UC患者PBMC中TLR4、NF-κB水平的变化及其临床意义

目的 探讨溃疡性结肠炎(UC)患者外周血单核细胞(PBMC)中TOLL样受体(TLR)4、NF-κB水平的变化及在UC发病中的可能机制.方法 选取武警浙江省总队医院嘉兴医院消化科2014年1月至2015年1月收治的UC患者30例作为观察组,另选取该院体检科健康体检者10例作为对照组.采用流式细胞仪检测外周血CD14+单核细胞表面TLR4阳性表达率,RT-PCR检测TLR4、髓样分化因子88(MyD88)、NF-κB(P65) mRNA表达水平,Western blot检测TLR4、MyD88、NF-κB(P65)蛋白水平.结果 观察组外周血CD14+单核细胞表面TLR4阳性表达率明显高于对照组(P＜0.05);对照组TLR4、MyD88、NF-κB(P65) mRNA及蛋白水平明显低于观察组(P＜0.01);TLR4、MyD88、NF-κB(P65)蛋白水平与UC严重程度呈正相关.结论 UC患者PBMC中TLR4、NF-κB明显增高,临床可通过检测TLR4、NF-κB水平判断UC的发展程度.     

5岁以下喘息患儿哮喘预测指数与外周血单核细胞TLR4表达的相关性研究

目的 探讨5岁以下喘息患儿外周血单核细胞(PBMCs)表面Toll样受体4(TLR4)及血清白细胞介素6(IL-6)的表达.方法 选取该院门诊或住院患儿共224例,其中哮喘预测指数(API)阳性组116例,阴性组108例.两组患儿均在喘息症状缓解1个月后分别抽取外周血,流式细胞仪检测PBMCs TLR4阳性率,酶联免疫吸附法(ELISA)检测血清IL-6水平.结果 API阳性组患儿CD14+单核细胞表面TLR4阳性率明显高于API阴性组[(34.9±10.0)％vs.(30.2±8.8)％];API阳性组患儿血清IL-6水平明显高于API阴性组[(46.4±15.1)ng/L vs.(40.5±13.6)ng/L];且两组TLR4阳性率和IL-6水平均呈线性相关(P＜0.05).结论 TLR4的激活诱导IL-6等细胞因子表达可能和哮喘的发生、发展有关,TLR4可能可以作为喘息发展为哮喘的预测指标.     

系统性红斑狼疮患者外周血CD14+单核细胞表面TLR2、TLR4表达的变化

目的:探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者外周血单核细胞表面Toll样受体2(toll-likereceptor-2,TLR2)和Toll样受体4(toll-like receptor-4,TLR4)表达的变化。方法:流式细胞术分别检测75例SLE患者(SLE组)和44名正常人(对照组)外周血单核细胞表面TLR2和TLR4的阳性率和平均荧光强度(meam fluorescence intensity,MFI)。统计分析TLR2和TLR4阳性率和MFI与相关临床与实验室指标的相关性。结果:TLR2在SLE组外周血CD14+单核细胞表面的阳性率和MFI均低于对照组;而TLR4在SLE组外周血CD14+单核细胞表面的阳性率高于对照组,但MFI表达低于对照组(P<0.01)。TLR2阳性率与SLE活动指数呈负相关(P<0.01)。结论:TLR2和TLR4在SLE患者外周血CD14+单核细胞表面表达有显著变化,提示可能与SLE的发生及病情存在一定的关联。     

乌司他丁对重症急性胰腺炎患者早期外周血单核细胞Toll样受体4表达的影响

目的:研究乌司他丁对重症急性胰腺炎患者早期外周血单核细胞Toll-样受体4(TLR4)表达的影响.方法:将58例重症急性胰腺炎患者随机分为乌司他丁组(29例,予以常规治疗+乌司他丁)和常规组(29例,予以常规治疗),同时选择20例健康志愿者作为对照组.入院后第1、3、5、7、14天采集静脉血,对照组仅采血1次.用流式细胞仪检测外周血单核细胞TLR4、CD14的表达,用ELISA试剂盒检测血浆TNF-α、IL-6的浓度,并分析与TLR4表达的相关性.结果:与对照组比较,在入院第1天常规组和乌司他丁组患者外周血单核细胞TLR4表达明显增高(P＜0.01),两组在入院后第3、5天TLR4表达逐渐降低,但仍高于对照组(P＜0.05).乌司他丁组与常规组相比,入院第1天治疗前,外周血单核细胞TLR4表达差异无统计学意义(P＞0.05),而在入院后第3、5、7天乌司他丁组外周血单核细胞TLR4的表达均明显低于常规组(P＜0.05).血浆TNF-a、IL-6浓度的变化与TLR4变化一致.结论:重症急性胰腺炎患者早期外周血单核细胞表面TLR4的表达明显增高,乌司他丁对重症急性胰腺炎引起的全身炎症反应的拮抗和抑制作用与其抑制单核细胞表面Toll样受体4的表达从而抑制炎症反应有关.     

恶性肿瘤患者不同病期阶段外周血单核细胞CD14和TLR4的表达研究

目的探讨恶性肿瘤患者不同病期外周血单核细胞CD14和TLR4（Toll样受体4）的表达。方法采用流式细胞术检测50例健康体检者（对照组）及80例恶性肿瘤患者（按照影像学观察到肿瘤大小变化和相关肿瘤标志物的测定值分为稳定期及进展期）外周血单核细胞CD14和TLR4的表达。结果恶性肿瘤患者外周血单核细胞CD14稳定期及进展期的表达水平分别为（6.1600&#177;2.32217）％、（5.8629&#177;1.91896）％,与健康体检者（对照组）（5.5580&#177;1.42272）％比较,无统计学意义,恶性肿瘤患者稳定期TLR4表达水平为（10.4444&#177;3.16225）％与健康体检者（对照组）的（8.8780&#177;5.24612）％比较无统计学意义;进展期TLR4表达水平为（14.7286&#177;6.95213）％,明显高于健康体检者（对照组）（8.8780.4-5.24612）％（P〈0.05）和恶性肿瘤患者稳定期（10.4444&#177;3.16225）％（P〈0.05）。结论单核细胞表面的TLR4的表达水平在恶性肿瘤患者进展期较稳定期及对照组显著增高,而CD14的表达与病期无关,与对照组无差异。因此在CD14处于稳定状态下,TLR4的表达上调有可能预测肿瘤患者病情恶化。     

慢性阻塞性肺疾病患者和吸烟者CD14+单核细胞Toll样受体的表达及意义

目的 探讨稳定期慢性阻塞性肺疾病(COPD)患者和肺功能正常的吸烟者外周血CD14+单核细胞Toll样受体(TLR)表达的变化及意义.方法 选择COPD稳定期患者30例(COPD组)、健康吸烟者21例(吸烟组)及健康不吸烟者25例(不吸烟组),用肺功能仪测定第一秒用力呼气容积(FEV1)占预计值的百分比(FEV1占预计值%)和FEV1/用力肺活量(FVC);应用流式细胞仪全血双色免疫荧光直标法检测外周血CD14+单核细胞的TLR2、TLR4表达水平,结果 以CD14+细胞TLR相对平均荧光强度(rmfi)和TLR相对阳性细胞百分率(rpcp)表示,并进行TLR2、TLR4表达与肺功能指标相关性分析.结果 COPD组CD14+单核细胞TLR2表达的rmfi(6.3±1.4)和rpcp(52.9%±20.5%)均明显低于吸烟组(分别为8.2±2.2和73.5%±19.O%,均P<0.01)和不吸烟组(分别为11.0±2.4和82.8%±17.9%,均P<0.01);TLR4表达的nnfi(2.2±0.9)明显低于不吸烟者组(3.0±0.5,P<0.01),与吸烟组(2.5±0.6)差异无统计学意义(P>0.05),而rpcp(M=1.3%,Q1～Q3为0.7%～2.4%)则明显低于吸烟组(M=4.7%,Q1～Q3为2.7%～9.4%,P<0.01)和不吸烟组(M:5.3%,Q1～Q3为2.6%～8.4%,P<0.01).吸烟组CD14+单核细胞中TLR2、TLR4表达的rmfi均明显低于不吸烟组(P<0.01,P<0.05);而rpcp与不吸烟组差异无统计学意义(P0.05).CD14+单核细胞TLR2和TLR4的表达与FEV1占预计值%、FEV1/FVC呈显著正相关(均P<0.01).结论 稳定期COPD患者和吸烟者外周血CD14+单核细胞TLR2及TLR4表达显著下调,固有免疫可能受到抑制,TLR表达下调与肺功能下降有关.     

脂多糖对结核病患者外周血单核细胞Toll样受体4表达及细胞内活性氧产生的影响

目的:探讨脂多糖(LPS)对结核病患者外周血单核细胞Toll样受体4(TLR4)表达及细胞内活性氧(ROS)产生的作用。方法:收集健康志愿者外周血标本和结核病患者外周血标本,各13例;取二者肝素抗凝血100μL,荧光探针DHR123或抗人anti-TLR4-PE荧光素标记抗体,全血染色后,流式细胞仪技术检测分析二者外周血单核细胞TLR4表达及细胞内ROS产生水平;再取二者抗凝血100μL于96孔培养板中,按如下分组进行处理:健康志愿者抗凝血为A组,结核病患者抗凝血为B组,结核病患者抗凝血+LPS 100 ng/mL为C组,每组6孔,培养24 h后,流式细胞仪技术检测单核细胞TLR4表达及细胞内ROS产生水平。结果:结核病患者外周血单核细胞TLR4阳性表达率为(17.6±3.6)%,较健康志愿者的(30.0±2.4)%显著降低(P<0.01);结核病患者外周血单核细胞细胞内ROS水平(74.8±11.4)较健康志愿者(109.6±13.2)显著降低(P<0.01)。LPS刺激24 h后,C组单核细胞胞内ROS水平(182.1±11.3)与B组(127.6±14.1)相比差异有统计学意义(P<0.01);C组单核细胞TLR4阳性表达率为(62.1±3.3)%,与B组的(47.6±4.7)%差异有统计学意义(P<0.01)。结论:LPS可促进结核病患者外周血单核细胞TLR4表达及细胞内ROS产生水平。     

医学生外周血T细胞mIL-2R的表达

目的:测定正常医学生外周血T细胞数量及其亚群比例和活化后mIL-2R的表达水平,为正常机体细胞免疫功能状态提供参考数据.方法:用生物素-链霉亲和素法对49名在校医学生外周血T淋巴细胞亚群及mIL-2R进行检测.结果:男生外周血淋巴细胞中总T细胞亚群(CD3+)占(64.90±4.11)%,其中CD4+和CD8+ T细胞亚群分别为(42.84±4.08)%和(30.23±2.03)%,CD4+/CD8 +比例为1.42±0.10;植物血凝素(PHA)诱导前后淋巴细胞的mIL-2R表达水平分别为(3.08± 1.22)%和(3 1.76±3.52)%;女生T细胞亚群阳性百分率分别为CD3+(66.61±3.36)%、CD4+(43.83± 3.85)%、CD8+(29.06±2.53)%、CD4+/CD8+1.52±0.16,PHA诱导前后的mI L- 2R表达水平分别为(3.48±1.41)%和(34.58±3.05)%.虽然女生CD3+、CD4+和mIL- 2R表达水平偏高,CD8+偏低,但差异均无显著性(P＞0.05);女生CD4+/CD8+ 比值及诱导期mIL-2R表达水平较男生增高(P＜0.05和P＜0.01). 结论:医学生外周血T淋巴细胞亚群的百分率均在正常范围,男生和女生之间无明显差异,但女生CD4+/CD8+比值较高;PHA刺激诱导mIL-2R正常表达,但在女生较高.     

胃癌和食管癌外周血CD4+CD25+调节性T细胞检测及其临床意义

目的 探讨胃癌和食管癌外周血表达CD25的CD4+调节T细胞(CD4+CD25+Tr)比率变化的特点及其临床意义.方法 采用流式细胞术检测49例胃癌和28例食管癌患者外周血CD4+CD25+调节T细胞水平,并进行分层分析.结果 食管癌患者外周血CD4+CD25+Tr细胞占总CD4+T细胞的(24.37±4.82)%(n=28);胃癌患者外周血CD4+CD25+Tr细胞占总CD4+T细胞的(17.74±4.24)%(n=49).与健康对照组比较,外周血CD4+CD25+Tr细胞比率均明显升高,差异有显著统计学意义(P＜0.01).该CD4+CD25+Tr细胞低表达CD45RA及CD69.分层分析外周血CD4+CD25+Tr细胞比率与肿瘤临床分期的关系显示,胃癌患者Ⅰ～Ⅲ期,其外周血CD4+CD25+Tr细胞占CD4+T细胞的比率为(16.69±5.71)%(n=15);Ⅳ期为(18.08±4.99)%(n=16).与Ⅰ～Ⅲ期比较,Ⅳ期患者外周血CD4+CD25+Tr细胞比率升高,但是,差异无统计学意义(P＞0.05).胃癌复发患者18例,其外周血CD4+CD25+Tr细胞占CD4+T细胞的比率为(23.32±4.98)%(n=18).明显高于原发胃癌组(P＜0.01).食管癌患者Ⅰ-Ⅲ期外周血CD4+CD25+Tr细胞占CD4+T细胞的(25.17±5.87)%(n=18),Ⅳ期患者外周血CD4+CD25+Tr细胞占CD4+T细胞的(26.46±4.84)%(n=10),差异无统计学意义(P＞0.05).结论 胃癌和食管癌患者外周血CD4+CD25+Tr细胞比率明显升高.提示祛除人的CD4+CD25+Tr细胞是一种有效的治疗肿瘤的新方法.     

中国HGV/HIV合并感染者或HIV单一感染者T淋巴细胞表面CD25和GXCR3表达的研究

目的探讨T淋巴细胞表面CD25分子和趋化因子受体CXCR3,在丙肝病毒(HCV)单一感染,艾滋病病毒(HIV)单一感染和HCV/HIV合并感染过程中的表达及意义.方法分离HCV感染组(n=21),HIV感染组(n=14),HCV/HIV感染组(n=28)及正常对照组(n=30)人外周血单个核细胞.采用流式细胞术,计数CD4+和CD8+T淋巴细胞数,检测外周血CD4+CD25+T细胞百分含量和CD4+和CD8+T淋巴细胞表面CXCR3的表达水平.结果CD4+T细胞表面CD25的表达在HCV感染组轻度升高,而在HIV感染组及HCV/HIV合并感染组CD25的表达显著降低(P＜0.001).HIV感染组及HCV/HIV合并感染组CD4+T细胞表面CXCR3表达显著降低(P＜0.001),CD8+T细胞表面CXCR3表达显著升高(P＜0.001);HCV感染组CD4+及CD8+T细胞表面CXCR3表达轻度升高,但差异不显著.结论结果提示中国病毒感染者外周血T淋巴细胞表面CD25和CXCR3分子表达水平和机体免疫调节功能受到HIV感染的影响.     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.