负荷量氯吡格雷对脓毒症血小板聚集和急性肺损伤影响的实验研究

目的：观察负荷量氯吡格雷对脂多糖诱导的脓毒症大鼠血小板聚集和肺组织炎症损伤的影响。方法36只雄性Wistar大鼠随机分为对照组、脓毒症组、氯吡格雷组,每组12只。对照组大鼠腹腔注射生理盐水10 mg/kg;脓毒症组大鼠予腹腔注射脂多糖建立脓毒症/急性肺损伤（ALI）模型;氯吡格雷组大鼠在腹腔注射脂多糖后立即给予氯吡格雷800 mg/kg灌胃,建模后3 h,取血测量动脉血氧分压（PaO2）,计算氧合指数（PaO2/FiO2）,运用全血电阻法测定血小板聚集率,用酶联免疫分析法测量血及肺组织中肿瘤坏死因子-α（ TNF-α）浓度,取肺组织HE染色观察肺组织病理,并计算肺湿/干重比值（ W/D比值）。结果脓毒症组、氯吡格雷组PaO2、PaO2/FiO2均低于对照组（P＜0．05）;但氯吡格雷组PaO2、PaO2/FiO2均明显高于脓毒症组（P＜0．05）。脓毒症组、氯吡格雷组大鼠肺湿/干重比值、血清及肺组织TNF-α均高于对照组（P均＜0．05）,但氯吡格雷组上述指标均明显低于脓毒症组（P均＜0．05）。氯吡格雷组血小板聚集率明显低于另外两组（P＜0．05）。脓毒症组大鼠肺组织可见明显炎症损伤,氯吡格雷组肺组织炎性损伤程度明显减少。结论负荷量氯吡格雷可迅速抑制脓毒症大鼠急性肺损伤血小板的活化和聚集,并减轻肺组织炎症损伤。     

双联抗血小板药物对大鼠小肠的损伤及其机制

目的:探讨双联抗血小板药物对大鼠小肠的损伤及其机制.方法:SD大鼠80只随机分为4组,每组20只:阴性对照组、阿司匹林组、氯吡格雷组、阿司匹林联合氯吡格雷组(双抗组),分别予生理盐水、阿司匹林(10.41 mg/kg)、氯吡格雷(7.81 mg/kg)、阿司匹林(10.41 mg/kg)联合氯吡格雷(7.81 mg/kg)灌胃1次/d,共14d.所有大鼠于末次给药后手术,观察小肠的损伤情况;免疫组化法测定小肠黏膜细胞肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)的表达水平.结果:(1)各实验组大鼠小肠的损伤程度均高于对照组(P＜0.01),且阿司匹林组高于氯吡格雷组(P＜0.01),双抗组最高(P＜0.01);(2)各实验组大鼠小肠黏膜TNF-α、IL-1β较对照组均呈明显高水平表达(P＜0.05),且阿司匹林组高于氯吡格雷组(P＜0.05),双抗组最高(P＜0.05).结论:常规剂量抗血小板药物可造成大鼠小肠损伤,且联合用药较单一用药损伤程度重,同时其TNF-α、IL-1β表达增强,提示这种变化可能参与了小肠损伤.     

美托洛尔联合氯吡格雷对心肌缺血再灌注损伤小鼠的作用机制

目的 探讨美托洛尔联合氯吡格雷对心肌缺血再灌注（MI/R）损伤小鼠的效果及机制。方法 10周龄SPF级雄性C57BL/6小鼠75只被随机分为假手术组、模型组、美托洛尔组、氯吡格雷组及联合组,每组15只。分别术前给予假手术组和模型组生理盐水灌胃、美托洛尔组小鼠美托洛尔（10 mg/kg）灌胃、氯吡格雷组小鼠氯吡格雷（20 mg/kg）灌胃、联合组小鼠美托洛尔（10 mg/kg）和氯吡格雷（20 mg/kg）灌胃。再灌注24 h后,超声检测各组小鼠左心室射血分数（EF）和左心室缩短分数（FS）;麻醉后取小鼠心脏组织,染色后计算各组小鼠缺血再灌注区心肌梗死面积;取小鼠外周血,采用流式细胞仪检测外周血血小板活化水平;对小鼠心脏组织进行免疫荧光检测缺血再灌注区血小板、中性粒细胞沉积水平;通过TUNEL染色检测缺血再灌注区心肌细胞凋亡水平;采用Western blot检测缺血再灌注区心肌组织的胱天蛋白酶3（Caspase 3）和多聚ADP核糖聚合酶（PARP1）水平。结果 相较于假手术组,模型组小鼠左心室EF、FS水平显著降低,缺血区心肌梗死面积显著增加（P＜0.05）;美托洛尔组、氯吡格雷组及联合组小鼠左心室EF、FS水平显著高于模型组,缺血区心肌梗死面积显著少于模型组,且联合组上述指标水平均显著优于美托洛尔组或氯吡格雷组（P＜0.05）。模型组小鼠外周血血小板活化水平,缺血区心肌组织的血小板、中性粒细胞沉积及心肌细胞凋亡数量、剪切的Caspase 3和PARP1水平显著高于假手术组（P＜0.05）;美托洛尔组、氯吡格雷组及联合组小鼠缺血区心肌细胞凋亡数量、剪切的Caspase 3和PARP1水平显著低于模型组（P＜0.05）;氯吡格雷组及联合组小鼠外周血血小板活化及缺血区心肌组织血小板、中性粒细胞沉积显著低于模型组（P＜0.05）;联合组上述指标水平均显著优于氯吡格雷组和美托洛尔组（P＜0.05）。结论 美托洛尔联合氯吡格雷治疗心肌缺血再灌注损伤效果优于美托洛尔或氯吡格雷单独治疗,其机制与抑制心肌细胞凋亡及血小板激活有关     

氯吡格雷用药时间对接受急诊介入治疗急性心肌梗死患者临床疗效的影响

目的 评价氯吡格雷用药时间对接受急诊冠状动脉介入治疗的急性心肌梗死患者随访期预后疗效的影响.方法 214例接受了急诊直接PCI治疗急性心肌梗死患者纳入本研究,根据氯吡格雷用药时间分为两组:氯吡格雷用药时间＜1年组(n=59)和≥1年组(n=155),收集基线资料包括年龄、性别、心肌梗死部位、梗塞相关血管、冠脉病变血管支数、支架类型、术前Killip分级、出院前左室射血分数(LVEF)、肌酸肌酶(CK)、肌酸肌酶同工酶(CK-MB)、肌钙蛋白I(CTnI)、血红蛋白、冠心病危险因素(吸烟、肥胖、高血压、糖尿病和高血脂),临床随访平均(41.6±16.3)个月,主要不良心脏事件(MACE)发生28例.结果 两组在性别、心肌梗死部位、血管病变支数、梗死相关血管、Killip分级(Ⅰ级)、阿司匹林使用的比例及吸烟、肥胖、高血压和高血脂所占比例,差异均无统计学意义(P＞0.05);在氯吡格雷用药时间＜1年组,平均LVEF、血红蛋白水平及药物支架比例显著低于氯吡格雷用药时间≥1年组(P＜0.0001,P＜0.0001,P=0.0065);在氯吡格雷用药时间＜1年组中,糖尿病的比例和平均年龄高于氯吡格雷用药时间≥1年组(P=0.0190,P＜0.0001);在氯吡格雷用药时间≥1年组中,平均CK、CK-MB、CTnI高于氯吡格雷用药时间＜1年组(P均＜0.0001).在氯毗格雷用药时间≥1年组中,随访期间MACE发生率明显低于氯吡格雷用药时间＜1年组(6.45%vs30.51%,P＜0.01).停用氯吡格雷后,氯吡格雷用药时间≥1年组随访期间MACE发生率明显低于氯吡格雷用药时间＜1年组(2.58% vs 20.34%,P＜0.01).结论 急诊直接PCI治疗急性心肌梗死是一种有效的方法,氯吡格雷用药时间≥1年以上患者其随访期MACE发生率明显低于氯吡格雷用药时间＜1年者,氯吡格雷用药时间影响其随访期预后.     

氯吡格雷对小鼠小肠黏膜的损伤及其机制研究

目的 初探氯吡格雷对小鼠小肠黏膜的损伤及可能的机制。方法 20 只无特定病原体（SPF）级 BALB/c 雄性小鼠,随机分为2 组：空白对照组、氯吡格雷组,空白对照组灌服生理盐水,氯吡格雷组灌服氯吡 格雷,2 周后处死小鼠,观察小鼠小肠黏膜大体变化及组织学变化,免疫组织化学（简称免疫组化）法检测小 肠黏膜组织中Occludin 蛋白的表达情况。结果 氯吡格雷组小鼠小肠黏膜大体损伤、组织病理学损伤高于空 白对照组（P <0.05）;免疫组化测得氯吡格雷组小鼠小肠黏膜Occludin 蛋白表达低于空白对照组（P <0.05）。 结论 氯吡格雷可造成小鼠小肠黏膜损伤;可能通过降低Occludin 蛋白表达造成小肠黏膜损伤。     

经皮冠状动脉介入治疗患者氯吡格雷抵抗的临床观察

目的:观察在经皮冠状动脉介入治疗(PCI)患者中硫酸氯吡格雷抵抗的发生情况.评价冠心病危险因素与氯吡格雷抵抗发生率的相关性,并进一步探讨氯吡格雷抵抗对PCI后心肌损伤的影响.方法:68名接受PCI治疗的患者在服用氯吡格雷前,服药后24小时和服药后5天取血,利用电阻法分别测定ADP诱导的血小板聚集率,根据聚集率降低程度判断氯吡格雷抵抗发生率.采集患者冠心病危险因素资料,对各项因素与氯吡格雷抵抗发生率进行相关分析.测定PCI术前和术后的心肌酶(CK-MB、TnI)水平,对比两组患者心肌酶升高比例.结果:给予氯吡格雷负荷量后24小时氯吡格雷抵抗者为9例(13.2%);连续服药(75mg/d)5天后抵抗者为6例(8.8%).两者间无显著性差异(P=0.412).研究中观察的临床指标与氯吡格雷抵抗发生率无相关性.CK-MB升高在抵抗组发生率(77.8%)明显高于有效组(27.1%)(P=0.009).TnI升高在抵抗组发生率(66.7%)同样明显高于有效组(20.3%)(P=0.011).结论:PCI介入治疗的患者中存在部分氯吡格雷抵抗者.氯吡格雷抵抗的患者在接受PCI治疗后心肌酶升高比例增加,提示发生心肌损伤的危险高于氯吡格雷敏感者.     

不同双联抗血小板方案对PCI手术患者心肌血流灌注的影响比较

目的:探讨不同双联抗血小板药物对经皮冠状动脉介入术(PCI)治疗患者心肌血流灌注的影响.方法:回顾性分析108例接受PCI治疗的急性ST段抬高型心肌梗死(STEMI)患者的临床资料.根据接受双联抗血小板方案不同,分为替格瑞洛组(阿司匹林+替格瑞洛,n=57)和氯吡格雷组(阿司匹林+氯吡格雷,n=51).比较PCI术后血小板聚集率、冠状动脉血流灌注、肌酸激酶同工酶(CK-MB)水平、心脏超声指标和不良心血管事件(MACCE)发生率.结果:替格瑞洛组PCI术后2 h、1 d、3 d血小板聚集率均低于氯吡格雷组(P<0.05),PCI术后冠脉血流TIMI 3级比重高于氯吡格雷组(P<0.05).替格瑞洛组术后8～20 h CK-MB水平和CK-MB达峰时间均低于氯吡格雷组(P<0.05),术后4周LVEF高于氯吡格雷组(P<0.05).两组随访6个月MACCE发生率比较,差异无统计学意义(P>0.05).结论:阿司匹林联合替格瑞洛对STEMI患者PCI术后心肌血流灌注和心功能的改善效果优于阿司匹林联合氯吡格雷.     

乌司他丁对脓毒症大鼠心肌损伤的保护作用

目的 探讨乌司他丁(ulinastatin,UTI)对脓毒症大鼠心肌损伤的保护作用.方法 63只SD大鼠随机分为假手术组(A组)、脓毒症组(B组)和乌司他丁组(C组),检测脓毒症前及脓毒症后3、6、12和24 h大鼠血浆TNI、BNP水平和心肌MDA含量、SOD活性,以及UTI的影响,并观察心肌组织超微结构变化.结果 脓毒症后3、6、12和24 h大鼠血浆TNI、BNP水平以及心肌MDA含量均显著高于假手术组(P＜0.05).心肌SOD活性低于假手术组(P＜0.05);UTI组较脓毒症组血浆TNI、BNP、心肌MDA明显降低(P＜0.05).心肌SOD活性明显升高(P＜0.05);UTI组心肌组织超微结构的损害较脓毒症组明显减轻.结论 脓毒症大鼠早期即发生明显的心肌损伤,乌司他丁能够显著减轻脓毒症时心肌损伤的程度,对脓毒症大鼠的心肌损伤有显著的保护作用.     

氯吡格雷对乙酸诱导大鼠胃溃疡愈合的影响及机制

 目的 明确氯吡格雷对实验性大鼠胃溃疡愈合的影响,并从微血管形成的角度探讨其延缓胃溃疡愈合的机制。方法 以乙酸性大鼠胃溃疡模型为基础,将22只大鼠分为模型组(n=6)、氯吡格雷组(n=8)和生理盐水组(n=8),观察氯吡格雷对胃溃疡愈合的影响,及对溃疡底部微血管密度(microvessel density,MVD)、胃黏膜内皮抑素(endostatin,ES)及血管内皮生长因子A165(vascular endothelial growth factor A165,VEGF A165)表达的影响。结果 制模术后第10天,氯吡格雷组和生理盐水组溃疡面积分别为(11±3.07) mm2、(7±1.85) mm2,差异有统计学意义(P=0.023 0)。氯吡格雷组溃疡底部MVD显著低于生理盐水组 (P=0.011 4)。氯吡格雷组胃黏膜VEGF A165含量显著低于生理盐水组(P<0.01),ES含量显著高于生理盐水组(P<0.01)。溃疡底部MVD与胃黏膜VEGF A165含量正相关(r=0.688 8、P=0.003 2),与胃黏膜ES含量负相关(r=-0.767 1、P=0.000 5)。结论 氯吡格雷可显著延缓乙酸性大鼠胃溃疡愈合,推测可能是通过调节胃黏膜VEGF A165及ES的表达以抑制溃疡底部的微血管形成,从而使损伤黏膜修复受阻。     

冠心舒通胶囊联合氯吡格雷对急性心肌梗死并心力衰竭患者的治疗作用探讨

目的:探讨在急性心肌梗死并心力衰竭(心衰)患者中冠心舒通胶囊联合氯吡格雷的治疗作用。方法:将61例急性心肌梗死并心衰患者采用随机数表分为两组,西药组30例采用含有氯吡格雷的西药方案治疗,结合组31例在西药组的基础上联合冠心舒通胶囊。对比左心室功能变化、临床疗效。结果:2组治疗后LVEF、CO均升高(P<0.05),结合组均高于西药组(P<0.05);2组治疗后LVEDV和LVESV均下降(P<0.05),结合组均低于西药组(P<0.05);结合组临床总有效率高于西药组(P<0.05)。结论:对急性心肌梗死并心衰患者采用冠心舒通胶囊联合氯吡格雷治疗能够改善左心室功能,增强疗效。     

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.