.10±10.26)μmol/L和(1.46±0.37)mm]及稳定性斑块组[(20.13±7.31)μmol/L和(1.31±0.32)mm]血清Hcy水平及IMT均高于无斑块组[(12.35±4.32)μmol/L和(1.02±0.21)mm],且不稳定性斑块组IMT(1.46±0.37)mm高于稳定性斑块组(1.31±0.32)mm,差异均有统计学意义(P0.05)。血清Hcy10μmol/L组入院第1、90天的NIHSS评分、m RS评分2分比率和IMT均高于Hcy≤10μmol/L组(P0.05)。预后不良组血清Hcy水平及IMT均高于预后良好组[(25.63±10.58)μmol/L vs(12.18±4.40)μmol/L;(1.39±0.32)mm vs(1.14±0.16)mm,P0.01]。Logistic回归分析显示,高Hcy(OR=1.346,95%CI:1.163~1.541,P=0.02)、IMT(OR=2.094,95%CI:1.251~3.728,P=0.02)及NIHSS评分(OR=1.443,95%CI:1.176~1.752,P=0.00)是预后不良的独立危险因素。相关分析显示,血清Hcy与NIHSS、m RS及IMT均呈正相关(r=0.538,P=0.04;r=0.514,P=0.05;r=0.726,P=0.00)。结论血清Hcy与NIHSS、m RS及IMT具有良好的相关性,高Hcy可促进高龄急性脑梗死患者颈动脉粥样硬化的发生且患者预后较差。     

急性冠脉综合征与高敏C反应蛋白及颈动脉粥样硬化的相关研究

目的探讨急性冠脉综合征(ACS)病人与高敏反应C蛋白(hs-CRP)水平及颈动脉超声检查变化及其相关性.方法将109例观察对象分为病例组(急性冠脉综合征,56例)和对照组(53例).采用酶联免疫吸附法(ELISA)检测血清hs-CRP水平.使用多谱勒超声检查颈动脉内-中膜厚度(IMT)及斑块发生率.同时将109例观察对象分为hs-CRP≤3 mg/L组(43例)和hs-CRP＞3 mg/L组(66例),分析hs-CRP与IMT的关系.结果病例组血清hs-CRP(4.72±2.55)mg/L明显高于对照组(1.85±0.79)mg/L,差异具有统计学意义(P＜0.01).病例组颈动脉内-中膜厚度(1.82±0.66)mm,明显厚于对照组(1.01±0.40)mm,斑块发生率(85.7%)高于对照组(35.8%),差异均具有统计学意义(P＜0.001).hs-CRP＞3 mg/L组IMT为(1.80±0.63)mm,斑块发生率为83.7%,急性冠脉综合征发生率为83.7%;hs-CRP≤3 mg/L组IMT为(1.17±0.59)mm,斑块发生率为37.9%,急性冠脉综合征发生率为30.3%,2组比较差异均具有统计学意义.血清hs-CRP水平与IMT厚度呈正相关(rs=0.434,P＜0.05).结论血清hs-CRP水平可作为反映急性冠脉综合征患者的敏感标志物,颈动脉粥样硬化程度可以反映急性冠脉综合征的斑块不稳定性,炎症反应可能参与颈动脉硬化形成.     

Hcy与急性脑梗死合并动脉粥样硬化患者关系分析

目的:探讨血清同型半胱氨酸(Hcy)与急性脑梗死合并动脉粥样硬化患者关系。方法:选取2015年1月-2017年6月本院收治的急性脑梗死患者80例作为研究对象,根据颈动脉超声结果分为无斑块组(n=20)、不稳定斑块组(n=28)和稳定斑块组(n=32);另选取同期健康体检者20例作为对照组。以酶循环法测定血清Hcy水平,观察比较四组血清Hcy水平。另根据患者血清Hcy水平将其分为低水平组、中水平组和高水平组,比较三组颈动脉IMT厚度。结果:急性脑梗死患者中Hcy水平升高者,无斑块组35.00%(7/20),不稳定斑块组89.29%(25/28),稳定斑块组75.00%(24/32)。四组患者血清Hcy水平的关系:对照组无斑块组稳定斑块组不稳定斑块组(F=115.15,P0.001);不同Hcy水平急性脑梗死患者的内膜中层厚度(IMT值)的关系:低水平组中水平组高水平组,差异有统计学意义(F=84.26,P0.001);脑梗死患者血清Hcy水平与IMT值呈正相关(r=0.784,P0.01)。结论:血清Hcy水平与急性脑梗死患者颈动脉粥样硬化呈正相关,可作为评估急性脑梗死合并动脉粥样硬化患者的参考指标。     

血清Cys-C和Hcy水平与急性脑梗死患者颈动脉粥样硬化的关系研究

目的 探讨血清胱抑素C(Cys-C)、同型半胱氨酸（Hcy）水平与急性脑梗死患者颈动脉粥样硬化的关系。方法 选取2018年6月至2020年5月本院接诊的84例急性脑梗死患者为研究对象,按照颈动脉粥样硬化程度分为IMT正常组（n=25）、IMT增厚组（n=29）和颈动脉斑块形成组（n=30）。比较不同颈动脉粥样硬化分级患者血清Cys-C、Hcy水平,分析血清Cys-C、Hcy与IMT的相关性。结果 颈动脉斑块形成组血清Cys-C、Hcy水平分别为（2.55±0.21）mg/L、（26.51±2.13）μmol/L,高于IMT增厚组的（1.98±0.15）mg/L、（18.55±1.49）μmol/L和IMT正常组的（1.06±0.12）mg/L、（11.72±1.24）μmol/L,差异有统计学意义（P<0.05）;急性脑梗死患者血清Cys-C、Hcy水平和IMT呈正相关（r=0.792、0.783,P<0.05）。结论 血清Cys-C、Hcy水平与急性脑梗死患者颈动脉硬化程度密切相关,可作为颈动脉粥样硬化的早期预测指标,利于防止病情恶化,延缓疾病进展。     

脑梗死患者检测超敏C反应蛋白和同型半胱氨酸的临床意义

目的：观察血清同型半胱氨酸（ Hcy）和超敏C反应蛋白（ hs-CRP）的变化与脑梗死患者的相关性。方法：选择脑梗死患者120例为脑梗死组,同期130名健康体检者为对照组,分别测定2组患者血清中的Hcy和hs-CRP含量,其中脑梗死合并高血压72例,非高血压患者48例。结果：脑梗死组Hcy与hs-CRP分别为（22.1±6.3）μmol/L和（9.4±2.6）mg/L,均高于对照组的（10.4±2.5）μmol/L和（1.8±0.8）mg/L（P〈0.01）,合并高血压组的Hcy、hs-CRP分别为（31.4±8.5）μmol/L和（13.7±4.9）mg/L,均高于非高血压组的（23.4±4.6）μmol/L和（10.7±4.3）mg/L（P〈0.01）。结论：脑梗死患者血清中的hs-CRP和Hcy水平与疾病的发生、发展密切相关,联合检测hs-CRP和Hcy对脑梗死患者具有重要的临床价值。     

急性脑梗死患者LDL-C、Hcy、Npt、CRP水平的改变及其与颈动脉粥样硬化的关系

目的探讨急性脑梗死(ACI)患者低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、新蝶呤(Npt)、C反应蛋白(CRP)水平的改变及其与颈动脉粥样硬化的关系。方法 2014年6月—2015年6月诊治ACI死患者68例为ACI组,选取同期行健康检查的体检者60例为健康对照组,应用多普勒超声仪测定2组颈动脉内膜中层厚度(IMT),ELISA法测定2组血浆Hcy、Npt,酶直接法测定血浆LDL-C,乳胶免疫比浊法测定CRP。结果 ACI组患者颈动脉斑块发生率为91.17%,显著高于健康对照组10.00%(P<0.05);ACI组血浆LDL-C(4.98±0.89)mmol/L、Hcy(38.96±4.89)μmol/L、Npt(2.45±0.48)ng/ml、CRP(6.89±0.48)mg/L水平高于健康对照组(2.86±0.93)mmol/L、(18.02±3.88)μmol/L、(1.38±0.59)ng/ml、(1.58±0.56)mg/L(P<0.05),而颈动脉IMT(1.85±0.32)mm大于健康对照组(0.42±0.16),差异均有统计学意义(P<0.05)。ACI患者中软斑亚组、混合斑亚组血浆LDLC、Hcy、Npt、CRP水平显著高于硬斑亚组(P<0.05)。经Pearson单因素分析,血浆LDL-C、Hcy、Npt、CRP水平与IMT呈正相关(r=0.412、0.326、0.345、0.369,P<0.05)。结论 ACI合并颈动脉不稳定斑块患者血浆LDL-C、Hcy、Npt、CRP水平显著高于斑块不稳定患者,提示血浆LDL-C、Hcy、Npt、CRP水平可反映ACI患者颈动脉粥样硬化稳定性。     

急性脑梗死与高敏C反应蛋白水平及颈动脉斑块性质关系的研究

目的探讨急性脑梗死与高敏C反应蛋白（hs-CRP）、颈动脉斑块性质的关系。方法观察组为急性脑梗死患者75例,对照组选同期在我院体检的健康人群60例。采用彩色多普勒超声检测2组患者的颈动脉内膜斑块性质,根据检查结果将急性脑梗死患者分为无斑块、稳定斑块和不稳定斑块进行比较。应用散射比浊法测定血清hS-CRP浓度。结果急性脑梗死组颈动脉内膜斑块明显多于对照组（P〈0.01）;脑梗死组hs-CRP水平显着高于对照组;脑梗死患者不稳定斑块、稳定斑块、无斑块间hs-CRP含量分别为：（9.85±2.56）mg/L、（8.75±2.43）mg/L及（6.87±1.86）mg/L,差异均有统计学意义（P〈0.05）。结论颈动脉斑块不稳定性和hs-CRP水平的升高与进展性脑卒中的发生密切相关。     

脑梗死患者同型半胱氨酸水平与颈动脉粥样硬化的相关性

目的:探讨血清同型半胱氨酸(homocysteine,Hcy)水平与脑梗死患者颈动脉粥样硬化的相关性。方法:选择脑梗死患者132例设为观察组,36例无心脑血管疾病的健康体检者设为健康对照组。采用循环酶法检测所有受试者血清Hcy水平,采用多普勒彩色超声检查所有患者颈动脉内膜中层厚度(intima-media thickness,IMT),并根据结果将观察组患者分为IMT正常组、IMT轻度狭窄组和IMT中重度狭窄组。比较观察组与健康对照组以及观察组各组间Hcy水平的差异,及Hcy水平与IMT的相关性。结果:观察组的Hcy水平高于健康对照组(P<0.01)。颈动脉粥样硬化患者(IMT轻+中重狭窄组)Hcy增高发生率(78.79%,104/132)显著高于IMT正常组(P<0.01)。Hcy水平为IMT中重度狭窄组>IMT轻度狭窄组>IMT正常组(P<0.01,P<0.05)。Pearson相关性分析表明,Hcy水平与IMT值呈正相关(r=0.863,P=0.000)。结论:脑梗死患者Hcy水平与颈动脉粥样硬化程度呈正相关,提示高Hcy与颈动脉粥样硬化发生发展密切相关,有助于脑梗死早期预防、干预治疗和判断预后。     

同型半胱氨酸和超敏C反应蛋白检测对糖尿病合并脑梗死预后价值评价

目的 探讨同型半胱氨酸(Hcy)与超敏C反应蛋白(hs-CRP)在糖尿病合并脑梗死发生发展中的作用.方法 脑梗死患者126例,其中合并糖尿病66例(糖尿病脑梗组)未合并糖尿病60例(非糖尿病脑梗组),检测两组患者血浆Hcy和hs-CRP表达水平.结果 糖尿病脑梗组血浆Hcy及hs-CRP水平分别为(24.65±4.19)μmol/L(19.18±4.53)mg/L,均明显高于非糖尿病脑梗组的(16.10±3.67)μmol/L及(11.05±3.37)mg/L(P均＜0.05).重型糖尿病脑梗死患者血浆Hcy和hs-CRP水平明显高于轻型、中型组(P＜0.05);糖尿病脑梗组患者血浆Hcy与hs-CRP水平呈直线正相关(P＜0.05).结论 糖尿病合并脑梗死患者血浆Hcy与hs-CRP高表达,可作为指导治疗及判断预后指标.     

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.