帕金森病模型小鼠黑质纹状体系统氧化应激的增龄性改变

目的：观察不同月龄小鼠帕金森病（PD）模型黑质纹状体系统氧化应激损伤的增龄性改变并检测老龄PD小鼠氧化应激相关基因的差异性表达。方法选用健康雌性3、6、10月龄快速老化小鼠P8系（SAMP8）42只，各月龄小鼠随机平均分为 MPTP 组与对照组，分别给予背部皮下急性注射1-甲基-4-苯基-1，2，3，6-四氢吡啶（MPTP）及等量0．9％NaCl处理。给药后72 h，采用开放旷场实验观察其运动功能，高效液相色谱法检测黑质DA含量，分光光度计法检测纹状体超氧化物歧化酶（SOD1）活性和丙二醛（MDA）含量，比较不同月龄小鼠黑质DA系统、纹状体氧化应激相关指标损伤的差异。采用PCR Array检测两组10月龄小鼠纹状体氧化应激相关基因表达的差异。结果与对照组相比，MPTP组各月龄小鼠水平运动距离与站立次数均减少，DA水平、SOD活性明显下降，MDA含量明显增加（P＜0．05）；与3、6月龄相比，10月龄小鼠上述指标变化更明显；与对照组相比，10月龄MPTP组小鼠环氧化酶-2表达明显上调，而谷胱甘肽过氧化物酶3、6、8，乳酸过氧化物酶、核氧化还原酶、肌红蛋白、神经珠蛋白酶、过氧化物还原酶1和嗜酸粒细胞过氧化物酶9种基因明显下调（倍数改变＞2）。结论月龄是影响PD模型黑质纹状体系统损伤的重要因素；与氧化应激相关的基因的上调或下调可能参与了PD的早期发病。     

JNK通路对亚急性帕金森病MPTP模型小鼠黑质COX-2表达的影响

目的:研究JNK在1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)所致小鼠帕金森病(PD)模型中对环氧合酶-2(COX-2)的表达调控作用,以探讨可能导致PD黑质多巴胺(DA)能神经元变性失活的机制. 方法:采用MPTP制备亚急性PD小鼠模型,观察模型小鼠行为学变化,观察PD模型小鼠黑质区酪氨酸羟化酶(TH),COX-2,磷酸化c-Jun的表达变化;观察给予JNK通路特异性抑制剂SP600125对上述变化的影响. 结果:与对照组小鼠相比,模型组小鼠出现典型PD症状,在MPTP第3次注射后6 h,黑质区COX-2阳性细胞显著增加,p-c-Jun特异性表达于黑质区细胞核内,在MPTP第5次注射后7 d,黑质区TH阳性神经元显著丢失65% (P＜0.01);经SP600125处理后,模型小鼠PD症状减轻,与对照组比较,在MPTP第5次注射后7 d,TH阳性细胞数仅下降约15%,与模型组比较,在MPTP第3次注射后6 h,黑质区COX-2阳性细胞明显减少(P＜0.01),黑质区p-c-Jun表达于细胞质内. 结论:JNK通路在亚急性PD MPTP模型早期对黑质COX-2表达中可能起重要调控作用;抑制JNK通路对PD小鼠具有神经保护作用.     

老龄帕金森病模型小鼠氧化应激相关基因的表达差异

目的：探讨老龄帕金森病( PD)模型小鼠行为学改变及黑质纹状体系统氧化应激相关基因的表达差异。方法10月龄快速老化P8系( SAMP8)小鼠16只,随机均分为对照组和模型组。模型组小鼠背部皮下注射1-甲基-4-苯基-1,2,3,6-四氢吡啶( MPTP)制成急性损伤模型,对照组小鼠给予同量生理盐水。给药后72 h进行行为学测试,高效液相色谱法检测黑质多巴胺( DA)含量,PCR Array检测其纹状体氧化应激相关基因的表达。结果与对照组相比,模型组小鼠DA水平下降,行为学成绩下降,差异有统计学意义( P<0．01);环氧化酶-2、可诱导型一氧化氮合酶2、还原型烟酰胺腺嘌呤二核苷酸磷酸( NADPH)氧化酶基因表达上调;而谷胱甘肽过氧化物酶3、6、8等9种基因明显下调(改变倍数>2)。结论老龄PD模型小鼠氧化应激相关的基因发生上调或下调,导致氧化应激反应的发生。     

人参皂甙Rg1通过P38信号通路影响帕金森病MPTP模型小鼠黑质COX-2的表达

目的 研究P38信号通路在1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)所致小鼠帕金森病(PD)模型中对环氧合酶-2(COX-2)的表达调控作用,以探讨导致多巴胺(DA)能神经元变性失活的可能机制,以及人参皂甙Rg1对P38信号通路的影响和对多巴胺神经元的保护作用.方法 采用MPTP制备亚急性PD小鼠模型.用免疫组织化学和免疫蛋白印记法,观察小鼠黑质酪氨酸羟化酶(TH),COX-2,前列腺素E2(PGE2)以及磷酸化P38(p-P38)的表达变化;并观察给予人参皂甙Rg1对上述变化的影响.结果 与对照组小鼠相比,模型组小鼠出现典型PD症状,在MPTP第3次注射后6 h,黑质区p-P38,COX-2,PGE2阳性细胞显著增加(P＜0.01).在MPTP第5次注射后24 h,黑质区TH阳性神经元显著丢失60%(P＜0.01);经人参皂甙Rg1处理后,模型小鼠PD症状减轻,与模型组比较,在MPTP第3次注射后6 h,黑质区p-P38,COX-2,PGE2阳性细胞明显减少(P＜0.01),在MPTP第5次注射后24 h,TH阳性细胞数较对照组仅下降30%.结论 P38通路在亚急性PD模型早期对黑质COX-2表达可能起重要调控作用:人参皂甙Rg1可影响P38信号通路及COX-2的表达而对小鼠多巴胺神经元起到一定保护作用.     

不同帕金森病模型小鼠空间参考记忆及脑内多巴胺水平的比较研究

目的 比较1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)所致的急性、亚急性和慢性帕金森病(PD)模型小鼠空间参考记忆和脑内多巴胺(DA)水平的差异.方法 用相同的MPTP使用总量不同的注射间隔分别制作急性、亚急性和慢性PD小鼠模型.Morris水迷宫检测小鼠空间参考记忆,高效液相(HPLC)检测纹状体、海马和前额叶皮层的DA含量,免疫组化染色检测黑质酪氨酸羟化酶(TH)阳性神经元数量.结果 慢性PD小鼠的逃避潜伏期较对照组有明显延长(P＜0.05),而急性和亚急性PD小鼠则无明显变化.3组实验组纹状体DA含量[(1180.1±293.0)ng/ml,(1177.4±450.5)ng/ml,(1149.6±353.0)ng/ml]均较对照组[(225.6±79.7)ng/ml,(273.6±64.9)ng/ml,(327.1±126.2)ng/ml]有显著减少(P＜0.01),急性PD小鼠前额叶皮层DA含量[(65.3±23.9)ng/ml]较对照组[(41.2±18.8)ng/ml]有显著减少(P＜0.05),3组实验组海马DA含量无明显变化.3组实验组黑质TH阳性神经元数量均较对照组有显著减少(P＜0.05).结论 3种PD模型小鼠空间参考记忆差异可能不是由其脑内DA水平差异所致.     

磷酸化c-Jun表达对亚急性帕金森病MPTP模型小鼠黑质COX-2表达的影响

目的 研究磷酸化c-Jun(p-c-Jun)在1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)所致亚急性帕金森病(PD)小鼠模型中对环氧合酶-2(COX-2)的表达调控作用,以探讨PD黑质多巴胺(DA)能神经元变性失活的可能机制.方法 采用MPTP制备亚急性PD小鼠模型.通过行为学观察,免疫组织化学SP法,免疫荧光双标记法和免疫蛋白印记法,观察模型小鼠行为学变化,观察PD模型小鼠黑质区酪氨酸羟化酶(TH)、COX-2和p-c-Jun免疫组织化学变化以及中脑黑质TH、COX-2和p-c-Jun表达水平的变化;观察给予JNK通路特异性剂SP-600125对上述变化的影响.结果 与对照组小鼠相比,模型组小鼠出现典型PD症状.黑质区TH阳性神经元下降约65%(P＜0.001),中脑黑质TH表达水平显著降低约75%;黑质区COX-2阳性细胞显著增加,中脑黑质COX-2表达水平明显升高;p-c-Jun特异性表达于黑质区细胞核内,p-c-Jun表达水平显著升高.免疫荧光双标记染色可见,COX-2和p-c-Jun共同表达于TH阳性细胞.抑制剂组,经SP600125处理后,模型小鼠PD症状减轻,与对照组比较,在MPTP第5次注射后七天,TH阳性细胞数和TH表达水平仅下降约15%和20%,与模型组比较,黑质区COX-2阳性细胞明显减少,中脑黑质COX-2表达水平明显降低,p-c-Jun仅表达于黑质区细胞的胞浆内,中脑黑质p-c-Jun表达水平明显下降.结论 p-c-Jun表达对亚急性帕金森病MPTP模型中脑黑质COX-2表达中可能起重要调控作用;抑制p-c-Jun表达对帕金森病小鼠可能具有一定的神经保护作用.     

选择性环氧化酶-2抑制剂对MPTP致帕金森病模型小鼠多巴胺能神经元保护作用的研究

目的 探讨选择性环氧化酶-2(COX-2)抑制剂塞来昔布对1-甲基4-苯基-1,2,3,6-四氢吡啶(1-methy-4-phenyl-1,2,3,6-tetra-hydropyridine,MPTP)致帕金森病小鼠黑质多巴胺(dopamine,DA)能神经元变性的保护作用及其可能机制.方法 30只健康雄性C57BL6小鼠随机分成3组:PBS对照组、生理盐水治疗组(生理盐水+MPTP)和塞来昔布治疗组(塞来昔布+MPTP),每组各10只.采用免疫组织化学法观察大鼠黑质酪氨酸羟化酶(TH)阳性细胞的减少,免疫印迹法检测黑质COX-2蛋白表达.结果 与PBS对照组比较,生理盐水治疗组TH阳性细胞明显减少(P＜0.05),黑质COX-2蛋白表达明显增加,塞来昔布治疗组TH阳性细胞数较生理盐水治疗组明显增多(P＜0.05),黑质COX-2蛋白表达含量明显减少.结论 COX-2的表达与PD模型小鼠黑质内DA能神经元的丢失有关,塞来昔布可能对PD模型小鼠黑质内DA能神经元有保护作用.     

肌苷对帕金森病小鼠模型的神经保护作用

目的: 观察肌苷对MPTP致帕金森病(PD)小鼠模型的神经保护作用.方法: 用MPTP建立C57BL小鼠PD模型,在MPTP前给予肌苷,通过行为学检测(自主活动计数、Rotarod检测、游泳实验)、免疫组织化学和荧光分光光度法,观察肌苷对PD小鼠模型的行为学表现、黑质多巴胺(DA)神经元和纹状体酪氨酸羟化酶免疫反应阳性(TH-ir)神经纤维以及纹状体DA水平的影响.结果: 给予MPTP后,小鼠行为学计数降低,自主活动计数、Rotarod检测、游泳实验分别降低约45%、43%和22%,黑质DA神经元数目减少约58%,纹状体TH-ir神经纤维密度减低,纹状体DA水平明显降低约88%,提前给予肌苷后降低程度减轻,自主活动计数、Rotarod检测、游泳实验降低程度分别约为5%、11%和12%,黑质DA神经元数目减少约43%,纹状体DA水平降低约71%,两组相比有显著性差异(P＜0.01).结论: 肌苷对MPTP所致的C57BL小鼠的神经损伤具有保护作用.     

ERK1／2信号通路对亚急性帕金森病MPTP模型小鼠黑质COX-2，PGE2表达的影响

目的：研究ERK1/2信号通路对1-甲基-4-苯基-1,2,3,6-四氢吡啶（MPTP）所致帕金森病（PD）小鼠模型中脑黑质环氧合酶-2（COX-2）和前列腺素E2（PGE2）的表达调控作用,探讨多巴胺（DA）能神经元变性失活的可能机制.方法：采用MPTP制备亚急性PD小鼠模型,应用免疫组织化学和免疫蛋白印记法观察小鼠黑质酪氨酸羟化酶（TH）,COX-2,PGE2以及磷酸化ERK1/2（p-ERK1/2）的表达变化;并观察给予ERK特异性抑制剂U0126对上述因子变化的影响.结果：模型组小鼠出现典型PD样症状,在MPTP第3次注射后1h,黑质区p-ERK1/2阳性细胞数明显增加,在MPTP第5次注射后24h,黑质区出现大量COX-2,PGE2阳性细胞,伴有约50%的TH阳性神经元丢失;给予ERK特异性抑制剂U0126后小鼠PD样症状减轻,p-ERK1/2,COX-2,PGE2阳性细胞数明显减少,MPTP第5次注射后24h,TH阳性细胞数较对照组仅下降25%.结论：ERK1/2通路可能参与调控COX-2及PGE2的表达而在PD发病过程中发挥重要作用,抑制ERK信号通路对帕金森病小鼠具有一定的神经保护作用.     

染料木黄酮对帕金森病模型小鼠多巴胺能神经元的保护作用

目的 探讨染料木黄酮对1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)制备的帕金森病(PD)模型小鼠多巴胺能神经元的保护作用.方法 将C57BL6雄性小鼠随机分为正常对照组、MPTP模型组及染料木黄酮预处理组.用逆转录-聚合酶链式反应(RT-PCR)技术检测黑质酪氨酸羟化酶(TH)及多巴胺转运体(DAT) 基因的表达水平.应用高效液相色谱法检测纹状体(Str)内DA及其代谢物二羟基苯乙酸(DOPAC)含量.结果 MPTP模型组黑质TH和DAT基因的表达较正常对照组明显降低,染料木黄酮预处理组可逆转上述改变(F=20.31、13.19,P<0.01).MPTP模型组Str内DA及其代谢产物DOPAC的含量较对照组明显减少,应用染料木黄酮后可逆转上述改变(F=63.58、16.12,P<0.01).结论 染料木黄酮对MPTP制备的PD模型小鼠黑质纹状体DA能神经元有明显的保护作用.     

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.