贲门癌组织端粒酶活性和端粒酶RNA表达的检测

目的 :检测贲门癌组织中端粒酶 (Telomerase)活性和端粒酶RNA (hTR)的表达 ,探讨其在贲门癌发生发展中的作用。方法 :采用TRAP -ELISA法、原位杂交的方法对 4 6例贲门癌、配对癌旁及 30例手术残断正常黏膜中端粒酶活性和hTR的表达进行检测。结果 :4 6例贲门癌、癌旁及 30例正常黏膜组织中端粒酶阳性率和hTR表达率分别为 91.30 %和 82 .6 1% ;39.13%和 4 3.4 8% ;16 .6 7%和 13.33%。癌组织与癌旁及正常黏膜组织相比端粒酶阳性率及hTR表达率差异有统计学意义 (P <0 .0 1)。端粒酶平均吸光值癌组织为 1.89± 0 .4 1,癌旁及正常黏膜组织分别为 1.4 9± 0 .4 3,0 .5 4± 0 .4 5 ;hTR平均阳性细胞面积癌组织为 0 .31± 0 .10 ,癌旁及正常黏膜组织分别为 0 .2 0± 0 .13和 0 .0 6± 0 .11,2指标癌组织与癌旁及正常黏膜组织相比差异有统计学意义 (P <0 .0 5 )。结论 :端粒酶活性表达及hTR的表达与贲门癌的发生密切相关。原位杂交是检测端粒酶活性更为简单的方法     

结直肠腺瘤及癌组织中缺氧诱导因子-1a的表达

目的 :探讨缺氧诱导因子 1α(HIF 1α)的表达与结直肠癌发生发展的关系。方法 :用免疫组化SABC法检测 2 7例结直肠正常黏膜、1 3例腺瘤和 6 1例癌组织中HIF 1α的表达 ,并探讨HIF 1α与结直肠癌患者的年龄、性别、肿瘤浸润等的关系。结果 :正常结直肠黏膜组织中HIF 1α无表达 ;腺瘤组织中阳性表达率为 1 5 .4 % (2 / 1 3) ,且均为弱阳性表达 ,2组HIF 1α阳性表达率差异无统计学意义 (P >0 .0 5 )。癌组织中HIF 1α阳性表达率为 6 5 .6 % (4 0 /6 1 ) ,其中弱阳性、阳性及强阳性表达率分别为 2 7.9%、1 9.7%、1 8.0 % ,癌组织中阳性表达率显著高于正常粘膜和腺瘤组织 (P <0 .0 1 )。HIF 1α表达与肿瘤浸润深度、淋巴结转移 (P <0 .0 5 )和Dukes分期密切相关 (rs=0 .5 5 4 ,P <0 .0 1 ) ,而与患者年龄、性别及肿瘤部位、大小、组织病理学类型无关 (P >0 .0 5 )。结论 :HIF 1α过表达可能是结直肠癌发生的晚期事件 ,与结直肠癌的浸润、转移密切相关     

结直肠癌端粒酶活性检测及其对预后判断的意义

目的 探讨端粒酶活化与结直肠癌临床病理特点之间的关系及对预后的意义.方法 采用TRAP-ELISA法检测64例结直肠癌及相应癌旁组织、30例正常黏膜端粒酶活性并随访.结果 结直肠癌组织端粒酶活性表达为93.8%(60/64)、较癌旁组织15.6%(10/64)、正常黏膜0(0/30)明显增高(P＜0.01).64例癌组织端粒酶活性,中度18例,占28.1%;高度28例,占43.8%.与病理组织学分级、漫润深度、临床分期、有元淋巴结和远处转移无明显相关(P＞0.05).高活性者5年生存率为50.0%(14/28),中度以下及无活性者为77.8%(28/36),高活性者明显降低(P＜0.01).结论 端粒酶可以作为结直肠癌早期诊断的标志物,其活性上调是结直肠癌患者预后不良的一个独立因素.     

罗非昔布对大鼠结肠肿瘤细胞外信号调节蛋白激酶表达的影响

目的　研究选择性COX 2抑制剂罗非昔布对大鼠结肠肿瘤的防治作用及对肿瘤组织细胞外信号调节蛋白激酶(ERK/pERK)表达的影响。方法　利用二甲肼(DMH)诱导Wister大鼠结直肠肿瘤发生;用5mg/kg罗非昔布给大鼠灌胃,观察药物对大鼠结直肠肿瘤的预防和治疗作用及对肿瘤组织ERK/pERK表达的影响。结果　DMH能诱发大鼠结直肠腺瘤及腺癌,2 2周末,罗非昔布预防组腺瘤发生率为5 0 %,对照组腺瘤发生率为10 0 %;罗非昔布预防组及对照组大鼠平均每只腺瘤数分别为1 . 66±0 . 5 7与2 83±1 16,二者有显著差异(P <0 . 0 5 )。2 4周末,罗非昔布预防组腺癌发生率为5 0 %,对照组发生率为83 . 3 %;预防组及对照组腺癌分别为1 . 3 3±0 . 5 8与2 . 40±0 . 89,二者有显著差异(P <0 . 0 5 )。大鼠结直肠肿瘤组织pERK水平较正常结肠组织明显升高,腺瘤和腺癌组织pERK的表达无明显差异;罗非昔布作用组pERK表达明显下调。结论　罗非昔布不仅能预防化学致癌剂诱发大鼠结直肠腺瘤发生,还能减少腺癌发生;这种作用可能部分通过抑制结直肠肿瘤pERK表达实现。     

结直肠黏膜光镜下炎症表现及NF-κB、COX-2的表达与结直肠肿瘤发病的相关性研究

目的了解结直肠癌、腺瘤患者结直肠黏膜是否存在慢性炎症状态,并通过检测炎症因子NF-κB、COX-2的表达,了解炎症与结直肠肿瘤发病的关系。方法根据结肠镜检查及病理结果分三组:(1)结直肠癌组31例;(2)结直肠腺瘤组29例;(3)正常对照组18例。取肿瘤组织及距肿瘤5cm处正常黏膜,对照组取正常黏膜组织制作标本切片,显微镜下比较各组组织淋巴细胞浸润程度及腺体形态变化情况;采用免疫组化方法比较炎症因子NF-κB、COX-2的表达水平。结果(1)淋巴细胞浸润程度根据严重程度分为四级,1～4级在结直肠癌旁黏膜中分别占6.5%、29%、51.6%、12.9%,在腺瘤旁黏膜中分别为31%、41.3%、27.6%、0%,在正常黏膜中分别为66.7%、16.7%、16.7%、0%,癌旁黏膜、腺瘤旁黏膜淋巴细胞浸润程度均显著高于正常结肠黏膜(P&lt;0.001,P&lt;0.05)。(2)结直肠癌旁黏膜腺体变异率(61.3%)显著高于正常结肠黏膜组织(27.8%)(P&lt;0.05),腺瘤旁黏膜腺体变异率(44.8%)与正常结肠黏膜无明显差异(P=0.37)。(3)依表达程度由(-)至(+++)四级计算,NF-κB的表达率在结直肠癌组织中...     

大肠癌端粒酶活性的意义及其与人端粒酶催化亚基表达的相关性

目的 :研究大肠癌组织中端粒酶活性在大肠癌发生发展中的作用及其与人端粒酶催化亚基 (h TERT)表达的相关性。方法 :运用 PCR- TRAP- EL ISA及免疫组织化学方法 (免疫组化法 )对 30例大肠癌及相应的癌旁组织、正常大肠组织及 2 0例大肠腺瘤性息肉组织中端粒酶活性和 h TERT表达进行检测。结果 :1端粒酶在大肠癌组织中的阳性表达明显高于癌旁组织、正常大肠黏膜及大肠腺瘤性息肉 (P<0 .0 5 ) ;2大肠癌组织端粒酶与淋巴结转移关系密切 ,伴淋巴结转移大肠癌端粒酶阳性表达率明显高于无淋巴结转移者 (P <0 .0 1 ) ;3相关分析显示端粒酶活性与 h TERT表达存在相关性 (P <0 .0 5 )。结论 :端粒酶在大肠癌的发生发展过程中可能起着重要作用 ,h TERT的表达与端粒酶活性密切相关     

PTEN在结直肠癌中的表达及其临床意义

目的　观察肿瘤抑制基因 PTEN蛋白在结直肠良、恶性组织中的表达水平 ,探讨 PTEN表达与结直肠癌发生、增殖、分化、转移等的相关性及其在结直肠癌诊断、治疗和判断预后的应用价值。　方法　采用免疫组织化学 SP法定性、半定量检测 /分析 110例结直肠癌组织、13例癌旁粘膜组织、17例结肠腺瘤组织、8例正常结肠粘膜组织的 PTEN的表达情况。　结果　 (1)结直肠癌、癌旁粘膜、结肠腺瘤、正常结肠粘膜 PTEN蛋白阳性表达率分别为 5 9.1% ,76 .9% ,76 .4 % ,10 0 %。结肠癌阳性表达率明显低于非癌组 ,P<0 .0 1。良性结肠粘膜组织 PTEN蛋白表达水平高于恶性结肠粘膜组织 (rs= - 0 .2 39,P<0 .0 5 )。 (2 )结直肠癌组中 PTEN蛋白的阳性检出率与患者性别、年龄、癌肿部位无关 (P>0 .0 5 )。 (3)PTEN表达水平与癌组织浸润深度呈负相关 (rs=- 0 .2 82 ,P<0 .0 5 )。 PTEN表达水平随淋巴结转移、癌远处转移呈逐渐下降趋势 (P<0 .0 5 )。 (4 ) PTEN表达水平与结直肠癌TNM分期 (rs=- 0 .4 70 ,P <0 .0 5 )、 Dukes'分期 (rs=- 0 .5 0 0 ,P<0 .0 5 )呈负相关 ,与病理组织分化呈正相关 (rs=- 0 .4 12 ,P相似文献   

survivin在结直肠癌中表达及与临床病理特征的关系

目的:检测survivin在结直肠癌及正常结肠黏膜中的表达,为研究结直肠癌浸润转移及可能的预后因素提供理论依据。方法:应用流式细胞术和S-P免疫组织化学检测100例结直肠癌及11例癌旁正常黏膜中survivin的表达情况,并结合临床病理相关因素进行分析。结果:FCM检测发现,高、中、低分化及粘液癌组survivin表达平均FI值分别为3.16±1.39、3.20±1.04、3.32±0.48和3.31±1.06,均显著高于正常结直肠黏膜(P<0.01)。结直肠癌淋巴结转移组平均FI值为3.11±1.19,显著高于无淋巴结转移组(2.26±1.38,P<0.05)。survivin的表达与结直肠癌患者的年龄、性别、肿瘤的发生部位以及分化程度无明显相关(P>0.05)。免疫组化染色结果显示,结直肠癌中survivin的阳性表达率为68.00%,而结直肠正常黏膜无survivin阳性表达(P<0.05);有淋巴结转移的结直肠癌组织survivin阳性表达率显著高于无淋巴结转移组(87.50%vs 50.00%,P<0.05)。结论:survivin在结直肠癌中表达异常增高,显著高于正常结直肠黏膜。survivin在结直肠癌中的表达与淋巴结转移密切相关。     

卵巢恶性肿瘤细胞端粒酶表达和hTERT基因，c—myc基因的调控

目的　研究端粒 (TL M)在卵巢恶性肿瘤中的表达和相互关系。　方法　 (1)采用 PCR- EL ISA半定量方法研究端粒酶活性在卵巢恶性肿瘤、癌旁组织、交界性肿瘤、良性肿瘤、正常卵巢及卵巢肿瘤细胞株的表达情况。(2 )采用 RT- PCR方法检测人端粒酶逆转录酶 (h TERT)基因 m RNA和 c- myc基因m RNA在上述标本中的表达情况 ,分析端粒酶活性、h TERT基因、c- myc基因间的关系。(3)用顺铂对卵巢肿瘤细胞株 HO-8910、COC1 进行处理 ,同步检测 h TERT和 c- myc基因 m R-NA、端粒酶活性表达情况 ,分析 h TERT和 c- myc基因 m R-NA水平改变与端粒酶活性的相互影响。　结果　 (1)卵巢良性肿瘤组织与正常卵巢端粒酶活性差别无显著性 (P>0 .0 5 ) ,正常卵巢端粒酶活性 0 .2 2为上限 (0 .2 13± 0 .0 70 ,可信区间97.5 % ) ,恶性卵巢肿瘤组织端粒酶活性表达率 91.30 % ,明显高于交界性卵巢肿瘤组织 2 0 .0 0 % (P<0 .0 1)、良性卵巢肿瘤组织 7.13% (P<0 .0 1)和正常卵巢 0 (P<0 .0 1)。交界性卵巢肿瘤组织端粒酶活性表达率与后两者差异具有显著性 (P<0 .0 1)。端粒酶活性值在恶性卵巢肿瘤组织表达中临床分期 、 期明显高于 、 期 (P<0 .0 5 ) ,分化程度低者高于分化高者 (P<0 .0 5 ) ,恶性卵巢肿瘤组织端粒酶活性明显高     

eIF4E和cyclinD1在结直肠癌中的表达和临床意义

目的探讨eIF4E和cyclinD1蛋白表达在结直肠癌的发生发展中的临床意义。方法用EnVision二步法检测80例原发性结直肠癌、30例结直肠腺瘤和20例正常结直肠黏膜eIF4E和cyclinD1蛋白表达。结果①eIF4E蛋白在结直肠黏膜、腺瘤和腺癌组中的阳性率分别为10.0%,83.3%,92.5%,腺癌组和腺瘤组阳性率均高于黏膜组(P<0.01)。eIF4E蛋白在结直肠癌中的表达与肿瘤浸润深度、淋巴结转移、TNM分期和5年生存有显著相关性(P<0.05);②cyclinD1蛋白在结直肠黏膜、腺瘤和腺癌组中的阳性率分别为0、46.7%,55.0%,腺癌组和腺瘤组阳性率均高于黏膜组(P<0.01)。cyclinD1蛋白在结直肠癌中的表达与组织学分级(P<0.05)、淋巴结转移和TNM分期(P<0.01)有显著相关性;③结直肠癌组织中eIF4E与cyclinD1蛋白表达呈正相关(r=0.914,P<0.01)。结论①eIF4E蛋白表达上调可发生结直肠癌发展的全过程,提示eIF4E在结直肠癌的发生发展中起重要作用。eIF4E蛋白高表达的结直肠癌大多浸润深、淋巴结转移较多,患者预后较差,eIF4E可作为临床上结直肠癌的预后评价指标;②结直肠癌中eIF4E与cyclinD1蛋白表达呈正相关,提示两者存在协同关系。     

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.