肝再生增强因子联合肝细胞脾内移植治疗急性肝衰的实验研究

目的:探讨应用rALR与新生大鼠肝细胞脾内移植联合治疗大鼠急性肝衰竭的疗效.方法:采用D-gal诱导大鼠急性肝衰竭模型,36h后随机分为6组:(Ⅰ组:造模对照组;Ⅱ组:脾脏注射生理盐水1ml,腹腔注射生理盐水1ml/d;Ⅲ组:脾脏注射rALR 1ml(50μg/(kg·d)),腹腔注射rALR 1ml(50μg/(kg·d));Ⅳ:脾脏移植2×107新生大鼠肝细胞,腹腔注射生理盐水1ml/d;Ⅴ组:脾脏移植2×107新生大鼠肝细胞,腹腔注射rALR 1ml;Ⅵ组:脾脏移植2×107新生大鼠肝细胞,腹腔注射CsA1ml(10mg/(kg·d)).比较各组生存率.术后第1、5天、14天获取肝组织,观察病理变化.术后第1、2、5、12天采血,检测肝功能指标.结果:Ⅱ组存活时间与Ⅰ组比较无差异.Ⅲ组最长存活时间为118h,肝脏病理及肝功能改变情况基本同Ⅰ组和Ⅱ组.Ⅳ组有部分长期存活,2周生存率为33.3%.Ⅴ组两周存活率显著高于Ⅳ组(75%对33.3%,P＜0.02),Ⅵ组和Ⅳ组2周存活率比较无显著性差异(P＞0.05).肝功能及病理情况在Ⅳ、Ⅴ、Ⅵ组有明显改善,尤以Ⅴ组最为显著.)结论:应用rALR联合新生大鼠肝细胞移植能有效治疗大鼠急性肝衰竭,改善D-gal诱导的肝衰竭大鼠的存活率,促进肝功能恢复及改善肝脏病理状况.     

永生化肝细胞移植治疗肝衰竭

目的: 观察永生化胎肝细胞及胚胎肝细胞经脾脏移植对D-氨基半乳糖(D-gal)诱导的急性肝衰竭大鼠的治疗作用. 方法: 采用D-gal诱导大鼠急性肝衰竭,分3组进行治疗实验,Ⅰ组: 经脾脏移植永生化胎肝细胞2×107个;Ⅱ组: 移植原代胚胎肝细胞2×107个;Ⅲ组: 脾脏注射生理盐水1 mL,各组大鼠同时肌肉注射环孢霉素A(CsA) 10 mg/kg. 观察大鼠的存活率、肝脏功能、肝脏病理变化情况. 结果: Ⅰ组及Ⅱ组大鼠存活率均显著高于Ⅲ组大鼠(72.2% vs 22.2%, 61.1% vs 22.2%, P＜0.01),肝脏功能及肝脏病理均有改善, Ⅰ组与Ⅱ组之间大鼠存活率无明显差异(72.2% vs 61.1%, P＞0.05). 结论: 经脾脏移植胚胎肝细胞可明显改善D-gal诱导的肝衰竭大鼠的存活率,改善肝功能及肝脏病理,该永生化胎肝细胞可以成为肝细胞移植研究中的理想细胞材料.     

环孢霉素A联合脾内肝细胞移植治疗急性肝衰竭的实验研究

目的探讨应用环孢霉素A（CsA）与同种异体肝细胞脾内移植联合治疗大鼠急性肝衰竭的疗效.方法采用硫代乙酰胺（TAA）诱导大鼠急性肝衰竭模型,24 h后随机分为三组：Ⅰ组：脾内注射浓度约为2×107个/mL肝细胞悬液1 mL,肌肉注射CsA 10 mg/（kg.d）;Ⅱ组：仅脾内注射约2×107个/mL肝细胞悬液1 mL,不用CsA;Ⅲ组：仅脾内注射生理盐水1 mL,作为空白对照.观察各组存活率、肝功能、肝脏病理变化及脾内移植肝细胞的存活情况.结果Ⅰ组、Ⅱ组1周存活率显著高于Ⅲ组（64.7%vs 12.5%,P〈0.01;56.3%vs 12.5%,P〈0.01）,但Ⅰ组和Ⅱ组之间比较无显著性差异（64.7%vs 56.3%,P〉0.05）.肝功能及病理情况在Ⅰ组、Ⅱ组有明显改善,尤以Ⅰ组最为显著.结论 CsA联合同种异体肝细胞移植能有效治疗大鼠急性肝衰竭,改善TAA诱导的肝衰竭大鼠的存活率,促进肝功能恢复及改善肝脏病理状况.     

微囊化肝细胞移植治疗大鼠急性肝功能衰竭的研究

[目的 ]探讨微胶囊包裹肝细胞 (microencapsulatedhepatocyte)腹腔移植治疗急性肝功能衰竭的机制与可行性 ,评价生物膜功能。 [方法 ]D -氨基半乳糖 (D - gal)诱发急性肝功能衰竭大鼠模型 ,分成 4组 :Ⅰ组生理盐水组 ;Ⅱ组空微胶囊对照组 ;Ⅲ组促肝细胞生长素 (hepatocytegrowthfac tor ,HGF)组 ;Ⅳ组微囊化肝细胞组 ,观察 2周存活率、肝功生化指标的变化 ,2周后收集腹腔内微胶囊 ,观察其形态与功能。 [结果 ]Ⅳ组存活率较Ⅲ、Ⅱ、Ⅰ组有明显改善 (分别为 6 6 .7%、2 0 .0 %、1 3.3%、2 0 .0 % ,P <0 .0 5 ) ,其他组间存活率无显著性差异 ;Ⅳ组自移植后 2 4h起白蛋白 (ALB)、总胆红素 (TBIL)、凝血酶原时间 (PT)较其他组有明显改善 (P <0 .0 5 )。 2周后收集的空微胶囊形态完整 ,微囊内肝细胞部分保持存活。 [结论 ]微囊化肝细胞移植可以明显改善肝功能衰竭大鼠的存活率 ,显著改善肝脏生化功能。生物微胶囊可以有效阻断免疫排斥作用 ,保护移植肝细胞 ,有利于其发挥生物功能。     

PLA-O-CMC纳米粒子培养的猪肝细胞移植对急性肝衰竭大鼠肝再生作用的初步研究

目的:探讨胶原凝胶包埋聚乳酸-O-羧甲基壳聚糖(PLA-O-CMC)纳米粒子粘附培养猪肝细胞移植对急性肝衰竭(ALF)大鼠肝的再生作用。方法:D-氨基半乳糖腹腔内注射制作大鼠ALF模型;48h后分别将5mlⅠ型胶原凝胶包埋的PLA-O-CMC纳米粒子粘附培养24h猪的肝细胞、5mlⅠ型胶原凝胶固定培养24h的猪肝细胞、5ml培养24h的猪肝细胞悬液(均含5.0×107个)移植到各组ALF大鼠腹腔内,并以5mlRPMI1640腹腔内注射作为阴性对照。观察大鼠14天存活率和受体肝脏的病理变化。结果:移植后14天ALF大鼠的存活率:单纯肝细胞移植组(Ⅰ组)为56.25%,胶原肝细胞移植组(Ⅱ组)为62.5%,纳米胶原肝细胞移植组(Ⅲ组)为75%,阴性对照组(Ⅳ组)为18.75%,各移植组14天存活率高于对照组(P<0.05),各移植组间无统计学意义(P>0.05)。ALF大鼠肝脏再生于ALF后5～7天最为显著;各组肝脏病理变化以Ⅲ组恢复最好,双核细胞最多,肝再生最快。结论:应用PLA-O-CMC纳米粒子和Ⅰ型胶原联合培养猪肝细胞移植于ALF大鼠腹腔内能促进肝脏的再生。     

肝细胞脾内移植治疗大鼠肝衰竭

目的:优化急性肝衰竭模型的构建方法及探讨经脾内同种异体肝细胞移植治疗大鼠急性药物性肝衰竭的疗效,并观察脾内移植肝细胞的生物学活性。方法:采用D-氨基半乳糖(D-gal)建立大鼠急性药物性肝衰竭模型。腹腔注射不同剂量的(1.0,1.2,1.4,1.6g/kg)D-gal后,以肝功能指标、病理形态学、死亡率等综合评估肝脏细胞损伤的状态,确定模型构建的最佳方案。造模后24h,随机分为2组进行治疗,Ⅰ组:经脾内移植肝细胞悬液1ml(4.4×107个);Ⅱ组:经脾内移植不含肝细胞的培养液1ml。观察大鼠1周的存活率、肝脏功能和病理变化及移植肝细胞的生物学活性。结果:①不同剂量的D-gal可导致不同程度的肝损伤,而以1.2g/kgD-gal造模组的大鼠死亡率适中,肝功能损害及其肝脏病理组织学改变均符合临界急性肝衰竭的程度,较好地模拟了急性肝衰竭的病理生理改变且稳定性较好。②移植后3d,Ⅰ组与Ⅱ组大鼠存活率相比具有显著性差异(P<0.01);肝功能指标:丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和总胆红素(TBiL)均有明显改善(P<0.01);肝组织病理切片显示:Ⅰ组的肝组织损伤程度明显比Ⅱ组轻。经HE和PAS染色证实,移植的肝细胞在受体脾内结构和功能保持较好。结论:①D-gal1.2g/kg腹腔注射可较好构建SD大鼠急性肝衰竭模型。②经脾内肝细胞移植能明显提高药物性肝衰竭大鼠的存活率、改善肝功能及肝组织病理变化。     

肝细胞移植对大鼠实验性肝衰竭的疗效研究

目的　探讨同种异体肝细胞经腹腔、门静脉移植对D-氨基半乳糖 (D- gal)诱导的急性肝衰竭大鼠的治疗作用 .方法　采用 D- gal诱导大鼠急性肝衰竭 ,诱导后 6 0 h,分 4组进行治疗实验 , 组 :经门静脉移植 2× 10 7肝细胞 ,同时肌注环孢霉素 A(Cs A) 10 mg· kg- 1 ; 组 :经门静脉注射生理盐水 1m L ,同时肌注 Cs A 10 mg· kg- 1 ; 组 :经腹腔移植 4×10 7肝细胞 ; 组 :经腹腔注射生理盐水 2 m L ,观察大鼠的存活率、肝脏功能、病理变化 .结果　 组大鼠存活率与 组无明显差异 (42 % vs 37% ,P>0 .0 5 ) ,肝脏功能、病理无明显改善 . 组大鼠存活率显著高于 组 (75 % vs 33% ,P<0 .0 5 ) ,肝脏功能、病理均有部分改善 .结论　经腹腔移植同种异体肝细胞可明显改善 D- gal诱导的肝衰竭大鼠的存活率 ,部分改善肝功能、病理 ;经门静脉移植同种异体肝细胞不能改善D- gal诱导的肝衰竭大鼠的存活率、肝脏功能及病理改变 .     

肝细胞移植治疗大鼠急性肝衰竭的研究

目的 :探讨同种异体肝细胞经腹腔、脾腔移植对 D-氨基半乳糖 ( D- gal)诱导的急性肝衰竭大鼠的治疗作用。方法 :采用 D- gal诱导大鼠急性肝衰竭 ,诱导后 6 0小时 ,分 4组进行治疗实验 ,I组 :脾内移植 2× 10 7肝细胞 ,同时肌肉注射环孢霉素 A ( Cs A ) 10 m g/kg;II组 :脾内注射生理盐水 1m l,同时肌注 Cs A 10 m g/kg;III组 :经腹腔移植 2× 10 7肝细胞 ,IV组 :经腹腔注射生理盐水1m l,观察大鼠的存活率、肝脏功能、肝脏病理变化情况。结果 :I组大鼠存活率与 II组有明显差异( 46 .7%对 13.3% P<0 .0 5) ,肝脏功能及肝脏病理亦有改善 ,III组大鼠存活率显著高于 IV组( 6 0 %对 13.3% P<0 .0 1) ,肝脏功能及肝脏病理均有部分改善。结果 :经腹腔、脾脏移植同种异体肝细胞可明显改善 D- gal诱导的肝衰竭大鼠的存活率 ,部分改善肝功能及肝脏病理     

链脲佐菌素诱导1型糖尿病大鼠模型方法改进

目的 探讨非禁食与禁食后诱导1型糖尿病大鼠模型2周后存活率的差异,从而对链脲佐菌素诱导1型糖尿病大鼠模型方法进行改进,并用于胰岛细胞移植研究.方法 Wistar大鼠40只随机分为2组,每组20只,第1组不禁食,腹腔注射链脲佐菌素,第2组禁食12 h后腹腔注射链脲佐菌素(50 mg/kg),测定随机血糖2次,如均≥16.8 mmol/L,并出现典型的糖尿病症状,连续观察2周,计算模型存活情况,成模后实施开腹手术进行胰岛细胞移植.结果 2周后第1组存活率为100%,第2组存活率为75%,两种方法的死亡率率有统计学差异(P＜0.05),手术后大鼠均可成活,血糖可恢复正常,相关情况需进一步观察.结论 非禁食腹腔注射链脲佐菌素制作糖尿病大鼠存活率高且模型稳定,对手术创伤耐受良好.     

经大鼠脾动脉行肝细胞移植建立动物模型

 目的 建立经SD大鼠颈动脉途径脾动脉插管行肝细胞移植的动物模型,并探讨其临床意义。方法 采用D-氨基半乳糖(D-galactosamine,D-gal)诱导大鼠急性肝损伤(acute liver injury,ALI),24 h后40只SD大鼠分为两组:A组(n=20)经左侧颈动脉插管,进入腹腔干,通过脾动脉移植1×107个肝细胞;B组(n=20)通过同样的方法经脾动脉注射0.5 mL Hank′s液作为对照,观察不同时间点（1、3、6、10、15天）大鼠肝功能的变化情况以及脾内白蛋白合成作用,HE染色观察脾内肝细胞分布情况。结果 经颈动脉途径脾动脉插管成功率约90%,荧光示踪剂CFDA SE标记的肝细胞脾内移植1天后,受体大鼠脾脏可以看到散在绿色荧光分布。A组移植10天后,HE染色可以看到肝细胞在脾脏散在分布;A组移植15天后,共聚焦白蛋白免疫荧光结果表明,脾内有白蛋白绿色荧光信号。结论 经大鼠颈动脉途径脾动脉插管移植的肝细胞能在脾内存活,证实该途径是肝细胞有效移植途径之一。     

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.