艾司氯胺酮复合丙泊酚用于无痛人工流产术ED95的测定

目的测定艾司氯胺酮复合丙泊酚用于无痛人工流产术的95%有效剂量（ED95）。方法选择2021年11月浙江中医药大学附属杭州市中医院择期行无痛人工流产术的孕妇20例。采用Dixon''sup-and-down序贯法，艾司氯胺酮的初始剂量为0.335mg/kg，上下调的剂量根据几何级数计算，若未出现体动，则下一例孕妇下调一个阶梯；若出现体动，则下一例孕妇上调一个阶梯。计算ED95及95%CI。结果艾司氯胺酮复合丙泊酚用于无痛人工流产术的ED95为0.385mg/kg，95%CI：0.368～0.434mg/kg。结论艾司氯胺酮复合丙泊酚用于无痛人工流产术的ED95为0.385mg/kg。     

丙泊酚联合不同镇痛药抑制人工流产扩张宫颈时体动的半数有效剂量

目的 测定无痛人工流产麻醉诱导时丙泊酚联合芬太尼或联合芬太尼加氯胺酮抑制扩张宫颈时体动的半数有效剂量(ED50).方法 拟行无痛人工流产的患者160例,随机分为4组:F组予丙泊酚联合芬太尼(1μg/kg),其中年龄≤25岁为F1组,26～35岁为F2组;KF组予丙泊酚联合芬太尼(1μg/kg)加氯胺酮(0.3 mg/kg),其中年龄≤25岁为KF1组,26～35岁为KF2组.采用序贯法进行试验,F组和KF组丙泊酚的初始诱导剂量分别为1.8和1.2 mg/kg,入选样本从扩张宫颈时有体动的上一例患者开始计算,其后各患者丙泊酚的诱导剂量根据上1例患者扩张宫颈时有无体动进行调整,变化间隔为0.2 mg/kg.计算各组丙泊酚的ED50及其95%可信区间(95%CI).结果 无痛人工流产麻醉诱导时,F1、F2、KF1和KF2组丙泊酚抑制扩张宫颈时体动的ED50分别为2.0、1.5、1.1和0.9 mg/kg,95%CI间分别为1.6～2.5、1.1～1.9、0.7～1.8和0.7～1.3 mg/kg.结论 无痛人工流产麻醉诱导时,小剂量氯胺酮0.3 mg/kg可以减少扩张宫颈时抑制患者体动所需丙泊酚的ED50.     

艾司氯胺酮抑制宫腔镜患者体动反应的有效剂量分析

目的：探讨艾司氯胺酮联合丙泊酚血浆浓度3 μg·mL^-1 靶控输注在宫腔镜检术中抑制患者体动反应的半数有效剂量（ED50）和95%有效剂量（ED95）。方法：选择2021年12月至2022 年1月海口市妇幼保健院接受宫腔镜检术的全麻患者26例,患者均静脉推注艾司氯胺酮,艾司氯胺酮初始剂量为0.5 mg·kg^-1,同时丙泊酚的血浆浓度设为3 μg·mL^-1进行靶控输注。本研究使用序贯法,相邻患者的艾司氯胺酮剂量之比设为0.9。采取Probit概率法检测艾司氯胺酮的ED50、ED95和95%CI。记录生命体征[心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）]、体动反应的级别、手术时间、苏醒时间、VAS疼痛评分（苏醒10 min后）;记录呼吸抑制（当SpO2＜90%时）、低血压、复苏期躁动、恶心呕吐、头晕和噩梦等并发症。结果：艾司氯胺酮复合丙泊酚血浆浓度3 μg·mL^-1靶控输注时,抑制患者行宫腔镜检查术时体动反应的ED50 是0.391 mg·kg^-1（95%CI =0.340～0.431 mg·kg^-1）,ED95是0.476 mg·kg^-1（95%CI =0.434～0.778 mg·kg^-1）,手术时间是（24.84±8.45）min,苏醒时间是（7.16±3.23）min,VAS疼痛评分（苏醒10 min后）为1（1, 2）分。26 例患者均未出现呼吸抑制、低血压和噩梦,3 例出现头晕,2 例出现呕吐,1 例出现苏醒期躁动。结论：在宫腔镜检查术中,艾司氯胺酮联合丙泊酚的血浆浓度3 μg·mL^-1进行靶控输注时,抑制患者体动反应的ED50和ED95分别是0.391 mg·kg^-1和0.476 mg·kg^-1。     

复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量

目的 探讨复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量。方法 选择2021年10月-2022年4月在嘉兴市第二医院妇科手术中心行择期无痛人工流产术的患者,年龄18~35岁,体质量指数（body mass index,BMI）18~28kg/m2,美国麻醉医师协会（American Society of Anesthesologists,ASA）分级为I或II级,胎儿年龄<10周,初次妊娠或无经阴道分娩史。采用随机数字表法将患者分为2组：丙泊酚组（P组）和环泊酚组（C组）。麻醉诱导时静脉注射阿芬太尼后给予改良序贯法设定剂量的丙泊酚或环泊酚,若术中患者出现肢体不自主运动并影响术者手术操作且需追加麻醉药物即判定为阳性反应,并且静脉追加丙泊酚或环泊酚0.5mg/kg或0.1mg/kg,下一例患者丙泊酚或环泊酚增加一个剂量梯度。反之则下一例患者丙泊酚或环泊酚减少一个剂量梯度,相邻患者的丙泊酚或环泊酚剂量梯度分别为0.5mg/kg和0.1mg/kg。采用Probit回归分析法计算丙泊酚和环泊酚的50%有效剂量（median effective dose,ED50）、95%有效剂量（95% effective dose,ED95）及相应的置信区间（confidence interval,CI）。结果 P组丙泊酚抑制人工流产术中体动反应的ED50（95%CI）为1.815（1.315~2.319）mg/kg,ED95（95%CI）为2.901（2.368~6.447）mg/kg;C组环泊酚抑制体动反应的ED50（95%CI）为0.381（0.279~0.484）mg/kg,ED95（95%CI）为0.613（0.501~1.344）mg/kg,两者对应的等效比值为4.76（4.71~4.79）。结论 复合阿芬太尼时环泊酚抑制人工流产术中体动反应的效价大于丙泊酚。     

复合丙泊酚麻醉时纳布啡抑制无痛胃镜检查老年患者体动反应的半数有效剂量

目的确定复合丙泊酚麻醉时纳布啡抑制无痛胃镜检查老年患者体动反应的半数有效剂量(ED50)。方法选择2018年10月至12月在广元市中心医院行无痛胃镜检查的老年患者,性别不限,年龄65～83岁,体质指数（BMI） 18～25 kg/m2,美国麻醉医师协会（ASA）分级Ⅱ级或Ⅲ级。采用序贯法进行试验。纳布啡初始剂量为0. 1mg/kg,静脉注射完毕3 min后推注丙泊酚1～1. 5mg/kg,待睫毛反射消失后行胃镜检查。发生体动反应时,追加丙泊酚0. 5mg/kg,同时下1例患者纳布啡用量增加1个剂量梯度,如顺利完成胃镜检查则在下1例患者降低1个剂量梯度。两相邻剂量的差值0. 01mg/kg。记录术中体动反应和呼吸暂停等并发症的发生情况。采用直线回归Probit法计算纳布啡抑制体动反应的ED50及其95%的可信区间。结果复合丙泊酚时,纳布啡拟制老年患者胃镜检查时发生体动反应的ED50及其95%的可信区间为0. 073（0. 067～0. 080） mg/kg。结论复合丙泊酚时,纳布啡拟制老年患者胃镜检查时发生体动反应的ED50为0. 073 mg/kg。     

瑞马唑仑与阿芬太尼联用抑制日间人流手术体动反应的半数有效剂量

目的 通过序贯法测定在瑞马唑仑镇静下,阿芬太尼抑制日间人流手术体动反应的半数有效剂量(ED₅₀)。方法 根据序贯法要求,共纳入浙江省杭州市临平区妇幼保健院2021年5月1日-10月30日行无痛人流手术患者47例。所有患者麻醉诱导时静脉缓慢注射瑞马唑仑0.3mg/kg,2分钟后缓慢注射阿芬太尼,初始剂量为18.6μg/kg,待患者睫毛反射消失后手术开始,观察术中置入宫腔探条时体动反应。研究采用序贯法确定阿芬太尼的使用剂量,若患者在置入宫腔探条时出现体动反应,则下一例增加1.2倍,反之降低1.2倍,直至出现至少6个反折点,结束试验。采用概率单位(Probit)回归分析法计算阿芬太尼抑制人流手术体动反应的ED₅₀及95%的可信区间(CI),记录术中生命体征,有无呼吸抑制、静脉注射痛、苏醒时间,及术后10分钟疼痛评分(VAS₁)、30分钟疼痛评分(VAS₂)、出院时疼痛评分(VAS₃),以及不良反应。结果 在瑞马唑仑镇静下,阿芬太尼抑制人流手术体动反应的ED₅₀为...     

复合羟考酮时丙泊酚抑制无痛胃镜患者体动反应的ED50/ED95

目的 确定复合羟考酮时丙泊酚抑制无痛胃镜患者体动反应的量效关系.方法 选取2016年7月在海南省人民医院内镜中心择期行无痛胃镜检查患者60例,按随机数字表法分为丙泊酚组(P组)和羟考酮复合丙泊酚组(OP组),每组30例,两组再各自分六个亚组.P组患者先静脉注射生理盐水2 mL后,各亚组分别静脉推注丙泊酚2.2 mg/kg、2.4 mg/kg、2.6 mg/kg、2.8 mg/kg、3.0 mg/kg、3.2 mg/kg,药物注射时间为40 s;OP组患者先静脉注射羟考酮2 mg(2 mL)后,各亚组后分别给予异丙酚1.4 mg/kg、1.6 mg/kg、1.8 mg/kg、2.0 mg/kg、2.2 mg/kg和2.4 mg/kg,给药2 min后,若患者睫毛反射消失,Bis低于65,置入胃镜无体动反应,则记为阳性病例,反之记为阴性病例,则酌情追加丙泊酚0.2~0.5 mg/kg直至患者无体动完成检查.记录每组的相应的剂量及阳性病例数.采用Probit法计算丙泊酚的ED50和ED95.结果 丙泊酚抑制无痛胃镜患者体动反应的ED50为2.6(2.4~2.9)mg/kg,ED95为3.1(2.9~4.0)mg/kg,复合羟考酮2 mg时丙泊酚抑制胃镜患者体动反应的ED50为1.8(1.6~1.9)mg/kg,ED952.1(2.0~2.9)mg/kg.结论 复合2 mg羟考酮后异丙酚的用量可以减少约30%.     

甲苯磺酸瑞马唑仑联合瑞芬太尼对无痛胃镜置入反应的药效学研究及其性别差异

目的探讨甲苯磺酸瑞马唑仑联合瑞芬太尼抑制无痛胃镜置入反应的半数有效剂量(ED_(50))及95%有效剂量(ED_(95))及性别差异。方法66例无痛胃镜检查患者分为A、B及C组,A组性别不限(20例),B组仅纳入男性患者(23例),C组仅纳入女性患者(23例)。各组第1例患者均接受0.5μg/kg瑞芬太尼联合0.2 mg/kg瑞马唑仑静脉注射麻醉,2min后置入上消化道内镜,依据改良序贯法(Dixon)以0.05mg/kg为剂量梯度,当患者出现置入反应时,下一例患者瑞马唑仑用药剂量增加一级,否则降低一级,以阳性反应转阴性为交叉点,在第7个交叉点出现后结束研究。采用概率单位回归分析法计算各组瑞马唑仑ED_(50)、ED_(95)及95%置信区间(95%CI).结果A组ED_(50)为0.206 mg/kg(95%CI:0.161〜0.234 mg/kg),ED_(95)为0.320 mg/kg(95%CI:0.244〜0.501 mg/kg);B组ED_(50)为0.177mg/kg(95%CI:0.148〜0.232mg/kg),ED_(95)为0.253 mg/kg(95%CI:0.213〜0.417 mg/kg);C组ED_(50)为0.229 mg/kg(95%CI:0.185〜0.274mg/kg),ED_(95)为0.354mg/kg(95%CI:0.270〜0.536mg/kg).3组中C组ED_(50)及ED_(95)最高,A组次之,B组最低。结论甲苯磺酸瑞马唑仑联合瑞芬太尼抑制无痛胃镜置入反应的ED_(50)为0.206mg/kg,ED_(95)为0.320 mg/kg,且女性患者甲苯磺酸瑞马唑仑ED_(50)及ED_(95)高于男性患者。     

依托咪酯在老年患者诱导时抑制气管插管反应的最低有效量

目的测定依托咪酯在老年患者诱导时抑制气管插管反应的最低有效量即半数有效量(ED50)。方法 35例拟行气管插管全身麻醉老年患者(ASAⅠ～Ⅲ级),诱导方法:第1例患者采用依托咪酯0.2 mg/kg静脉注射,其后各患者的药物剂量依序贯法进行选择,若患者的平均动脉压(MAP)或心率(HR)增快大于20%,为阳性,则下例患者取高一级别剂量,若患者的平均动脉压或心率增快小于20%,为阴性,则下例患者取低一级别剂量,相邻级别的药物剂量比为1∶1.1,而后维库溴铵0.1 mg/kg及芬太尼4μg/kg静脉注射。结果在老年患者行气管插管全身麻醉诱导时依托咪酯抑制气管插管反应的ED50为0.244 mg/kg,95%CI为0.158～0.330 mg/kg。结论依托咪酯在老年患者诱导时抑制气管插管反应的最低有效量即ED50为0.244 mg/kg,其95%CI为0.158～0.330 mg/kg。     

舒芬太尼抑制高血压病患者气管插管反应ED50的临床研究

目的探讨丙泊酚靶控输注下(targeted-controlled infusion,TCI)舒芬太尼抑制40~79岁高血压患者气管插管反应的半数有效剂量(50%Effect Dose,ED50)。方法研究对象为160例择期拟行全麻气管插管下手术合并高血压病的患者,ASAⅡ-Ⅲ级,按年龄段分为四组:A组(40~49)岁,B组(50~59)岁,C组(60~69)岁,D组(70~79)岁,每组40人。待TCI丙泊酚血浆浓度与效应室浓度达平衡后,静脉缓慢输注预设剂量的舒芬太尼,病人意识消失后给予0.1 mg/kg维库溴铵静注,2 min后行气管插管,舒芬太尼的剂量按序贯法确定。结果 A组患者有效抑制气管插管反应的舒芬太尼ED50为0.45 ug/kg,95%可信区间(confidence interval,CI)为0.4 ug/kg~0.5 ug/kg;B组患者ED50为0.38 ug/kg,95%CI为0.31 ug/kg~0.45 ug/kg;C组患者ED50为0.32 ug/kg,95%CI为0.22 ug/kg~0.42 ug/kg;D组患者ED50为0.28 ug/kg,95%CI为0.2ug/kg~0.36 ug/kg。结论高血压病控制正常的患者TCI丙泊酚3 ug/ml,复合序贯法静注舒芬太尼抑制气管插管反应的ED50随年龄的增长逐渐下降,半数的病例可有效抑制气管插管应激反应,对提高此类患者全麻诱导气管插管期间安全性提供临床参考。     

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.