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1.
目的:研究黄芩苷对糖尿病肾病小鼠肾脏的保护作用及机制。方法:构建糖尿病肾病(DN)小鼠模型并用黄芩苷进行干预。ELISA法检测小鼠尿白蛋白。qRT-PCR和Western Blot检测miR-141、Sirt1/Nrf2,HO-1的表达。化学比色法检测细胞中SOD水平,流式细胞检验检测细胞凋亡水平。结果:黄芩苷下调DN小鼠肾组织中miR-141表达,上调Sirt1和Nrf2表达。过表达Sirt1慢病毒注射DN小鼠后,尿白蛋白排泄率明显减少,肾组织中HO-1的表达明显上调。肾小球系膜细胞系转染miR-141 inhibitor后,Sirt1/Nrf2信号激活,SOD水平上升,细胞凋亡减少;而si-Sitrt1能逆转miR-141 inhibitor的作用。此外,过表达miR-141能逆转黄芩苷对Sirt1和Nrf2表达、SOD水平和细胞凋亡的作用,而过表达Sirt1能进一步逆转过表达miR-141对细胞的作用。结论:黄芩苷通过抑制miR-141激活Sirt1/Nrf2信号改善小鼠糖尿病肾病。  相似文献   

2.
【立论依据】 观察左归降糖益肾方对2型糖尿病肾病(DN)小鼠血糖、血肌酐、尿素氮、尿微量白蛋白及Rho、ROCK蛋白表达的影响研究左归降糖益肾方对2型糖尿病肾病小鼠的肾脏保护作用及基于Rho/ROCK信号通路改善足细胞损伤的影响。 【设计思路】 MKR转基因2型糖尿病小鼠给予高脂饮食联合右侧肾切除建立糖尿病肾病模型。观察左归降糖益肾方对DN小鼠血糖、肾功能及Rho、ROCK蛋白表达等的影响研究其是否具有保护DN肾脏的作用及是否通过抑制Rho/ROCK信号通路改善足细胞损伤。 【实验内容】 8周龄MKR小鼠50只随机分为5组,空白组(A组)、DN组(B组)、DN+左归降糖益肾方组(C组)、DN+Rho/ROCK信号通路抑制剂Y-27632组(D组)、DN+糖适平+贝那普利组(E组)。B、C、D、E组给予高脂饮食联合右侧肾切除造模。手术后2周开始给药。C组小鼠给予中药提取液灌胃治疗30 d。D组小鼠给予Y-27632腹腔注射15 d(隔天注射)。E组给予糖适平+贝那普利灌胃治疗30 d。A、B组则以等体积蒸馏水灌胃。30 d后处死小鼠。电化学法检测小鼠空腹血糖,全自动生化仪检测尿素氮、血肌酐,ELISA法测定尿微量白蛋白,免疫组化及蛋白质印迹法测定肾脏组织Rho、ROCK蛋白表达,光镜观察肾小球形态结构,电镜观观察足细胞形态结构。 【材料】 MKR小鼠、左归降糖益肾方、贝那普利、糖适平、Y-27632、高脂饲料等。 【可行性】 课题组前期研究表明高脂饮食联合右侧肾切除的MKR转基因2型糖尿病小鼠是良好的糖尿病肾病模型;左归降糖益肾方具有改善糖尿病肾病的作用。国内外研究中均表明抑制Rho/ROCK信号通路具有保护糖尿病肾脏的作用。故本实验基于Rho/ROCK信号通路研究左归降糖益肾方对糖尿病肾病的作用机制具有可行性。 【创新性】 (1)MKR转基因2型糖尿病小鼠给予高脂饮食联合右侧肾切除建立糖尿病肾病模型。(2)近年来研究发现Rho/ROCK信号通路在糖尿病肾病发生发展过程中起重要作用。本实验基于Rho/ROCK信号通路探讨左归降糖益肾方对糖尿病肾病足细胞损伤的影响。  相似文献   

3.
目的 探讨硫化氢(hydrogen sulfide,H2S)与糖尿病肾病(diabetic nephropathy,DN)大鼠肾细胞外基质过度积聚的关系。方法 21只SD大鼠随机分成正常对照组(对照组)、糖尿病肾病组(DN组)、硫化氢干预组(DN+H2S组)。链脲佐菌素(STZ)法建立糖尿病大鼠模型,DN+H2S组给予NaHS治疗8周,其他组给予同等剂量的0.9%生理盐水治疗。观察3组大鼠肾脏病理改变、BrdU阳性细胞和α平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)分布差异。结果 与对照组比较,DN组大鼠尿蛋白量、相对肾重均明显增多,病理呈典型的DN改变,BrdU阳性细胞比值、肾小球α-SMA表达和分布显著增多(P<0.01);应用NaHS治疗后,大鼠肾脏DN改变明显减轻(P<0.01),BrdU阳性细胞比值、肾小球α-SMA表达和分布与正常对照组比较,差异无统计学意义(P>0.05)。结论 H2S可以抑制DN大鼠肌性成纤维细胞增殖,减少α-SMA表达和分布,减缓DN大鼠的肾小球细胞外基质积聚。  相似文献   

4.
目的 探讨2型糖尿病患者血尿酸(SUA)水平与糖尿病肾病(DN)的相关性及糖尿病肾病发生的危险因素。方法 选取2012~2015年合肥市第二人民医院内分泌科2型糖尿病患者273例,根据尿清蛋白/肌酐(uACR)分为单纯糖尿病组(n=171),早期糖尿病肾病组(n=62)和临床糖尿病肾病组(n=40)。所有受试者分别检测空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、SUA等生化指标,并结合临床资料进行分析。结果 随DN进展,糖尿病病程、HbA1c、收缩压(SBP)、SUA呈增加趋势(P均 < 0.05),临床DN组和早期DN组患者年龄、舒张压(DBP)、FBG、2 h PG大于单纯糖尿病组(P均 < 0.05),临床DN组TG、TC、VLDL-C大于早期DN组和单纯糖尿病组(P均 < 0.05)。回归分析显示,糖尿病病程、SBP、HbA1c、SUA是DN发生的独立危险因素。结论 SUA是糖尿病肾病发生的独立危险因素,在糖尿病肾病的临床治疗中除了降糖、降压之外,有效地降低血尿酸水平也是治疗的一个重要环节。  相似文献   

5.
目的 探讨多巴胺D5受体是否会通过抑制氧化应激来影响扩张型心肌病(dilated cardiomyopathy)的发生发展。方法 建立心脏特异表达人多巴胺D5受体突变基因F173L(α-MHC-hD5F173L)和正常基因(α-MHC-hD5WT)转基因小鼠。用3月龄小鼠, 首先检测比较转基因小鼠心脏内ROS的产量和NOX2的表达量。然后对α-MHC-hD5F173L小鼠通过皮下给NADPH氧化酶的抑制剂罗布麻宁(Apocynin)4周, 同时给PBS作为对照组, 然后检测各项心肌病相关指标。同时构建人多巴胺D5受体突变基因(hD5F173L)和正常多巴胺D5受体基因(hD5WT)的大鼠心肌细胞(H9C2), 检测两者在基础条件下ROS产量的变化。结果 α-MHC-hD5F173L转基因小鼠的NADPH氧化酶的活性和NOX2蛋白的表达量均明显高于野生型α-MHC-hD5WT 小鼠, 罗布麻宁能显著改善α-MHC-hD5F173L转基因小鼠的心脏功能。H9C2-hD5F173L大鼠细胞系NOX2的表达量及ROS产量高于H9C2- hD5WT对照细胞。结论 多巴胺D5受体可能通过抑制氧化应激而防止扩张型心肌病的发生发展。  相似文献   

6.
目的 基于p38丝裂原活化蛋白激酶(MAPK)信号通路,探讨富马酸二甲酯对肾草酸钙结石大鼠肾功能及氧化应激的影响及其作用机制。方法 将30只SPF级SD雄性大鼠随机分为对照组、模型组、富马酸二甲酯组,每组10只。其中模型组、富马酸二甲酯组大鼠腹腔注射0.25% L-羟脯氨酸2.5 kg/(kg·d)复制肾草酸钙结石大鼠模型。富马酸二甲酯组大鼠腹腔注射富马酸二甲酯25 mg/(kg·d),连续28 d,对照组、模型组同时腹腔注射等量生理盐水。采用全自动生化分析仪检测大鼠尿蛋白、尿钙,以及血肌酐水平;HE染色检测大鼠肾组织草酸钙晶体形成情况;试剂盒检测血清超氧化物歧化酶(SOD)活性、丙二醛(MDA)及活性氧簇(ROS)水平;Western bloting检测大鼠肾组织p38 MAPK通路蛋白相对表达量。结果 与对照组比较,模型组和富马酸二甲酯组大鼠肾组织SOD活性降低,草酸钙晶体含量、尿蛋白、尿钙、血肌酐及肾组织MDA、ROS水平,p-JNK、p-p38蛋白相对表达量升高(P <0.05);但富马酸二甲酯组大鼠SOD活性高于模型组(P <0.05),肾组织草酸钙晶体含量、尿蛋白、尿钙、血肌酐,肾组织MDA、ROS水平,p-JNK、p-p38蛋白相对表达量低于模型组(P <0.05)。结论 富马酸二甲酯可能通过抑制p38 MAPK通路活化,抑制肾脏组织氧化应激反应,从而抑制肾草酸钙结石形成,进而保护肾功能。  相似文献   

7.
目的:探讨杵针治疗糖尿病周围神经病变对Kelch样ECH相关蛋白1(Keap1)/核因子相关因子2(Nrf2)/抗氧化反应元件(ARE)通路及氧化应激的影响。方法:将符合纳入标准的60例糖尿病周围神经病变患者随机分到对照组和杵针组,各30例。对照组给予常规治疗,杵针组在对照组的基础上加以杵针疗法,每周5次,共干预4周。两组治疗前后用比色法检查血清超氧化物歧化酶(superoxide dismutase,SOD)和谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)含量;酶联免疫吸附剂测定血清Nrf2信号通路相关因子表达水平;RT-PCR法测Keap1、Nrf2 mRNA表达。结果:与对照组比较,杵针组治疗后血清SOD、GSH-px水平明显升高,Keap1表达量减少,Nrf2表达量增加,Keap1 mRNA表达显著降低,Nrf2mRNA表达显著增加。结论:杵针可能通过调控Keap1/Nrf2/ARE信号通路使其下游抗氧化酶SOD和GSH-Px的产生增多,增强了机体抗氧化能力,从而保护和修复糖尿病周围神经病变患者受损的周围神经。  相似文献   

8.
目的:研究姬松茸酸性多糖A级分(ABP-A)对D-半乳糖(D-Gal)所致衰老模型小鼠的抗衰老作用,并探讨姬松茸多糖(ABP)的抗衰老机制。方法:水提醇沉法提取姬松茸粗多糖,并进行DEAE-纤维素离子交换柱层析分级及成分分析,得到ABP-A。48只ICR雄性小鼠随机分为对照组、模型组、阳性药物(吡拉西坦)组和ABP-A组,每组12只。给药70 d后进行小鼠Morris水迷宫、避暗和跳台行为学实验;检测各组小鼠血清中超氧化物歧化酶(SOD)活性、丙二醛(MDA)水平、总抗氧化能力(T-AOC)、过氧化氢酶(CAT)活性和活性氧(ROS)水平,Western blotting法检测各组小鼠脑组织中Nrf2、Keap1和HO-1蛋白表达水平。结果:ABP的总糖含量为75.1%,DEAE-纤维素离子交换柱层析分级得到ABP-A。行为学实验,与模型组比较,ABP-A组小鼠避暗潜伏期明显延长(P<0.05),错误次数明显减少(P<0.05),跳台潜伏期明显延长(P<0.05),错误次数明显减少(P<0.05),定位航行潜伏期明显缩短(P<0.05),进入平台次数明显增加(P<0.05)。生化指标检测,与模型组比较,ABP-A组小鼠血清中SOD和CAT活性升高(P<0.05),T-AOC升高(P<0.05),MDA和ROS水平降低(P<0.05)。Western blotting法,与模型组比较,ABP-A组小鼠脑组织中HO-1蛋白表达水平升高(P<0.05),Nrf2和Keap1蛋白表达水平降低(P<0.05或P<0.01)。结论:ABP可改善衰老模型小鼠学习记忆能力,其机制可能与调节以Nrf2为核心的Keap1/Nrf2/ARE氧化应激通路相关因子Nrf2、Keap1和HO-1发挥抗衰老作用有关。  相似文献   

9.
目的:观察冬虫夏草对糖尿病(DM)大鼠肾小管损伤的影响,基于抗氧化及抗衰老探讨冬虫夏草延缓糖尿病肾病进展的作用机制。方法:链脲佐菌素(STZ)诱导糖尿病肾病(DN)大鼠模型,与非DN大鼠一起随机分为四组:对照组、冬虫夏草组、DN组、DN+冬虫夏草组。饲养24周后检测肾脏GPx、SOD、MDA、ROS及Klotho mRNA蛋白表达水平,并检测血肌酐(Scr)、尿素氮(BUN)、24 h尿白蛋白、尿白蛋白肌酐比(UACR)、肌酐清除率(Ccr)。结果:DN组大鼠肾功能明显降低,肾脏氧化应激水平增加,肾小管Klotho mRNA及蛋白表达下降。经冬虫夏草治疗后肾功能明显改善;ROS和MDA水平降低,SOD及GPx水平增加;肾小管Klotho表达上调。结论:冬虫夏草可延缓DN进展,其机制可能与其在肾小管间质发挥的抗氧化及抗衰老作用有关。  相似文献   

10.
目的 探讨2型糖尿病患者尼克酰胺腺嘌呤二核苷酸磷酸氧化酶(NOX)的变化与肾功能及尿清蛋白排泄率(UAER)的关系,并分析比较氧化应激指标与糖尿病肾脏损害程度的相关性.方法 将100例2型糖尿病患者,排除感染应激和急慢性代谢紊乱,其中,50例为无肾病糖尿病组,另50例患者为糖尿病性慢性肾脏疾病(DKD)组,健康对照组50例.测定2组患者空腹血糖、肾小球功能、血和尿肌酐水平,以及血中糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、NOX、8-羟基脱氧鸟苷(8-OHdG)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平.同时留取所有受试者3次不同时间清洁尿液检测尿清蛋白与尿肌酐比值,计算UAER.结果 无肾病糖尿病组体内NOX、8-OHdG、MDA明显高于健康对照组,SOD明显低于健康对照组;而DKD患者NOX、8-OHdG UAER明显高于无肾病糖尿病组,Logistic回归分析显示NOX与DKD更为紧密(OR=1.199,P<0.01).结论 与3个氧化应激指标8-OHdG、MDA、SOD相比,NOX更能确切地反映2型糖尿病肾病患者体内的氧化应激水平,即NOX是反映氧化应激水平与2型糖尿病肾脏损害相关的更为理想的指标.  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
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.  相似文献   

15.
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.  相似文献   

16.
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.  相似文献   

17.
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.  相似文献   

18.
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.  相似文献   

19.
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.  相似文献   

20.
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.  相似文献   

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