盲肠结扎穿孔脓毒症大鼠心肌损伤的相关研究

【摘要】目的 通过盲肠结扎穿孔脓毒症大鼠心肌细胞凋亡率的变化,探讨心肌细胞凋亡与心肌损伤的关系。方法 将40只健康雄性Wistar大鼠随机分为假手术组（SH组,n=20）及脓毒症组（CLP组,n=20）,采用盲肠结扎穿孔法(CLP)制备脓毒症动物模型,24小时后,检测各组的血清脑钠肽(BNP)、肌钙蛋白I(cTnI)水平。观察心肌组织病理变化、心肌组织TNF-α的表达水平及心肌细胞凋亡率。结果 CLP组出现明显的心肌损伤,CLP组血清BNP、cTnI高于SH组（P＜0.01）,心肌组织TNF α、心肌细胞凋亡率高于SH组（P＜0.01）。结论 心肌细胞凋亡在脓毒症心肌损伤发病机制中可能起着重要的作用。     

胡芦巴碱对缺氧／复氧乳鼠心肌细胞的保护作用

目的：探究胡芦巴碱（T RG ）对缺氧／复氧乳鼠心肌细胞的保护作用及其机制。方法原代培养SD乳鼠心肌细胞,随机分成3组：正常对照（Control组）、缺氧／复氧组（H／R组）和TRG加缺氧／复氧组（TRG＋ H／R组）;采用流式细胞术分别检测TRG对缺氧／复氧乳鼠心肌细胞凋亡和线粒体膜电位的影响;采用超氧化物歧化酶（SOD）和丙二醛（MDA）试剂盒检测SOD活性和MDA水平,蛋白免疫印迹法（Western blot）检测procaspase‐9、cleaved caspase‐9、procaspase‐3和cleaved caspase‐3蛋白水平。结果 TRG能够显著降低缺氧／复氧乳鼠心肌细胞凋亡率（P＜0．05）,增强SOD活性（P＜0．05）,减少MDA的生成（P＜0．05）,稳定线粒体膜电位（ P＜0．05）,促进caspase‐9和caspase‐3的活化。结论 T RG可减轻缺氧／复氧对乳鼠心肌细胞的损伤,其机制可能与抗脂质过氧化和稳定线粒体膜电位有关。     

谷氨酰胺对脓毒症大鼠心肌B细胞淋巴瘤/白血病-2及p53表达的影响

目的 探讨谷氨酰胺对脓毒症大鼠心肌B细胞淋巴瘤/白血病-2 (Bcl-2)及p53表达的影响.方法 选取无特定病原体级健康成年大鼠42只,雌雄各半,随机分为3组:假手术组6只,手术组18只,谷氨酰胺组18只,采用盲肠结扎穿孔法制备脓毒症模型.手术组和谷氨酰胺组大鼠于6、12、24h 3个时相点各取6只大鼠心脏标本,每个时相点包含6只手术组大鼠和6只谷氨酰胺组大鼠.原位末端转移酶标记技术检测各时相点大鼠心肌凋亡指数,逆转录聚合酶链式反应法检测各时相点大鼠心肌Bcl-2及p53 mRNA的表达.结果 手术组术后6、12、24h的心肌细胞Bcl-2表达较假手术组明显下调,p53 mRNA的表达较假手术组明显上调(均P＜0.05).谷氨酰胺组术后6、12、24 h的心肌细胞Bcl-2mRNA表达较手术组明显上调,p53 mRNA的表达较手术组明显下调(均P＜0.05).手术组各时相点心肌细胞凋亡率明显高于假手术组,谷氨酰胺组心肌细胞凋亡率明显低于手术组(均P ＜0.05).结论 脓毒症大鼠心肌细胞凋亡明显增高,谷氨酰胺可以通过影响Bcl-2及p53的表达来显著抑制脓毒症大鼠心肌细胞的凋亡.     

NLRP3对病毒感染心肌细胞凋亡及炎症反应的作用

【摘要】目的 探讨核苷酸结合寡聚化结构域样受体蛋白3（NLRP3）对病毒感染的心肌细胞炎症及凋亡的影响。方法 分离培养SD乳鼠心肌细胞,采用基因沉默的方法敲减NLRP3基因的表达,然后随机分为4组,分别包括正常对照组、Scrambled siRNA组、CVB3+Scrambled siRNA组、CVB3+NLRP3 siRNA组。ELISA检测心肌损伤标志物CK MB、cTnI及IL 1β、IL 18等炎症因子水平,RT qPCR、Western blot检测NLRP3炎性小体通路的激活情况以及细胞内外源凋亡途径caspase 8、Bcl 2、Bax、caspase 9、caspase 3等的水平。结果 与正常对照组相比,CVB3+Scrambled siRNA组中NLRP3通路被激活,其下游的caspase 1被活化,IL 1β、IL 18表达增加（P＜005）,caspase 8、caspase 3、caspase 9活化增强,Bcl 2蛋白表达降低,Bax蛋白表达增高,Bax/Bcl 2比值增大（P＜005）,心肌细胞凋亡及CK MB、cTnI均增加（P＜005）。敲减NLRP3基因表达后,与CVB3+Scrambled siRNA组比较, caspase 1活性被抑制,IL 1β、IL 18表达降低（P＜005）,caspase 3、caspase 9活性降低,Bcl 2下降程度减弱,Bax/Bcl 2比值降低（P＜005）,但对caspase 8、Bax的蛋白表达无明显影响（P＞005）。结论 NLRP3信号通路在病毒感染早期导致心肌细胞损伤过程中起重要作用,抑制NLRP3过度激活会减轻心肌细胞炎症损伤及细胞凋亡,可能是治疗病毒性心肌炎的潜在靶点。     

黄芪甲苷对大鼠脓毒症肝损伤疗效及对TNF-α、IL-6的影响

【目的】研究黄芪甲苷对 SD大鼠脓毒症致肝损伤的保护作用。【方法】采用盲肠结扎穿孔（Cecal ligation and puncture ,CLP）诱导形成脓毒症大鼠肝损伤模型,黄芪甲苷分别于大鼠 CLP术前1 h灌胃给药。30只SD大鼠随机分为三组,分别为假手术组、CLP模型组、CLP＋黄芪甲苷（50 mg／kg）治疗组。记录一般情况并检测CLP术后24 h各组大鼠的存活率,血清中谷丙转氨酶（ALT）、谷草转氨酶（AST）水平及各组大鼠肝脏组织中TNF‐α、IL‐6水平及其 HE染色的病理变化情况。【结果】各时间点假手术组大鼠均无死亡。术后12 h ,模型组、黄芪甲苷组大鼠存活率分别为80％和100％,术后24 h ,模型组大鼠无存活,而黄芪甲苷组大鼠存活率为40％,经比较有显著性差异（χ2＝8．4,P＜0．05）,显示黄芪甲苷能提高实验性脓毒症大鼠的存活率;术后24 h ,大鼠血清AST、ALT值脓毒症模型组较假手术组显著升高（ P ＜0．05）,黄芪甲苷治疗组则明显改善（ P ＜0．05）;脓毒症模型组较假手术组肝组织 TNF‐α、IL‐6值显著升高（ P ＜0．05）,黄芪甲苷治疗组则明显改善（ P＜0．05）;病理切片显示假手术组大鼠肝脏结构轻微改变,脓毒症模型组肝组织点灶状坏死、混合炎细胞浸润、肝细胞脂肪变性,黄芪甲苷治疗组肝脏组织病理损伤情况均较模型组明显改善。【结论】黄芪甲苷对CLP诱导的SD大鼠肝损伤具有一定的保护作用。     

氧化苦参碱对脓毒症大鼠心肌细胞凋亡的影响

目的 探讨氧化苦参碱（OMT）对脓毒症大鼠心肌细胞凋亡的影响.方法 采用盲肠结扎穿孔（CLP）法复制大鼠脓毒症动物模型.造模后将48只SD大鼠分为6组,即CON（假手术）组、OMT对照组、CLP（模型）组、CLP＋ OMT（52、26、13mg·kg-1）剂量组.采用BL-420生物机能实验设备检测大鼠心功能改变,TUNEL法检测心肌细胞凋亡指数（AI）,放射免疫分析法测定心肌组织匀浆中肿瘤坏死因子-a（TNFa）蛋白含量的改变.结果 不同剂量的OMT能明显降低脓毒症大鼠的HR、左室舒张末压（LVEDP）,升高平均动脉压（MAP）、LVSP、±LVdp/dtmax（P＜0.05）,降低心肌组织匀浆中TNF-a蛋白含量（P＜0.05）及心肌细胞凋亡指数（P＜0.05）.结论 OMT（52、26、13mg·kg-1）能减轻脓毒症导致的大鼠心肌细胞凋亡现象,对抗由心肌细胞凋亡引起的心功能损伤.     

雌激素对异丙肾上腺素诱导的大鼠心肌损伤及心肌细胞凋亡的影响

目的：通过建立大鼠双侧卵巢切除及异丙肾上腺素诱导的心肌损伤模型,研究雌激素对异丙肾上腺素致大鼠心肌损伤及心肌细胞凋亡的影响。方法50只雌性 SD大鼠行双侧卵巢切除术和假手术后分为5组（每组10只）：假手术组（Sham组）;双侧卵巢切除组（OVX组）;心肌损伤组（OVX＋ISO＋Vehi组）,雌激素4μg· kg－1· d－1治疗组（OVX＋ISO＋E2 a组）,雌激素40μg·kg－1·d－1治疗组（OVX＋ISO＋E2 b组）。分别测量大鼠大体指标,颈总动脉置管监测心脏血流动力学参数,分离培养单个心肌细胞观察形态与收缩功能改变,以及蛋白免疫印迹法检测心肌细胞凋亡蛋白的表达。结果异丙肾上腺素明显降低心肌功能,增加心肌细胞肥大与凋亡,降低单个心肌细胞收缩功能（P＜0．05）。高剂量雌激素（40μg·kg－1·d－1）替代治疗显著改善异丙肾上腺素引起的心肌损伤与心肌功能下降（P＜0．05）,并通过增加 Bcl-2蛋白表达,减少 Bax蛋白表达与 Caspase-3的激活,降低心肌细胞肥大与凋亡（P＜0．05）。而低剂量雌激素（4μg·kg－1·d－1）只表现出轻度抗异丙肾上腺素心肌损伤的作用,但差异无统计学意义（P＞0．05）。结论适宜剂量的雌激素替代治疗通过降低心肌细胞凋亡,提高心肌细胞收缩功能,从而对异丙肾上腺素诱导的心肌损伤发挥保护作用。     

羟基积雪草苷对大鼠缺血再灌注心肌细胞凋亡影响的实验研究

目的：研究羟基积雪草苷（ AC）对在体大鼠心肌缺血再灌注损伤的保护作用,初步探讨其机制。方法：24只雄性SD大鼠,随机分为假手术组（ SH组）、心肌缺血再灌注模型组（ IR组）、羟基积雪草苷治疗组（ AC组）,每组8只。 AC组在冠状动脉左室支结扎60分钟前以6mg／100g体重的剂量静脉滴注羟基积雪草苷15分钟,其它2组同时点静脉滴注等剂量生理盐水。除SH组外,其它2组结扎冠状动脉左室支,使心肌缺血30分钟,再灌注60分钟。用7020全自动生化分析仪检测血清中乳酸脱氢酶（ LDH）、肌酸激酶（ CK）活性;TUNEL法检测各组大鼠缺血心肌细胞凋亡;RT－PCR法检测凋亡基因Bcl－2和Bax的mRNA表达。结果：与IR组比,羟基积雪草苷能降低血清中LDH、CK活性（P＜0．05）;降低心肌细胞凋亡指数（P＜0．05）;羟基积雪草苷组凋亡基因Bcl－2表达水平上升（P＜0．05）,Bax表达水平下降（P＜0．05）,Bcl－2／Bax比值升高（P＜0．05）。结论：羟基积雪草苷预处理能通过减少心肌细胞凋亡、抗脂质过氧化物产生等机制,对心肌缺血再灌注损伤产生保护作用。     

抑制线粒体动力相关蛋白1通过PI3K/AKT通路对糖尿病大鼠七氟醚后处理心肌细胞凋亡的影响

【摘要】目的 探究抑制线粒体动力相关蛋白1（Drp1）通过磷脂酰肌醇激酶3（PI3K）/蛋白激酶B（AKT）通路对糖尿病（DM）大鼠七氟醚（Sev）后处理心肌细胞凋亡的影响和机制。方法 60只雄性SD大鼠分为假手术（Sham）、缺血/再灌注（I/R）、I/R+DM、I/R+DM+Sev、I/R+DM+Sev+Mdivi 1、I/R+DM+Mdivi 1组,每组10只。通过腹腔〖JP2〗注射链脲佐菌素建立大鼠DM模型,通过结扎左冠脉前降支建立心肌I/R模型,在缺血后吸入Sev或腹腔注射Drp1的抑制剂Mdivi 1。〖JP〗比较各组的梗死体积、心肌组织损伤情况、心肌细胞凋亡水平以及PI3K/AKT通路水平。 结果 I/R 组的cTnI、CK MB、凋亡指数水平显著高于Sham组,PI3K、AKT水平显著低于Sham组（P＜005）。I/R+DM 组的cTnI、CK MB、凋亡指数水平显著高于I/R组,PI3K、AKT水平显著低于I/R组（P＜005）。I/R+DM+Sev组和I/R+DM+Mdivi 1组的cTnI、CK MB、凋亡指数水平显著低于I/R+DM组,PI3K、AKT水平显著高于I/R组（P＜005）。I/R+DM+Sev+Mdivi 1组的cTnI、CK MB、凋亡指数水平显著低于I/R+DM+Sev组和I/R+DM+Mdivi 1组,PI3K、AKT水平显著高于I/R+DM+Sev组和I/R+DM+Mdivi 1组（P＜005）。 结论 抑制Drp1可以通过促进PI3K/Akt通路抑制DM大鼠心肌I/R模型的心肌细胞凋亡,从而促进Sev对DM大鼠心肌I/R损伤的保护作用。     

心肌细胞凋亡对老年大鼠心脏功能的影响

目的 观察心肌细胞凋亡在老年大鼠心功能降低中的作用. 方法 将大鼠分为成年组（n=10）、老年组（n=10）以及广谱的caspase抑制剂Z-VAD-FMK组（n=10）.MS2000生物信号记录分析系统记录各组大鼠的心脏功能,用TUNEL和caspase-3活性检测各组大鼠的凋亡情况;并分析老年大鼠凋亡与心功能的关系. 结果 与成年大鼠相比,老年大鼠的心重/体重比显著下降,心肌收缩及舒张功能均明显降低,老年大鼠心肌细胞的凋亡明显增加.并且,caspase-3的水平与心肌收缩指数呈负相关（r=-0.772,P＜0.01）,与左室舒张压呈正相关（r=0.718,P＜0.01）.阻断老年大鼠心肌的凋亡后,心肌的收缩和舒张功能明显改善. 结论 心肌细胞凋亡在老年大鼠心功能下降中发挥着重要作用,提示临床可以通过抗凋亡措施来减少心肌细胞丢失进而延缓心功能的下降.     

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.