基于调控ABCA1表达探讨升麻苷抗动脉粥硬化的作用机制*

目的 研究升麻苷对人单核细胞(THP-1)源性巨噬泡沫细胞炎症因子IL-6, TNF-α的影响,调控ABCA1表达,探讨其抗动脉粥样化的机制。方法 使用适当升麻苷(16、64 μg/ml)作用于诱导成功的THP-1源性巨噬泡沫细胞,ELISA测定细胞上清培养液中IL-6、TNF-α表达,Western印迹测定IL-6、TNF-α以及ABCA1的表达量,闪烁计数法测定细胞内胆固醇流出率。结果 升麻苷浓度≤64ug/ml时,对泡沫细胞无明显毒性;ELISA测定显示不同浓度升麻苷能够降低IL-6、TNF-α的表达(P＜0.01; 0.05);Western印迹测定显示不同浓度升麻苷能够降低IL-6、TNF-α的表达,增加ABCA1的表达(P＜0.01; 0.05);闪烁计数法测定结果显示不同浓度升麻苷能够提升细胞胆固醇流出率(P＜0.01; 0.05)。结论 升麻苷可抑制THP-1源性巨噬泡沫细胞炎症因子IL-6、TNF-α表达,提升ABCA1表达,促进胆固醇外排,从而达到抗炎及抑制动脉粥样硬化的作用。     

小檗碱对THP-1巨噬细胞源性泡沫细胞胆固醇流出的影响

目的 观察不同浓度小檗碱对THP-1巨噬细胞源性泡沫细胞胆固醇流出的影响,并探讨其可能的作用机制.方法 佛波酯(PMA)刺激THP-1细胞分化为巨噬细胞后经乙酰化低密度脂蛋白(AcLDL)诱导泡沫化,建立THP-1巨噬细胞源性泡沫细胞模型.根据小檗碱干预与否及干预浓度将泡沫细胞分为空白对照组和小檗碱(5～20 μmol/L)干预组.细胞经分组处理24 h后,流式细胞仪检测AcLDL聚集量;酶法检测胆固醇和乙酰甘油含量;闪烁计数法检测各组胆固醇流出率,同时分析过氧化物酶体增殖物激活受体γ(PPARγ)抑制剂GW9662预处理对胆固醇流出率的影响(以吡格列酮作为阳性对照);RT-PCR检测肝X受体α(LXRα)和三磷酸腺苷结合盒转运体A1(ABCA1) mRNA表达.结果 与空白对照组比较,不同浓度小檗碱干预组泡沫细胞内AcLDL聚集量及胆固醇和乙酰甘油含量均显著减少(P＜0.01),而胆固醇流出率上升(P＜0.01),并呈现一定的量效关系.GW9662预处理后,不同浓度小檗碱干预组泡沫细胞的胆固醇流出率与对照组比较,差异均无统计学意义(P>0.05).不同浓度小檗碱干预组泡沫细胞LXRα和ABCA1 mRNA表达均高于空白对照组.结论 小檗碱可增加THP-1巨噬细胞源性泡沫细胞胆固醇的流出量,其作用机制可能与激活PPARγ途径,增加LXRα和ABCA1 mRNA表达有关.     

AGEs-RAGE相互作用对巨噬细胞胆固醇流出功能影响的研究

目的 观察糖基化终末产物(advanced glycation end products, AGEs)及其受体(receptor of advanced glycation end products, RAGE)对巨噬细胞胆固醇流出功能的影响。方法 培养THP-1细胞株并用佛波酯诱导分化使其成为巨噬细胞,与100μg/ml的氧化LDL(oxidized LDL, oxLDL)孵育细胞使其转化为泡沫细胞。分别以浓度为300μg/ml的AGEs、600μg/ml的AGEs对细胞进行刺激,用浓度为10μg/ml的抗RAGE抗体对细胞进行预处理,通过油红“O”染色测定来反映细胞内脂质含量,通过RT-PCR及Western Blot的方法来检测各组巨噬细胞RAGE表达以及与胆固醇流出相关因子ATP-结合盒转运子(ATP-binding cassette, ABC)G1、ABCA1及肝X受体-α(Liver X Receptor-α, LXR α的表达变化),通过将干预后的巨噬细胞与荧光标记的oxLDL共同孵育,并加入HDL及载脂蛋白A1(apolipoprotein A1, apoA1)介导胆固醇流出,测定细胞培养基中的荧光强度,动态观察巨噬细胞在不同干预条件下胆固醇流出功能变化。结果 经AGEs诱导后,巨噬细胞内脂质含量增加,RAGE表达增加,ABCG1表达下降,巨噬细胞胆固醇流出能力减弱。AGEs效应呈浓度依赖性。应用抗体阻断RAGE功能后,AGEs引起的改变均有明显恢复。结论 AGEs-RAGE相互作用可以抑制巨噬细胞流出胆固醇,增加细胞内脂质累积,从而易于形成泡沫细胞。     

血管紧张素Ⅱ对THP-1源性泡沫细胞ATP结合盒转运子A1表达的调控作用

目的:观察血管紧张素Ⅱ(AngⅡ)对THP-1源性泡沫细胞ATP结合盒转运子A1(ABCA1)表达的调控作用.方法:以50 mg/L的氧化低密度脂蛋白(ox-LDL)温育人巨噬细胞系THP-1源性巨噬细胞48 h为对照,同时分别加入10-7 mol/L、10-6 mol/L、10-5 mol/L的AngⅡ,采用RT-PCR和Western blotting法分别检测THP-1源性泡沫细胞中ABCA1 mRNA与蛋白的表达,采用酶法检测细胞内胆固醇含量,应用液体闪烁计数仪检测胆固醇流出的变化.结果:与对照组比较,10-7 mol/L、10-6 mol/L、10-5 mol/L AngⅡ组ABCA1 mRNA和蛋白表达均下降(P＜0.05),胞内胆固醇含量增加(P＜0.05),胆固醇流出率减少(P＜0.05).结论:AngⅡ可下调THP-1源性泡沫细胞ABCA1的表达,促进泡沫细胞形成.     

脂联素对平滑肌源性泡沫细胞三磷酸腺苷结合盒转运体A1表达的影响

目的研究脂联素在体外干预泡沫细胞形成的内在机制及其对胆固醇外转运蛋白三磷酸腺苷结合盒转运体A1表达的影响。方法以平滑肌源性泡沫细胞为研究对象,采用不同浓度的脂联素体外干预平滑肌源性泡沫细胞,油红O染色观察细胞内脂滴的形成,Real-time PCR检测ABCA1转录水平的表达,Western-blot检测泡沫细胞膜蛋白LXRα、ABCA1、ABCG1和核蛋白PPARγ的磷酸化水平。结果 10μg/L脂联素能通过激活PPARγ/LXRα/ABCA1,促进胆固醇外转运蛋白ABCA1表达。结论脂联素可以激活PPARγ信号通路,促进外转运蛋白ABCA1表达,抑制平滑肌源性泡沫细胞的形成。     

连翘苷通过非calpain途径升高ABCA1表达抑制动脉粥样硬化斑块形成

目的 验证连翘苷是否通过抑制钙激活中性蛋白酶（calpain）途径调节ATP结合盒转运蛋白A1(ABCA1)起到抗动脉粥样硬化作用。方法 利用雄性APOE基因敲除小鼠建立动脉粥样硬化模型,随机数字表法分为空白对照组、模型对照组、连翘苷低剂量组、连翘苷高剂量组、阿托伐他汀组,每组5只。试剂盒检测小鼠血清高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）、总胆固醇（TC）、葡萄糖、纤维蛋白原及超敏C反应蛋白（hs-CRP）水平;组织化学染色分析连翘苷对小鼠主动脉斑块的作用;免疫组织化学检测ABCA1、肝脏X受体α(LXR-α)、过氧化物酶体增殖物激活受体γ(PPAR-γ)、钙蛋白酶抑制蛋白（calpastatin）、calpain的表达。使用佛波酯和氧化低密度脂蛋白建立THP-1源性泡沫细胞模型,分为THP-1细胞组、泡沫细胞组、低浓度连翘苷组、高浓度连翘苷组,进行油红O染色观察脂质沉积,使用Western blot检测ABCA1蛋白表达。结果 与模型对照组比较,连翘苷高剂量组LDL-C [(7.10±1.10)mmol/L比（16.09±2.08）mmo...     

载脂蛋白A-Ⅰ模拟肽对RAW264.7巨噬细胞胆固醇流出的影响

目的：观察载脂蛋白A-Ⅰ（apoA-Ⅰ）模拟肽D-4F对RAW264.7巨噬细胞胆固醇流出的影响,并探讨其机制。方法：巨噬细胞种植于24孔板,用1.85×10^7Bq/孔3H-胆固醇和含50μg/mL氧化型低密度脂蛋白（ox-LDL）共同孵育24h后,给予不同浓度的D-4F（0～100μg/mL）干预24h,收集细胞用液体闪烁计数法检测胆固醇流出。采用酶联免疫吸附试验（ELISA）测定细胞内环磷酸腺苷（cAMP）含量,采用实时荧光定量PCR及Western印迹检测三磷酸腺苷结合盒转运体A1（ABCA1）的mRNA及蛋白表达。结果：D-4F呈浓度依赖及时间依赖性促进巨噬细胞内胆固醇流出,增加细胞内cAMP水平,上调ABCA1mRNA和蛋白表达。8-Br-cAMP显著增加D-4F介导的胆固醇流出和ABCA1表达,而蛋白激酶A（PKA）抑制剂虽然对基础胆固醇流出及ABCA1表达几乎无作用,却可以抑制8-Br-cAMP对胆固醇流出和ABCA1表达的促进作用。结论：D-4F促进巨噬细胞胆固醇流出,cAMP释放及ABCA1表达,可能与激活cAMP-PKA-ABCA1通路有关。     

桑抹茶对THP-1源性泡沫细胞脂质沉积的作用研究

目的 明确桑抹茶对THP-1泡沫细胞脂质沉积的改善作用。方法 实验分为正常对照组：佛波酯诱导的THP-1源性巨噬细胞,模型对照组：佛波酯+Ox-LDL诱导的THP-1源性泡沫细胞,药物干预组：THP-1源性泡沫细胞+不同浓度（10、20、40、80、160、320、640 μg/ml）桑抹茶提取物,同时设RPMI 1640培养基为空白对照。MTT法检测各组细胞活力;油红O染色观察细胞内脂质沉积;荧光显微镜观察THP-1巨噬细胞内吞Dil-Ox-LDL情况;Western blotting检测各组细胞介导细胞内胆固醇流出蛋白ABCA1及PPARγ蛋白表达水平。结果 桑抹茶提取物能浓度依赖地抑制THP-1源性泡沫细胞对Ox-LDL的摄取,减少THP-1泡沫细胞内脂质沉积;与对照组比较,模型组泡沫细胞内脂质水平显著升高[(0.974±0.033)比(0.794±0.030),P<0.01],ABCA1蛋白表达量增加[(0.702±0.005)比(0.575±0.014),P<0.01],PPARγ表达量降低[(0.099±0.004)比(0.875±0.019),P<0.01]。与模型组比较,93、186、372 μg/mL桑抹茶提取物能显著降低泡沫细胞内脂质水平[(0.876±0.032)、(0.835±0.019)、(0.815±0.028)比(0.974±0.033),P<0.01],增加PPARγ蛋白表达量[(0.270±0.006)、(0.328±0.014)、(0.706±0.020)比(0.099±0.004),P<0.01],93、372 μg/mL桑抹茶能提高ABCA1蛋白表达量[(0.823±0.041)、(1.411±0.048)比(0.702±0.005),P<0.01]。结论 桑抹茶可能通过减少Ox-LDL摄取,促进细胞内胆固醇流出,减少细胞内脂质沉积。     

小檗碱对THP-1巨噬细胞源性泡沫细胞胆固醇流出的影响

目的 观察不同浓度小檗碱对THP-1巨噬细胞源性泡沫细胞胆固醇流出的影响,并探讨其可能的作用机制。方法 佛波酯（PMA）刺激THP-1细胞分化为巨噬细胞后经乙酰化低密度脂蛋白(AcLDL)诱导泡沫化,建立THP-1巨噬细胞源性泡沫细胞模型。根据小檗碱干预与否及干预浓度将泡沫细胞分为空白对照组和小檗碱（5~20 μmol/L）干预组。细胞经分组处理24 h后,流式细胞仪检测AcLDL聚集量;酶法检测胆固醇和乙酰甘油含量;闪烁计数法检测各组胆固醇流出率,同时分析过氧化物酶体增殖物激活受体γ（PPARγ）抑制剂GW9662预处理对胆固醇流出率的影响（以吡格列酮作为阳性对照）;RT-PCR检测肝X受体α(LXRα)和三磷酸腺苷结合盒转运体A1(ABCA1) mRNA表达。结果 与空白对照组比较,不同浓度小檗碱干预组泡沫细胞内AcLDL聚集量及胆固醇和乙酰甘油含量均显著减少（P＜0.01）,而胆固醇流出率上升（P＜0.01）,并呈现一定的量效关系。GW9662预处理后,不同浓度小檗碱干预组泡沫细胞的胆固醇流出率与对照组比较,差异均无统计学意义（P>0.05）。不同浓度小檗碱干预组泡沫细胞LXRα和ABCA1 mRNA表达均高于空白对照组。结论 小檗碱可增加THP-1巨噬细胞源性泡沫细胞胆固醇的流出量,其作用机制可能与激活PPARγ途径,增加LXRα和ABCA1 mRNA表达有关。     

硫化氢上调ABCA1表达促进泡沫细胞胆固醇流出的实验研究

目的探讨外源性硫化氢(H2S)对泡沫细胞胆固醇流出和三磷酸腺苷结合盒转运体A1(ABCA1)表达的影响。方法氧化低密度脂蛋白孵育RAW264.7细胞诱导泡沫化,H2S供体硫氢化钠处理细胞,测定胆固醇流出率,高效液相色谱测定细胞内游离胆固醇(FC)、胆固醇酯(CE)和总胆固醇(TC)浓度。实时定量PCR和蛋白印迹法检测泡沫细胞中ABCA1mRNA和蛋白表达。结果与泡沫细胞组相比,外源性H2S以时间和浓度依赖的方式增加泡沫细胞胆固醇流出(P<0.05),降低细胞中TC、FC和CE及CE/TC水平(P<0.05),上调细胞中ABCA1表达。结论外源性H2S上调泡沫细胞中ABCA1表达,促进胆固醇流出。     

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.