针刺配合中西药物治疗Graves突眼的临床观察

目的:观察针刺治疗Graves突眼的临床疗效.方法:将67例Graves突眼患者随机分为针刺治疗组(35例)和中西医药物治疗对照组(32例),观察治疗后两组临床疗效、眼球突出度、甲状腺功能及抗甲状腺抗体变化的差异.结果:治疗组总有效率为80%,对照组总有效率为53.13%,两组比较有显著差异(P＜0.05);治疗组在降低眼球突出度及改善突眼局部症状方面明显优于对照组(P＜0.05).结论:针刺治疗Graves突眼有较好的临床效果.     

肝素与氨茶碱等联合应用治疗肺性脑病疗效观察

目的 :观察肝素、酚妥拉明、尼可刹米、氨茶碱联合治疗肺性脑病的临床疗效。方法 :选择肺性脑病患者 5 6例随机分为治疗组 30例 ,用肝素 5 0～ 10 0 mg,酚妥拉明 10～ 2 0 mg,加入 5 0 %葡萄糖溶液 2 5 0 ml静滴 ,每分钟 10～ 2 0滴 ,尼可刹米 1.875 g,氨茶碱 0 .375～ 0 .5 g加入 5 %葡萄糖溶液 5 0 0 ml,每分钟 2 0滴 ,7天为一疗程。对照组 2 6例采用常规疗法。结果 :总有效率治疗组 93.3% ,对照组 6 5 .4 % (P<0 .0 5 ) ;治疗两天后 ,治疗组、对照组对比 :1Pa O2 6 5 .1± 12 .2 mm Hg,5 8.2± 11.2 mm Hg,P<0 .0 5 ;2 Pa-CO2 分别为 4 9.8± 7.2 mm Hg,5 6 .2± 9.5 mm Hg,P<0 .0 5 ;3全血比粘度分别为 31.92± 7.91mpa.s,37.2 8± 8.2 2 mpa.s,P<0 .0 5 ,血浆比粘度分别为 1.6 9± 0 .13mpas,1.82± 0 .15 mpas,P>0 .0 5 ,红细胞压积相比差异不显著。 4治疗组呼吸率明显降低。结论 :该方法为治疗肺性脑病的一个有效方法。     

电针足三里对溃疡性结肠炎大鼠TNF-α的下调作用

目的 :探讨电针足三里穴对溃疡性结肠炎 (ulcera tivecolitis,UC)大鼠肿瘤坏死因子 α(TNF α)的调节作用及机制 .方法 :将 32只SD大鼠随机分为 4组 :正常对照组 ,UC模型对照组 ,UC模型 +针穴组 ,UC模型 +非穴组 .在诱导产生UC大鼠模型的基础上 ,分别电针其相应部位 ,1 0d后同时处死 4组大鼠 ,观察其结肠质量、结肠组织髓过氧化物酶(MPO)活性及TNF αmRNA表达水平、血清TNF α含量的变化 .结果 :与正常对照组相比 ,UC模型对照组结肠质量 /体质量 (mC/mB)及MPO活性均显著增加 (8.5 3± 2 .5 9vs 2 .4 6± 0 .4 2 ,1 4 5 .2± 2 5 .3vs 2 4 .3± 7.8,P <0 .0 1 ) ;血清TNF α含量和结肠组织TNF αmRNA表达水平分别上升 2 .5倍及 4 .3倍 (2 2 78± 1 70vs 894± 2 4 8,0 .98± 0 .1 1vs 0 .2 3±0 .1 1 ,P <0 .0 1 ) ;电针足三里穴后 ,mC/mB 和MPO活性显著降低 (5 .2 9± 2 .0 4vs 8.5 3± 2 .5 9,1 0 3.5± 35 .7vs 1 4 5 .2± 2 5 .3,P <0 .0 1 ,0 .0 5 ) ;TNF α含量和TNF αmRNA表达水平也分别减少 1 6 %和 4 4 % (1 91 3± 2 32vs2 2 78± 1 70 ,0 .5 5± 0 .1 3vs0 .98± 0 .1 1 ,P <0 .0 1 ) .非穴组与UC模型对照组相比无统计学显著性差异 (P >0 .0 5 ) .结论 :电针足三里穴能够良性下调TNF α生成     

防毒灵汤为主治疗复发性单纯疱疹性角膜炎40例

目的 :观察防毒灵汤为主治疗复发性单纯疱疹性角膜炎炎症期的疗效。方法 :70例 (78只眼 )单纯疱疹性角膜炎患者随机分为治疗组和对照组 ,治疗组用防毒灵汤加减内服及防毒滴眼液滴眼 ,对照组用无环鸟苷滴眼液。结果 :对于树枝状角膜炎 ,治疗组和对照组的有效率分别为 10 0 % ,88.2 4 % ;治疗组和对照组治愈时间分别为 (7.5 8± 1.6 6 )d ,(10 .11± 4 .5 1)d ,两组比较有显著性差异 (t =2 .32 ,P <0 .0 5 )。对于地图状角膜炎 ,治疗组和对照组有效率分别为94 .4 4% ,83.33% ;治疗组和对照组治愈时间分别为 (18.90± 3.2 1)d ,(2 5 .30± 7.2 8)d ,两组比较有显著性差异 (t =2 .4 0 ,P <0 .0 5 )。两组的视力治疗后比治疗前都有明显提高。结论 :防毒灵汤为主对急性期复发性单纯疱疹性角膜炎炎症期疗效优于无环鸟苷滴眼液。     

2(3)-叔丁基-4-羟基茴香醚对大鼠醋酸溃疡的治疗作用

目的 :观察 2 (3) 叔丁基 4 羟基茴香醚 [2 (3)tert butyl 4 hydroxyanisole ,BHA]对醋酸诱发大鼠胃溃疡的治疗作用。方法 :用 5 0 % (体积分数 )醋酸烧灼胃前壁浆膜面 1min ,制备大鼠胃溃疡模型。动物随机分为 3组 :BHA组、奥美拉唑组和对照组。测定指标包括 :溃疡指数、粘膜再生指数和溃疡底暴露减少指数。结果 :BHA组和奥美拉唑组溃疡指数分别为 (2 .98± 1.33)mm2 和 (2 .71± 1.45 )mm2 ,显著低于对照组 (5 .86± 1.6 9)mm2 (P <0 .0 1)。BHA组和奥美拉唑组溃疡粘膜再生指数分别为 (70 .1± 7.9) %和 (79.0± 8.1) % ,较对照组 (5 4.5± 7.3) %显著增加 (P <0 .0 0 1)。BHA组和奥美拉唑组的溃疡底暴露减少指数分别为 (6 0 .3± 13.4) %和 (6 8.2± 8.4) % ,较对照组 (46 .5± 7.9) %显著增加 ,P值分别小于 0 .0 5和 0 .0 1。但BHA组与奥美拉唑组相比 ,P值均大于 0 .0 5。结论 :BHA能促进醋酸诱发溃疡的愈合 ,其疗效与奥美拉唑相似。     

准分子激光原位角膜磨镶术后屈光的动态研究

目的　探讨准分子激光原位角膜磨镶术 (laserinsitiukeratomileusis ,LASIK)后屈光度数回退的原因。方法　将 2 0 1例 (386眼 )近视患者 (- 1 .2 5～ - 2 0 .0 0D)按屈光度数分为A组 2 1 8眼 (- 1 .2 5～ - 6 .0 0D)和B组 1 6 8眼 (- 6 .2 5～ - 2 0 .0 0D)行LASIK ,记录术前、术后视力、屈光度数、角膜厚度和角膜激光切削区直径 ,并进行统计学分析。结果　(1 )A组 :正常术眼 :术后屈光度数 <- 1 .0 0D 1 95眼 (89.4 5 % ) ,术前平均角膜厚度 (5 4 9.5± 31 .5 ) μm ,术中平均激光切削直径为 (4 .96± 0 .35 )mm ;回退术眼 :术后屈光度数≥ - 1 .0 0D 2 3眼 (1 0 .5 5 % ) ,术前平均角膜厚度 (5 4 7.5± 37.0 ) μm ,与正常术眼比较差异无显著意义 (P >0 .0 1 ) ;(2 )B组 :正常术眼 1 0 5眼 (6 2 .5 % ) ,术前平均角膜厚度为 (5 6 0 .9± 30 .9) μm ,术中平均激光切削直径为 (4 .5 1± 0 .2 8)mm ,术后回退术眼 77眼 (4 5 .83% ) ,术前平均角膜厚度为 (5 38.0± 31 .0 ) μm ,与A组比较差异有非常显著意义 (P <0 .0 1 ) ;术后平均屈光度数为 - 1 .99± 1 .0 1D。结论　LASIK可有效治疗 - 6 .0 0～ -1 5 .0 0D的近视。术中激光切削直径小者和高度近视术前角膜厚度薄者术后易出现屈光度数回退     

门冬氨酸钾镁治疗急性心肌梗死对QT离散度的影响

目的 :评估门冬氨酸钾镁治疗急性心肌梗死对QT离散度的影响。方法 :采用随机、单盲、对照的方法将44例急性心肌梗死患者在常规治疗的基础上分为两组。治疗组 (n =2 1 )给予静脉门冬氨酸钾镁治疗 ,对照组(n=2 3 )不用门冬氨酸钾镁治疗。取入院时、入院后 2 4h及 1周的心电图 ,测量QT离散度 ,观察急性心肌梗死后心律失常的发生率。结果 :治疗组与对照组QT离散度在入院后 2 4h分别为 61 .62±7.3 5ms和 71 .0 6±1 4.0 1ms(P <0 .0 5 ) ,1周时分别为 5 3 .0 7± 5 .64ms和 66.0 0± 1 0 .5 1ms(P <0 .0 5 )。治疗组与对照组住院期间室性心律失常的发生率分别为 2 3 .8%和 5 6.5 % (P <0 .0 5 )。结论 :门冬氨酸钾镁治疗急性心肌梗死可以减少QT离散度和室性心律失常的发生率。     

沙利度胺对小鼠肝癌血管形成的影响

目的 :研究沙利度胺对小鼠肝癌血管形成的影响 ,并初步探讨其抑瘤机制。方法 :小鼠肝癌 HAC细胞接种于昆明种小鼠前肢腋下皮下 ,建立小鼠肝癌皮下移植瘤模型 ,随机分为阴性对照组 (蒸馏水灌胃 )、阳性对照组 (接种后第 1、3、5天 ip环磷酰胺 10 0 m g/ kg)、沙利度胺 A组和沙利度胺 B组 (分别于接种后第 1、5天灌胃 5 0 m g· kg- 1 · d- 1 沙利度胺 0 .5 m l)。采用Envision System免疫组织化学方法 ,检测肿瘤组织微血管密度 (MVD)、增殖细胞核抗原 (PCNA)和血管内皮细胞生长因子(VEGF)。 结果 :阴性对照组、阳性对照组 MVD分别为 (16 .8± 5 .2 )、(11.5± 2 .8) ,PCNA指数分别为 (5 7.1± 6 .3) %、(6 8.2± 4.1) % ,VEGF阳性率分别为 (11.5± 4.3) %、(5 .4± 3.9) %。沙利度胺 A组、B组 MVD分别为 (2 .9± 1.3)、(10 .5±2 .7) ,PCNA指数分别为 (5 1.6± 3.3) %、(5 5 .7± 18.1) % ,VEGF阳性率分别为 (0 .8± 0 .2 ) %、(2 .2± 1.1) %。沙利度胺组MVD、VEGF阳性率均低于阴性对照组 ,差异显著 (P<0 .0 5 )。阳性对照组、沙利度胺 A组、B组抑瘤率分别为 83.8%、5 0 .1%、41.5 %。结论 :沙利度胺通过抑制小鼠肝癌的血管生成 ,抑制肿瘤生长 ,联合使用其他药物 ,可能在实体瘤的治疗中具有良好的应用     

针刺分离联合结膜下注射5-氟尿嘧啶治疗包裹滤过泡

目的 观察滤过泡针刺分离联合球结膜下5-Fu结膜下治疗青光眼滤过术后的包裹滤过泡的临床疗效。方法分析30眼行青光眼滤过手术术后发生滤过泡包裹并行针刺分离联合球结膜下5-Fu结膜下治疗的临床资料。其中22只眼为青光眼引流阀植入术后，8只眼小梁切除术后眼。以1mL注射针头针刺分离滤过泡周围的纤维瘢痕，联合球结膜下注射5-Fu，随访观察治疗前后视力、眼压、滤过泡形态、角膜内皮细胞计数及并发症情况。结果 治疗前眼压为(33. 30±5. 40) mm Hg，针刺分离后1天、1周、1个月、3个月眼压分别为:(12. 00±2. 59) mm Hg、(14. 97±3. 26) mm Hg、(20. 20±4. 17) mm Hg、(18. 17±2. 36) mm Hg，眼压明显下降(t=33. 36,P<0. 001)。治疗1个月时，8眼眼压超过21mmHg，需加用降压药物，3个月时有12眼需加用降压药。早期并发症主要有结膜下出血5例、角膜上皮点状剥脱2例，前房积血1例。结论 滤过泡针刺分离联合球结膜下5-Fu注射治疗青光眼滤过术后的包裹滤过泡是一种安全、有效的挽救失败滤过泡的方法。     

米力农治疗慢性肺心病呼吸衰竭合并心力衰竭的临床疗效观察

目的 :探讨米力农治疗慢性肺心病呼吸衰竭合并心力衰竭的临床价值。方法 :对观察组 2 2例和对照组 2 4例治疗前后血气中pH值、PaO2 、PaCO2 、心功能及临床症状的改善情况作比较 ,并作统计学处理。结果 :观察组治疗前后pH分别为 7.2 5± 0 .0 4和 7.3 8± 0 .0 5 (P <0 .0 5 ) ;PaO2 分别为 ( 4 0 .3 5± 10 .5 8)mmHg和 ( 5 4.98± 9.3 0 )mmHg(P <0 .0 1,1mmHg =0 .13 3kPa) ;PaCO2 分别为 ( 64 .80± 8.41)mmHg和 ( 4 6.13± 8.48)mmHg(P <0 .0 1) ;经治疗后 ,心功能改善观察组与对照组分别为 90 .91% ( 2 0 /2 2 )和 5 4.17% ( 13 /2 4) (P <0 .0 1)。结论 :米力农是治疗慢性肺心病呼吸衰竭合并心力衰竭较为理想的药物     

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.