18F-FDG PET-CT与乳腺癌新辅助化疗疗效中的关联性分析

目的 本研究旨在探讨¹⁸F-FDG PET-CT与乳腺癌新辅助化疗疗效的关联性。方法 2014年1月~2015年12月,收集笔者医院收治的行新辅助化疗的乳腺癌患者98例。前瞻性分析¹⁸F-FDG PET-CT与乳腺癌新辅助化疗疗效的关联性。结果 与病理无效组相比,病理有效组患者SUV_max0显著增加（9.54±3.11 vs 6.12±3.21,P=0.015）;SUV_max1变化率显著增加（53%±17% vs 29%±11%,P=0.000）;SUV_max2变化率显著增加（61%±21% vs 34%±12%,P=0.000）。与未pCR组相比,pCR组患者SUV_max0显著增加（10.54±4.11 vs 5.87±2.21,P=0.000）;SUV_max1变化率显著增加（57%±17% vs 28%±10%,P=0.000）;SUV_max2变化率显著增加（64%±23% vs 33%±11%,P=0.000）。结论 ¹⁸F-FDG PET-CT可作为评价乳腺癌新辅助化疗效果的一种影像学方式,值得临床进一步推广。     

胸腺五肽对新辅助化疗的乳腺癌患者局部组织中浸润淋巴细胞的影响

目的 探讨胸腺五肽对新辅助化疗的乳腺癌组织微环境中浸润淋巴细胞的影响。方法 自2012年1月~2014年1月,前瞻性收集笔者医院收治的接受新辅助化疗的乳腺癌患者80例,将患者随机分为研究组和对照组,所有患者均行新辅助化疗,研究组在新辅助化疗期间给予胸腺五肽,化疗结束后进行手术切除肿瘤组织,留取乳腺癌组织标本,观察乳腺癌组织中和外周血中CD4⁺T细胞、CD8⁺T细胞、CD4⁺/CD8⁺T细胞比例、外周血中IL-6、IL-10、TGF-β1水平。结果 与对照组比较,研究组患者乳腺癌组织中CD4⁺T细胞显著降低（21.47%±3.29% vs 23.88%±3.43%,P=0.002）;CD8⁺T细胞显著增高（30.36%±4.38% vs 28.43%±4.16%,P=0.047）;CD4⁺/CD8⁺T细胞显著降低（0.71±0.14 vs 0.84±0.18,P=0.001）。两组患者治疗前外周血CD4⁺T细胞、CD4⁺/CD8⁺T细胞、IL-6、IL-10、TGF-β1等比较,差异均无统计学意义（P>0.05）。与对照组比较,研究组患者术后外周血CD4⁺T细胞水平显著增加（27.67%±4.24% vs 25.09%±3.68%,P=0.005）;CD4⁺/CD8⁺T显著增加（0.83±0.14 vs 0.75±0.18,P=0.029）;IL-6水平显著增高（12.39±2.87 vs 9.24±3.38ng/L,P=0.000）;IL-10水平显著降低（8.49±2.59 vs 12.59±3.65ng/L,P=0.006）;TGF-β1水平显著降低（12.47±3.88 vs 17.76±4.12ng/ml,P=0.000）。两组患者住院时间、切口感染、手术部位出血、复发率和病死率等比较,差异均无统计学意义（P > 0.05）。结论 胸腺五肽联合新辅助化疗可能有助于改善乳腺癌组织微环境中免疫状态和全身免疫功能。     

肺功能及血清炎性因子与老年高血压合并冠状动脉疾病的关系

目的 探讨肺功能及血清炎性因子与老年高血压合并冠状动脉疾病的关系。方法 选择152例患高血压疾病的患者,根据是否合并冠状动脉疾病,将患者分为合并冠状动脉疾病组和非合并冠状动脉疾病组,合并冠状动脉疾病组84例,非合并冠状动脉疾病组68例。结果 对比两组的一般资料,发现高血压合并冠状动脉疾病组患者与非合并冠状动脉疾病组患者的年龄（75.23±7.49岁vs 71.42±8.21岁）、甘油三酯（1.59±0.41mmol/L vs 1.41±0.63mmol/L）、血肌酐（82.42±39.27μmol/L vs 70.39±25.76μmol/L）、血尿素氮（7.85±4.31mmol/L vs 6.12±2.49mmol/L）、IL-2（567.32pg/dl±191.53pg/dl vs 501.26±217.74）、IL-6（3.95±2.92pg/dl vs 3.04±2.61pg/dl）和CRP （1.75±1.84mg/dl vs 1.04±2.01mg/dl）相比较高,而FEV₁%（83.42%±24.57% vs 92.15%±19.38%）和FEV₁/FVC （62.91±13.65 vs 70.24±9.42）更低,差异均有统计学意义（P<0.05）;对差异有统计学意义的相关因素进行线性回归分析发现,FEV₁%（P=0.005）、FEV₁/FVC （P=0.003）、IL-2（P=0.012）和CRP （P=0.009）差异更明显,为高血压合并冠状动脉疾病的独立相关因素;对高血压患者的血清炎性因子IL-2、CRP与肺功能指标FEV₁%和FEV₁/FVC进行相关性分析发现,血清炎性因子IL-2与肺功能指标FEV₁%（r=-0.391,P=0.000）和FEV₁/FVC （r=-0.571,P=0.000）呈负相关,CRP也与肺功能指标FEV₁%（r=-0.437,P=0.000）和FEV₁/FVC （r=-0.559,P=0.000）呈负相关。结论 肺功能及血清炎性因子是老年高血压合并冠状动脉疾病的危险因素。     

帕金森病患者异动症临床特征及与GRIN2B基因多态性的关联性分析

目的 探讨帕金森病患者异动症临床特征及与GRIN2B基因多态性的关联性。方法 自2012年1月~2015年12月,前瞻性收集帕金森患者178例,根据患者是否合并异动症,将患者分为异动症组和对照组,主要观察指标为GRIN2B基因的多态性,次要观察指标为两组患者的主要临床特征。结果 与对照组相比,异动症组患者发病年龄显著降低（46.34±12.32岁vs 54.45±11.35岁,P=0.000）;病程显著延长（8.94±3.21年vs 7.34±2.48年,P=0.000）;服药时间显著延长（69.435±19.43月vs 59.65±11.46月,P=0.000）;左旋多巴剂量显著增高（577.34±248.54mg/d vs 475.87±290.43mg/d,P=0.000）;H-Y分期评分显著增加（3.43±1.19 vs 2.14±0.89,P=0.015）。两组患者临床分型和性别等差异无统计学意义（P=0.596）。GRIN2B基因遗传多态性位点共出现rs34315573、rs7301328、rs1805522、rs1806201、rs1806191和rs1805246共6个多态位点。与对照组相比,异动症组患者rs34315573基因型和rs1806191基因型分布差异有统计学意义（P<0.05）。两组患者rs7301328基因型、rs1805522基因型、rs1806201基因型和rs1805246基因型分布差异无统计学意义（P>0.05）。结论 帕金森病患者异动症发病具有年轻化、病程长、服药时间长、H-Y评分增加等特点,并与GRIN2B基因多态性相关。     

子宫肌瘤腹腔镜剥除术中止血药物效果分析

目的 探讨垂体后叶素与缩宫素在腹腔镜下肌壁间子宫肌瘤剥除术的临床效果。方法 选取2015年10月~2016年12月行腹腔镜下子宫肌瘤剥除术的患者60例,分成两组各30例。治疗组注射6IU垂体后叶素+10ml生理盐水,对照组注射20U缩宫素+10ml生理盐水,按照两组的用药情况,观察比较血压变化和其他情况。结果 治疗组与对照组比较,手术时间明显减少（98.13±5.07min vs 110.83±8.03min,t=-7.324,P=0.000）,术中出血量明显减少（67.50±10.24ml vs 97.83±16.10ml,t=-8.705,P=0.000）,血红蛋白术前术后变化（9.67±2.09g/L vs 11.53±2.21g/L,t=-3.362,P=0.001）。术中用药后15min,治疗组收缩压上升,显著高于对照组（150.77±5.57mmHg vs 142.03±5.21mmHg,t=6.273,P=0.000）。结论 腹腔镜下肌壁间子宫肌瘤剥除术应用垂体后叶素止血效果明显优于缩宫素,但会引起短暂性血压升高,临床使用应结合患者病情个性化选择。     

可注射型生物玻璃在口腔骨缺损填充修复中的应用效果

目的 研究可注射型生物玻璃在口腔骨缺损填充修复中的应用价值。方法 2013年9月至2014年9月连续选择58例口腔骨缺损大于1 mm患者,随机分为对照组26例和试验组32例,其中对照组应用羟基磷灰石生物陶瓷,试验组应用可注射型生物玻璃,对比愈合情况。结果 术后6个月和12个月X线检查,试验组骨愈合情况优于对照组,差异有统计学意义（6个月：53.1% vs 26.9%,χ²=4.060,P=0.044;12个月：78.1% vs 46.2%,χ²=6.348,P=0.012）;局部排斥反应发生率差异无统计学意义（6.3% vs 11.5%,χ²=0.059,P=0.808）。术后6个月和个12月锥形束CT（CBCT）检查,试验组平均骨厚度小于对照组,差异有统计学意义[6个月：（2.9±0.2）mm vs（3.4±0.3）mm,t=4.724,P=0.036;12个月：（1.6±0.2）mm vs（2.3±0.2）mm,t=5.123,P=0.027]。试验组的血清骨形态发生蛋白-2（BMP-2）和转化生长因子-β（TGF-β）水平均高于对照组,差异均有统计学意义[BMP-2：（65.3±14.5）pg/mL vs（32.8±9.6）pg/mL,t=5.623,P=0.023;TGF-β：（102.3±35.7）μg/L vs（72.6±26.8）μg/L,t=6.237,P=0.014]。结论 可注射型生物玻璃在口腔骨缺损填充修复中效果优于羟基磷灰石生物陶瓷,有较大的应用价值。     

线粒体DNA3243A>G突变糖尿病外周血单个核细胞生物力学变化特征

目的 探索线粒体DNA3243A>G （mt.3243A>G）突变糖尿病患者和正常对照外周血单个核细胞（PBMC）表面形貌和力学性能差异。方法 采集5例mt.3243A>G突变糖尿病患者和5例年龄、性别匹配的正常对照外周血2ml,然后利用聚蔗糖-泛影葡胺（Ficoll-hypaque）密度梯度离心法分离出PBMC。应用原子力显微镜（AFM）对突变患者和正常对照的PBMC进行表面形貌和力学性能测量。结果 运用AFM测量和分析发现,在表面形貌方面,mt.3243A>G突变糖尿病患者的PBMC高度（0.73±0.24μm vs 2.49±1.17μm,P=0.011）低于正常对照组;但其表面粗糙度（Ra：161.8±33.2nm vs 66.4±16.3nm,P=0.000;Rq：202.2±40.9nm vs 85.4±17.1nm,P=0.000）高于正常对照组。在力学性能方面,mt.3243A>G突变糖尿病患者PBMC黏附力约比正常对照组高3倍（779.6±190.0pN vs 161.1±83.1pN,P=0.000）。与正常对照组相比,mt.3243A>G突变糖尿病患者PBMC杨氏模量（138.3±77.2kPa vs 421.4±140.0kPa,P<0.01）显著增加,病变细胞表面硬度增加。结论 本研究利用AFM从单细胞水平上揭示了mt.3243A>G突变糖尿病患者PBMC的表面形貌和力学性能变化,有助于加深对该疾病病理生理机制的理解。     

心脏磁共振心功能指标评估肺动脉高压患者预后的价值

目的探讨心脏磁共振（CMR）成像指标与肺动脉高压（PH）患者预后的关系。方法纳入我院经右心导管插入确诊并行CMR检查的PH患者90例,分析其CMR图像并计算心功能指标：右心室和左心室舒张末期容积指数（EDVI）、收缩末期容积指数（ESVI）、每搏输出量指数（SVI）、射血分数（EF）,以及右房室瓣环收缩期位移（TAPSE）。随访终点为发生主要心血管不良事件（MACE）。采用两独立样本t检验对发生MACE患者（MACE组）与未发生MACE患者（non-MACE组）的CMR指标进行比较。采用Cox比例风险回归模型分析终点事件的独立预测因素,根据受试者工作特征（ROC）曲线获得的最佳截断值绘制Kaplan-Meier生存曲线。结果与non-MACE组相比,MACE组患者右心室EF、左心室SVI、TAPSE均降低[（27.00±9.92）% vs（32.68±11.34）%、（29.14±8.73）mL/m² vs（35.41±11.59）mL/m²、（12.51±4.17）mm vs（16.04±7.37）mm],右心室EDVI和ESVI均升高[（139.72±48.70）mL/m² vs（116.07±44.79）mL/m²、（104.26±42.88）mL/m² vs（79.37±35.67）mL/m²],差异均有统计学意义（t=－2.065、－2.286、－2.089、2.076、2.668,P均<0.05）。多因素分析结果显示,左心室SVI、TAPSE是PH患者发生MACE的独立预测因素[风险比（HR）=0.942、0.904,P=0.039、0.022]。ROC曲线确定的左心室SVI、TAPSE的最佳截断值分别为30.27 mL/m²、15.65 mm,Kaplan-Meier生存分析结果示当LVSVI≤30.27 mL/m²、TAPSE≤15.65 mm时MACE发生率增加（P=0.001、0.019）。结论发生MACE的PH患者左心、右心功能均较差,TAPSE、左心室SVI可作为PH患者发生MACE的独立预测因素。     

急性阑尾炎病理分型与血小板参数的相关性

目的 探讨血小板参数PLT、PDW、MPV与急性阑尾炎（AA）病情进展程度的相关性。方法 选取2017年1月至2019年7月在蚌埠市第三人民医院接受阑尾切除术的116例AA患者作为研究对象,所有患者术前均行PLT、PDW、MPV检查,术后均将切除的标本送病理检查。根据病理检查结果,将患者分为单纯性阑尾炎组（41例）与复杂性阑尾炎组（75例）,评估PLT、PDW、MPV与AA病情进展的相关性。结果 单纯性阑尾炎组患者PDW为（13.37±3.00）%、MPV为（11.42±1.27）fL、PLT为（220.96±58.79）×10⁹/L,与复杂性阑尾炎组相比,差异均有统计学意义（P<0.05）。PLT和MPV、PDW均呈负相关（r=-0.499,P=0.000;r=-0.464,P=0.000）,MPV和PDW则呈正相关（r=0.933,P=0.000）。结论 PLT、PDW、MPV与AA病理类型及病情严重程度有一定关联,可作为AA临床诊断参考。     

临床护理路径在小儿腹泻护理中的应用效果

目的 探讨临床护理路径在小儿腹泻护理中的应用效果。方法 选取2015年4月至2015年12月阜阳市第二人民医院住院的108例腹泻患儿,随机分为两组,观察组（54例）和对照组（54例）。观察组实施临床护理路径,对照组给予常规的护理。结果 观察组止泻时间、住院时间较对照组短[（3.32±1.03）d vs（4.12±1.06）d,（5.42±1.06）d vs（6.13±1.08）d],差异有统计学意义（t=3.9775,P < 0.001;t=3.4478,P < 0.001）;观察组住院费用低于对照组[（3 014.98±752.97）元vs（3438.12±671.33）元],差异有统计学意义（t=3.0824,P < 0.05）;观察组复发率及满意度均优于对照组,差异有统计学意义（P < 0.05）。结论 将临床护理路径应用于小儿腹泻护理过程中,能改善护理质量,具有良好的临床护理效果。     

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.