1型糖尿病大鼠肾脏病变与ADPN、TGF-β1、collagen Ⅳ、ICAM-1的关系

目的探讨脂联素、TGF-β1、collagen Ⅳ、ICAM-1在1型糖尿病肾脏病变发生及发展中的变化及作用。方法大鼠随机分为正常对照组和糖尿病组,每组分别于4周和8周,测24h尿白蛋白排泄量(UPro/24h)、空腹血浆葡萄糖、血肌酐、尿素氮、血清脂联素(ADPN)、肾重/体重,观察肾脏TGF-β1、Ⅳ型胶原蛋白(collagen Ⅳ)、ICAM-1的表达。结果糖尿病大鼠UPro/24h增高、TGF-β1、collagen Ⅳ、ICAM-1的表达增加、脂联素水平降低。结论TGF-β1、collagen Ⅳ、ICAM-1在肾脏组织中表达水平与血清ADPN呈负相关。随着ADPN水平降低,TGF-β1、collagen Ⅳ、ICAM-1在肾脏组织的表达增加。     

复方血栓通胶囊改善肾功能机制研究

[目的] 研究复方血栓通胶囊对糖尿病肾病(DN)大鼠24 h尿白蛋白、尿肌酐、血肌酐和血尿素氮等相关代谢指标的影响,及应用基因芯片探讨复方血栓通胶囊改善DN 大鼠肾功能的机制。[方法] 选用SD 大鼠45 只,高脂喂养/ 链尿佐菌素(STZ)注射法制备DN 模型,将DN 成模大鼠40 只随机分为小剂量、中剂量、大剂量血栓通组[ 分别给予0.3、0.6、1.2 g/(kg·d)的血栓通粉末悬浊液]、DN 模型组(给予生理盐水)。另外选用SD 大鼠10 只为正常对照组(给予生理盐水),均连续灌胃12 周。每月末测定大鼠空腹血糖(FBG)和体质量。3 个月末测定大鼠24 h尿白蛋白、尿肌酐、血肌酐和血清尿素氮水平。取大鼠肾脏组织进行Illumina基因芯片实验以期从整体基因角度揭示复方血栓通胶囊改善肾功能的机制。实时定量PCR 实验验证基因芯片的结果。[结果] 复方血栓通胶囊能以剂量依赖的方式降低24 h尿白蛋白、血肌酐和血清尿素氮,升高尿肌酐(P<0.05或P<0.01)。基因芯片显示大剂量血栓通组较模型组有67 个基因显著改变,其中34 个上调,33 个下调。实时定量PCR 实验发现大剂量血栓通组胶原蛋白1 型1(Col1a1)、结缔组织生长因子(Ctgf)和转化生长因子1(Tgfb1)基因较模型组显著下调,细胞色素P450 家族2 亚族C 肽23(Cyp2c23)和Nephrin-1(Nphs1)显著上调。[结论] 复方血栓通胶囊能有效改善DN 大鼠肾脏功能,其机制可能涉及Bmp2-Tgfβ-Ctgf通路,Cyp2c23 和足细胞损伤修复。     

糖肾清Ⅰ号对糖尿病大鼠肾脏保护作用的实验研究

[目的]探讨糖肾清I号对糖尿病肾病大鼠肾脏的保护作用。[方法]将四氧嘧啶所诱导的清洁级Wistar糖尿病肾病大鼠36只,随机分为正常对照组(A组)、糖尿病肾病未干预组(B组)和糖尿病肾病糖肾清Ⅰ号干预组(C组),每组各12只。糖尿病肾病模型成功后开始给予糖肾清Ⅰ号药物干预,8周后收集24h尿液及血标本,处死大鼠后,取肾组织行光镜、电镜、免疫组织化学及分子生物学检查。[结果]糖尿病肾病大鼠肾组织转化生长因子β1(TGF-β1)基因及蛋白水平表达明显增加,尿蛋白增加,肌酐清除率上升;糖肾清Ⅰ号使尿蛋白减少(P<0.01),肌酐清除率降低(P<0.01),TGF-β1基因及蛋白水平表达明显下降,病理学检查显示糖肾清Ⅰ号使糖尿病肾小球硬化减轻。[结论]糖肾清Ⅰ号通过部分抑制TGF-β1的活性而对糖尿病肾脏损害起到保护作用。     

鱼腥草对糖尿病大鼠肾脏组织中BMP-7和TGF-β1表达的影响

[目的]探讨鱼腥草对糖尿病肾脏组织中转化生长因子β1(TGF-β1)和骨形成蛋白-7(BMP-7)表达的影响。[方法]建立链脲佐菌素(STZ)诱导的糖尿病模型,随机分为模型组、鱼腥草组和洛汀新组,另设正常组;观察8周后肾质量/体质量比值、肾小球面积及24h尿β₂微球蛋白、24h尿白蛋白和肌酐清除率,并应用免疫组化检测肾脏组织中TGF-β1、BMP-7的蛋白表达。[结果]鱼腥草给药可明显抑制糖尿病模型大鼠肾小球的肥大,降低24h尿β₂微球蛋白、24h尿白蛋白排泄率和肌酐清除率(P<0.05);免疫组化半定量显示,与模型组比较,鱼腥草组TGF-β1表达明显减少(P<0.05),BMP-7表达增多(P<0.05),而与洛汀新组比较无显著差异(P>0.05)。[结论]鱼腥草对糖尿病肾脏组织有明显的保护作用,其机制可能与其降低肾脏中TGF-β1表达,增加BMP-7的表达有关。     

依帕司他对早期糖尿病肾病患者尿足细胞相关蛋白nephrin表达的影响

目的 研究依帕司他对早期2型糖尿病肾病尿足细胞相关蛋白nephrin表达的影响。 方法 将52例2型早期糖尿病肾病患者随机分为对照组和治疗组,对照组给予常规治疗,治疗组在对照组的基础上口服依帕司他胶囊(50mg,3次/日),疗程12周。在治疗前后测患者血压、血糖、血脂、糖化血红蛋白、血清肌酐及尿白蛋白排泄率(UAER)。采用酶联免疫吸附法测定两组患者尿液中TGF-β1和尿nephrin表达。 结果 依帕司他治疗前后患者血糖、血脂、血压、血清肌酐变化,差异无统计学意义(P>0.05)。治疗后两组患者UAER与治疗前相比差异有统计学意义(P<0.05),且治疗组UAER与对照组相比,差异有统计学意义(P<0.05)。与对照组相比,治疗组TGF-β1和nephrin差异有统计学意义(P<0.05)。 结论 依帕司他可减少早期糖尿病肾病患者尿nephrin表达,该途径可能是通过抑制TGF-β1的表达实现的。     

灵芝酸对2型糖尿病肾病大鼠免疫调节作用

【立论依据】 糖尿病肾病已成为终末期肾病的主要原因,其发生、发展与免疫因素密切相关,灵芝酸具有调节免疫等多种药理作用。 【设计思路】 观测2型糖尿病大鼠肾组织形态结构和免疫因子的变化,探讨灵芝酸对2型糖尿病大鼠肾病的干预作用。 【实验内容】 (1)制备糖尿病大鼠模型;(2)检测肾脏内生肌酐清除率(Ccr)和尿白蛋白排泄率(UAER)等指标;(3)察肾组织形态结构;(4)检测肾脏T/B细胞标志分子(CD4和CD8α/β)和效应分子(TNF-α、IFN-γ和TGFβ)的变化。 【材料】 8周龄SD大鼠,随机分为正常对照(A)组,模型(B)组、灵芝酸低浓度(C)组、灵芝酸高浓度(D)组,每组20只。适应性饲养7 d,B、C、D组高脂高糖喂养4周,静脉30 mg/kg注射1%链脲佐菌素(STZ)制备模型,C组灵芝酸3.0 mg/(kg·d)灌胃,D组灵芝酸6.0mg/(kg·d)灌胃,A和B组等体积生理盐水灌胃。20周龄,监测24 h尿量、尿白蛋白及尿肌酐(Ucr)、Ccr和UAER水平;分离血清,测定血糖,血肌酐及尿素氮水平;肾脏称重,计算肾脏指数;H-E,PAS和Masson染色观察肾组织病理变化、肾小球胶原纤维及ECM聚集情况;免疫组化SP法检测TGFβ;应用流式细胞术检测肾脏CD4和CD8α/β;ELISA方法检测TNF-α、IFN-γ和TGFβ。 【可行性】 前期实验结果表明:(1)20周龄时,与A组比较,B组各肾功能指标均表现出显著性差异(P<0.05),出现糖尿病肾病的明显特征;与B组比较,C组和D组各肾功能指标均有显著性差异(P<0.05);(2)与A组比较,B组出现肾小球肥大、纤维化,基底膜增厚等病理改变,肾小球面积及系膜增殖指数明显增大;与B组比较,C组和D组肾脏病变明显减轻,肾小球面积及系膜增殖指数明显降低。 【创新性】 系统研究灵芝酸对对大鼠肾组织保护作用,对临床糖尿病肾病的防护具有理论指导意义。     

玉米须水提物对2型糖尿病肾病大鼠转化生长因子-β1和纤维连接蛋白表达的影响

目的 研究玉米须水提物对2型糖尿病肾病大鼠肾组织中转化生长因子-β1(TGF-β1)和纤维连接蛋白(FN)表达的影响,探讨其可能的作用机制.方法 采用高糖高脂饲养加小剂量链脲佐菌素(STZ)诱导2型糖尿病肾病大鼠模型,将实验动物分为正常对照组、模型对照组和玉米须水提物低、中和高剂量组,共5组.给药8周后,测定各组大鼠空腹血糖、体重、肾重、血清尿素氮、血肌酐和24 h尿蛋白;免疫组化法分析TGF-β1表达水平;实时定量RT-PCR定量检测肾组织TGF-β1和FN的表达水平.结果 与模型对照组比较,中和高剂量组的玉米须水提物可显著降低糖尿病肾病大鼠血糖、肾指数、血清尿素氮、血肌酐和24 h尿蛋白(P ＜0.05或P＜0.01),明显降低肾组织中TGF-β1和FN mRNA的表达量(P＜0.05或P＜0.01).结论 玉米须水提物能够降低糖尿病大鼠血糖、肾指数、血清尿素氮、血肌酐和24 h尿蛋白的水平,下调肾病大鼠肾组织中TGF-β1和FN的表达,调节细胞外基质的生成和降解,从而减轻糖尿病肾病大鼠肾脏的病理损害,发挥其肾脏保护作用.     

吡格列酮对糖尿病大鼠足细胞的保护作用

目的 研究不同剂量盐酸吡格列酮(PIO)对链脲佐菌素(STZ)诱导的糖尿病大鼠肾脏足细胞的保护作用.方法 将SD大鼠随机分为正常对照组(NC组),糖尿病组(DM组),糖尿病低剂量PIO组(DR1组),糖尿病中剂量PIO组(DR2组)和糖尿病高剂量PIO组(DR3组).于0、8周末测尿白蛋白、尿nephrin、尿转化生长因子-β1(TGF-β1)和尿肌酐(UCr),并计算尿白蛋白/肌酐(UACR)、nephrin/肌酐(UNER)和TGF-β1/肌酐(UTGR).每周监测血糖(BG),8周末取血测糖化血红蛋白(HbA1c),免疫组化检测肾组织nephrin及TGF-β1蛋白表达.结果 ①糖尿病大鼠各时间点BG及8周末HbA1c显著高于NC组(P＜0.05),糖尿病大鼠组间差异无统计学意义.②8周末,各PIO组UACR、UNER和UTGR均显著低于DM组(P＜0.05),且DR2、DR3组UACR和UNER低于DR1组(P＜0.05);肾脏nephrin蛋白表达:NC组＞各PIO组＞DM组(P＜0.05),DR1、DR2和DR3组间差异无统计学意义;肾脏TGF-β1蛋白表达:DM组＞各PIO组＞NC组(P＜0.05),DR1、DR2和DR3组间差异无统计学意义.③UNER与UTGR呈显著正相关(r=0.787,P＜0.01),肾脏nephrin蛋白与TGF-β1蛋白呈显著负相关(r=-0.669,P＜0.01).结论 PIO对糖尿病大鼠足细胞有一定的保护作用,该作用可能与其上调足细胞nephrin表达和抑制肾组织局部TGF-β1表达有关.     

赤芍对早期糖尿病肾病大鼠肾脏AngⅡ、ET-1、PKC及TGF-β1的影响

目的 观察赤芍对早期糖尿病肾病大鼠的作用及赤芍对肾脏血管紧张素Ⅱ(AngⅡ)、内皮素-1(ET-1)、蛋白激酶C(PKC)及转化因子-β1 (TGF-β1)的影响.方法 腹腔注射STZ制备糖尿病肾病大鼠模型,随机分为正常对照组、糖尿病肾病模型组以及高、中、低赤芍组(腹腔注射5、15、30g/kg),8周后测定大鼠血糖、血脂及肾功能指标(尿素氮、血肌酐、24h尿蛋白),放射免疫法测定肾脏AngⅡ、ET-1含量,免疫组织化学染色法检测肾脏TGF-β1及PKC表达.结果 与正常对照组相比,糖尿病肾病组大鼠血糖、血脂、尿素氮、血肌酐及24h尿蛋白明显升高,AngⅡ、ET-1含量和TGF-β1、PKC表达增强(均P<0.01); 与糖尿病肾病组相比,赤芍能呈浓度依赖性的降低糖尿病肾病大鼠血脂、尿素氮、血肌酐及24h尿蛋白,明显下调肾脏ET-1、TGF-β1 及PKC(均P<0.01),AngⅡ虽有下调趋势,但与糖尿病肾病组相比无明显差异性(P>0.01).结论 赤芍能改善糖尿病早期肾功能,其机制可能主要与抑制肾脏ET-1表达继而下调PKC及TGF-β1水平有关.     

活血祛瘀方对单侧输尿管梗阻大鼠TGF-β1和CTGF表达的影响

目的 通过研究活血祛瘀方对单侧输导管梗阻 (UUO) 大鼠肾组织转化生长因子-β₁ (TGF-β₁)、结缔组织生长因子 (CTGF) 表达的影响,探讨其抗肾间质纤维化的作用机制。方法 建立大鼠 UUO 模型,48 只 SD 大鼠随机分为假手术组、模型组、代文组、活血祛瘀方组,于治疗 4 周后腹主动脉采血检测血肌酐 (SCr)、尿素氮 (BUN);收集 24 h 尿液检测 N-乙酰-β-D-氨基葡萄糖苷酶 (NAG)、β₂-微球蛋白 (β₂-MG);取梗阻侧肾组织,HE 染色观察肾小管间质病变;免疫组织化学染色观察 TGF-β₁、CTGF 的阳性表达,并进行半定量分析。结果 与假手术组相比,模型组大鼠血 SCr、BUN 和尿 NAG、β₂-MG 水平以及 TGF-β₁、CTGF 阳性表达显著升高。与模型组相比,活血祛瘀方组大鼠 BUN 水平降低,尿 β₂-MG、NAG 排泄减少;活血祛瘀方组和代文组肾间质 TGF-β₁、CTGF 阳性表达显著下调。结论 活血祛瘀方可降低 UUO 大鼠尿 NAG、β₂-MG 和血 BUN 水平,表明具有保护肾小管功能和改善肾功能作用,可能因其能抑制肾间质 TGF-β₁、CTGF 过度表达,从而减缓肾纤维化病程的进展。     

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.