罗哌卡因复合右美托咪定在肌间沟臂丛神经阻滞麻醉中的应用

目的 本研究旨在探讨罗哌卡因联合应用右美托咪定,对超声引导下肌间沟臂丛神经感觉阻滞的起效时间和持续时间、运动阻滞的起效时间和持续时间以及术后镇痛持续时间的影响.方法 选取40例ASAΙ～Ⅱ级择期前臂和手部手术患者,随机分为2组,在超声引导下行肌间沟臂丛神经阻滞术.RD组(罗哌卡因+右美托咪定):0.375％罗哌卡因20 mL含1μg/kg的右美托咪定;R组(罗哌卡因):0.375％罗哌卡因20 mL.分别记录RD组和R组感觉、运动阻滞的起效时间、持续时间和术后镇痛的持续时间.结果 较R组相比,RD组的感觉阻滞持续时间、运动阻滞持续时间和术后镇痛持续时间均显著延长(P<0.01),感觉阻滞的起效时间明显缩短(P<0.05).两组运动阻滞的起效时间之间的差异无统计学意义(P>0.05).与R组相比,在臂丛神经阻滞后的30、60 min,RD组的HR和MAP显著降低(P<0.05).结论 在超声引导下的肌间沟臂丛神经阻滞术中,联合应用罗哌卡因和1μg/kg的右美托咪定,可使感觉、运动阻滞的持续时间和术后镇痛的持续时间明显延长,同时缩短感觉阻滞的起效时间.     

超声引导下右美托咪定复合罗哌卡因行竖脊肌 平面阻滞对经皮肾镜取石术后镇痛效果的影响

目的 探讨超声引导下右美托咪定复合罗哌卡因行竖脊肌平面阻滞（erector spinae plane block,ESPB）对经皮肾镜取石术后镇痛效果的影响。方法 2019年1月至2021年12月选择90例在江西省赣州市立医院行经皮肾镜取石术患者,采用随机数字表法分为右美托咪定复合罗哌卡因组（DR组）和罗哌卡因组（R组）,两组患者先行竖脊肌平面阻滞后在诱导,DR组注入0.5%μg/kg右美托咪定+0.375%罗哌卡因混合液20ml;R组注入0.375%罗哌卡因20ml,记录两组患者瑞芬太尼用量和手术时间。记录两组患者3、6、9、12、24、48h静息和翻身时视觉模拟评分（visual analogue scales,VAS）,记录两组患者补救镇痛例数、镇痛泵首次按压时间、24h内镇痛泵有效按压次数、24h内镇痛满意度评分和当晚睡眠质量评分,记录两组患者术后24h内恶心、呕吐、烦躁不良反应发生情况。结果 与R组比较,12、24、48h DR组静息和翻身时VAS显著降低（P<0.05）,与R组比较,DR组舒芬太尼补救镇痛率显著降低（P<0.05）,镇痛泵首次按压时间显著延长（P<0.05）,24h内镇痛满意度评分和当晚睡眠质量评分显著升高（P<0.05）。两组恶心、呕吐及烦躁等不良反应发生率比较,差异无统计学意义（P>0.05）。结论 右美托咪定复合罗哌卡因用于超声引导下行竖脊肌平面阻滞对经皮肾镜手术患者具有舒适、安全可靠的镇痛效果,可以改善患者的术后疼痛,延长术后镇痛时间,患者满意度高。     

右美托咪定复合罗哌卡因硬膜外麻醉用于二次剖宫产手术效果观察

目的观察右美托咪定复合罗哌卡因硬膜外给药在二次剖宫产手术中的麻醉效果。方法将择期单胎足月妊娠二次剖宫产产妇60例按随机数字表法分为右美托咪定复合罗哌卡因组（Ｄ组）和罗哌卡因组（R组）,每组30例。选L2~L3间隙硬膜外穿刺并置管,D组患者硬膜外注射0.75%罗哌卡因15ml和右美托咪定0.5滋g/kg混合液,共17ml。R组患者硬膜外注射0.75%罗哌卡因15ml和0.9%氯化钠溶液2ml共17ml。记录两组产妇的感觉阻滞起效时间、最高阻滞平面、感觉阻滞时间、Ramsay评分,记录给药30min后Bromage评分,记录两组产妇术中牵拉反应程度,不良反应及术后恶心、呕吐、寒战、神经系统症状,记录新生儿出生后1min和5min的Apgar评分。结果与R组比较Ｄ组感觉阻滞起效时间缩短、最高阻滞平面升高,感觉阻滞时间延长,牵拉反应较轻,寒战发生例数明显减少（均P＜0.05）。Ｄ组产妇Ramsay评分明显升高（P＜0.05）。两组产妇Bromage评分、新生儿Apgar评分、术后恶心、呕吐发生率比较差异无统计学意义（均P＞0.05）。结论右美托咪定复合罗哌卡因可用于二次剖宫产手术硬膜外麻醉,并能取得更满意的麻醉效果。     

罗哌卡因复合右美托咪定对超声引导下腋路臂丛神经阻滞麻醉的影响

目的评价罗哌卡因复合右美托咪定应用于超声引导下腋路臂丛神经阻滞麻醉的有效性和安全性。方法择期行前臂或手部手术的患者120例被随机分入4组。在超声引导下行腋路臂丛神经(正中神经、尺神经、桡神经、肌皮神经)阻滞麻醉,罗哌卡因组和罗哌卡因+右美托咪定50静脉组患者4支神经各注射0.5%罗哌卡因7mL,罗哌卡因+右美托咪定50局部组患者4支神经各注射0.5%罗哌卡因和50μg右美托咪定混合液7mL,罗哌卡因+右美托咪定100局部组患者4支神经各注射0.5%罗哌卡因和100μg右美托咪定混合液7mL。罗哌卡因组、罗哌卡因+右美托咪定50局部组、罗哌卡因+右美托咪定100局部组患者在手术开始后静脉输注0.9%氯化钠溶液40mL/h,罗哌卡因+右美托咪定50静脉组患者在手术开始后静脉输注右美托咪定50μg(稀释至20mL,40 mL/h)。在麻醉前(T0)和麻醉后15 min(T1)、30 min(T2)、45 min(T3)、60min(T4)各时间点,记录患者的心率(HR)、平均动脉压(MAP)和镇静评分,以及4组患者的感觉和运动阻滞起效时间、运动阻滞时间、镇痛持续时间。结果罗哌卡因+右美托咪定50局部组和罗哌卡因+右美托咪定100局部组的感觉和运动阻滞起效时间均显著短于罗哌卡因组(P值均<0.05),运动阻滞时间和镇痛持续时间均显著长于罗哌卡因组(P值均<0.05);罗哌卡因+右美托咪定50静脉组与罗哌卡因组间差异均无统计学意义(P值均>0.05)。罗哌卡因+右美托咪定100局部组在T2、T3、T4时间点的HR和MAP分别显著低于罗哌卡因+右美托咪定50局部组和罗哌卡因组同时间点(P值均<0.05),罗哌卡因+右美托咪定50静脉组在T3和T4时间点的HR和MAP分别显著低于罗哌卡因+右美托咪定50局部组和罗哌卡因组同时间点(P值均<0.05)。结论超声引导下行腋路臂丛神经阻滞时,罗哌卡因局部复合50μg右美托咪定可以缩短感觉和运动阻滞起效时间,并延长运动阻滞时间和镇痛持续时间,且对血压和HR的影响小。     

右美托咪定复合罗哌卡因在乳腺癌术后镇痛中的应用

目的 观察右美托咪定复合罗哌卡因肋间神经阻滞在乳腺癌术后镇痛的应用.方法 40例患者随机分为RD组和R组(n=20),RD组肋间神经阻滞用0.375%罗哌卡因20 mL复合右美托咪定1μg/kg;R组用0.375%罗哌卡因20 mL.记录术后0、0.5、1、2、4、8 h血流动力学变化;观察神经阻滞起效时间、镇痛持续时间及术后首次VAS评分,并记录不良反应.结果 与R组相比,RD组患者注药后0.5、1、2、4 h心率减慢,差异有统计学意义(P<0.05),罗哌卡因起效时间缩短,镇痛时间明显延长,首次VAS评分降低(P<0.05),且口干发生率高.结论 右美托咪定1μg/kg复合0.375%罗哌卡因20 mL肋间神经阻滞可以有效用于乳腺癌术后镇痛.     

右美托咪定复合罗哌卡因行超声引导髋关节囊周阻滞在髋关节置换术中的应用

目的 探讨右美托咪定作为髋关节囊周阻滞的佐剂对髋关节置换术患者术后疼痛缓解的效果及安全性。方法 选择2022年1—7月在本院择期行髋关节置换术的60例老年患者作为研究对象,按随机数表法分为右美托咪定复合罗哌卡因组(DR组)和罗哌卡因组(R组)两组,每组各30例。两组患者均在全身麻醉喉罩插管前行超声引导髋关节囊周阻滞,DR组注射1μg/kg右美托咪定+0.3%罗哌卡因共20 ml, R组注射0.3%罗哌卡因20 ml。两组患者术后均采用舒芬太尼行静脉自控镇痛,记录术中瑞芬太尼用量,术后2、6、12、24、48小时静息/运动数字疼痛评分(NRS)和Ramsay镇静评分(RSS),记录感觉阻滞时间,记录镇痛泵按压次数、术后不良反应及患者满意度。结果 除术后2小时外,DR组静息及运动状态数字疼痛评分(NRS)低于R组(P<0.05)。与R组比较,DR组的感觉阻滞时间更长,术中瑞芬太尼用量更少,Ramsay镇静评分(RSS)及患者满意度更高,术后镇痛泵按压次数更少。两组窦性心动过缓发生率差异无统计学意义(P>0.05)。结论 相较于单纯使用罗哌卡因,罗哌卡因复合右美托咪定行髋关节囊周...     

右美托咪定复合罗哌卡因对腋路臂丛神经阻滞的影响

目的：观察右美托咪定复合罗哌卡因对腋路臂丛神经阻滞的影响.方法：选择30例拟行前臂或手指手术的病人,随机分为两组,均在超声联合神经刺激仪引导下行腋路臂丛神经阻滞麻醉.D组（n=15）采用0.375％罗哌卡因＋右美托咪定0.5 μg/kg共29 mL.R组（n=15）采用0.375％罗哌卡因29 mL.观察项目：①术中生命征、Ramsay镇静评分;②神经阻滞情况;③术后镇痛情况.结果：D组感觉、运动阻滞维持时间及术后镇痛时间较R组延长（P＜0.05）,术后镇痛药使用较R组少（P＜0.05）.D组3例患者阻滞后出现窦性心动过缓,余均无恶心、呕吐、低血压、呼吸抑制、局麻药中毒等不良反应.结论：0.5 μg/kg的右美托咪定能增强罗哌卡因臂丛神经阻滞效果,延长术后镇痛时间,减少患者术后镇痛药物用量.     

右美托咪定联合罗哌卡因在腋路臂丛神经阻滞中的应用效果

目的:探讨右美托咪定联合罗哌卡因在腋路臂丛神经阻滞中的应用效果。方法:将2014年9月-2016年8月我院接诊的60例拟行腋路臂丛神经阻滞患者纳入本次观察,按照随机数字表法均分为观察组和对照组,各30例。对照组给予罗哌卡因麻醉,观察组给予右美托咪定联合罗哌卡因麻醉。观察两组患者麻醉效果。结果:观察组感觉阻滞起效时间、运动阻滞起效时间均低于对照组(P<0.05);感觉阻滞持续时间、运动阻滞持续时间均高于对照组(P<0.05)。观察组术后首次疼痛时间晚于对照组(P<0.05);术后首次疼痛VAS评分低于对照组(P<0.05);术后镇痛持续时间长于对照组(P<0.05)。结论:和单纯采取罗哌卡因麻醉对比,右美托咪定联合罗哌卡因在麻醉效果方面,能够缩短感觉阻滞起效时间、运动阻滞起效时间,延长感觉阻滞持续时间、运动阻滞持续时间,延迟术后首次疼痛时间,降低术后首次疼痛VAS评分,延长术后镇痛持续时间,总体麻醉效果较好,临床应用价值较高。     

右美托咪定联合罗哌卡因对臂丛神经阻滞效应的影响

目的观察右美托咪定对罗哌卡因臂丛神经阻滞效应的影响。方法择期臂丛神经阻滞下行前臂或手部手术的患者40例,ASA分级Ⅰ或Ⅱ级,随机分为两组（n=20）,罗哌卡因组限组）：神经阻滞用药为O．375％罗哌卡因20ml＋生理盐水1ml;右美托咪定复合罗哌卡因组（D组）：神经阻滞用药为0．375％罗哌卡因20ml＋右美托咪定混和液100μg。观察注药前5min（T0）、注药后3min（T1）、5min（T2）、10min（T3）、15min（T4）、20minm）、30min（T6）各时点SBP、DBP、HR和SpO2的变化;评价感觉阻滞和运动阻滞的效果,记录感觉阻滞和运动阻滞起效时间、持续时间、镇痛维持时间、麻醉质量和肌松质量、术中疼痛评分;同时记录术中寒战、低血压、嗜睡等不良反应发生情况。结果无一例患者使用补救用药或者更改麻醉方式,所有患者均未发生寒战、低血压、嗜睡等并发症。T1、T2、T3、T4、T5和T6各时点SBP、DBP、HR和SpO2组间差异无统计学意义;与R组相比较,D组感觉阻滞起效时间短、持续时间长（P〈0．05）,运动阻滞起效时间短（P〉0．05）、持续时间长（P〈0．05）,镇痛维持时间元明显变化;麻醉质量、肌松质量和不良反应发生情况组间比较差异元统计学意义。结论右美托咪定复合罗哌卡因用于臂丛神经阻滞能增强罗哌卡因的麻醉效应,起效加快、维持时间延长,且无严重不良反应发生。     

超声引导腹横肌平面右美托咪定复合罗哌卡因阻滞对下腹部手术患者镇痛效果的临床观察

目的探讨盐酸右美托咪定（dexmedetomidine hydrochloride）复合罗哌卡因（ropivacaine）应用于超声引导腹横肌平面（transversus abdominal plane,TAP）阻滞对下腹部手术患者的镇痛效果。方法选择下腹部手术患者60例,ASA分级Ⅰ或Ⅱ级,随机分为3组（n=20）：0．75％罗哌卡因20ml＋生理盐水20ml（R组）、0．75％罗哌卡因20ml＋右美托咪定20μg＋生理盐水20ml（R＋D20组）、0．75％罗哌卡因20ml＋右美托咪定40μg＋生理盐水20ml（R＋D40组）。术后在麻醉恢复室内实施双侧TAP阻滞,每侧20ml。持续监测无创血压、心电图、呼吸、脉搏血氧饱和度。记录术后Ramsay评分、VAS评分、术后额外镇痛药使用情况及不良反应发生情况。结果各组间心率、血压、脉搏氧饱和度和Ramsay评分无明显差异（P〉0．05）,R＋D20组和R＋D40组的VAS评分和额外镇痛药使用次数低于R组（P〈0．05）;3组间不良反应（恶心、呕吐、皮肤瘙痒及呼吸抑制等）无明显差别（P〉0．05）。结论右美托咪定复合罗哌卡因TAP阻滞对下腹部手术患者镇痛效果好,且右美托咪定能延长罗哌卡因镇痛时间。     

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.