Integrative medicine (IM) has made great progress after more than half a century practice. However, many issues are yet to be in-depth explored. How to define clinical connotation and extension of IM, how to define feasible methods and means for diagnosis and treatment of IM, how to train more skilled talents of IM, how to elevate clinical efficacy of IM, these are all topics in need of further study. In this paper authors explored the clinical development mode of IM, extracted connotation and extension of IM clinics, hoping to promote the development of IM clinics.
Integrative Medicine ; trends

Objective To improve the sensitivity of MR molecular imaging by using targeting and magnifying effects of biotin-avidin system (BAS). Methods After preparing biotinylated monoclonal antibody HAb18, the number of biotin molecules coupled to each antibody and the binding capacity of biotinylated antibody were determined. Two-step pretargeting tumor imaging was first achieved by intravenously injecting biotinylated monoclonal antibody HAb18 into 8 BALB/c nude mice bearing QGY-7723 tumor cells line. 24 h later, Gd-DTAP-streptavidin (Gd-DTPA-SA) was injected. Gd-DTPA-HAb18 and Gd-DTPA were respectively injected intravenously into the other 12 tumor-bearing mice as contrast groups. MR imaging was performed before and 10, 30, 60 min, 3, 6, 12, 24 h, and 48 h after injection of MR contrast agents. All images were obtained using SE T_1-weighted imaging sequence. After MR imaging, enhancement time course of three different groups was determined by using enhancement data measured in the region of interest in the tumor. Enhancement ratio and contrast-to-noise of tumor were also calculated. Results The average number of biotin conjugated with each monoclonal antibody molecular was 20. And the immunoactivity of biotinylated antibody was 91%. In two-step pretargeting strategy, SI of tumor increased slowly and reached the maximum value at 6 h after injection of Gd-DTPA-SA, enhancement ratio and CNR of tumor had significant difference with other two enhancement methods. The enhancing effect of tumor was still perceptible even after 48 h. When using Gd-DTPA-HAb18, the tumor enhancement pattern was slow and slight. Even at 24 h after injection of Gd-DTPA-HAb18, enhancement ratio of tumor was 13.5%. After Gd-DTPA was injected, signal intensity of tumor increased rapidly, and reached the maximum value at 30 min after injection of Gd-DTPA, and then decreased rapidly. Conclusion Two-step pretargeting strategy based on BAS has specific and signal magnifying effects in tumor MR imaging. It can increase the number of gadolinium that bind to the tumor and provide new approach to MR molecular imaging.

AlM: To investigate the clinical effect of preserved amniotic membrane transplantation in the treatment to conjunctival rupture, dehiscence and socket contracture after hydroxyapatite ( HA) orbital implantation.
METHODS: ln 16 cases of conjunctival rupture and socket contracture after HA orbital implantation, conjunctival tension was release by operation and preserved amniotic membrane was transplanted on conjunctival scleral exposure area.
RESULTS:ln all cases, conjunctiva healing, completely cover the sclera and conjunctiva socket recover ideal depth after operation in 15 cases, 1 case was fail.
CONCLUSlON: Preserved amniotic membrane transplantation is an effective method to treat conjunctival dehiscence and keeping the ideal conjunctival socket depth after orbital implantation.

Objective To investigate the effects of different doses of estradiol on apoptosis of T lymphocytes from spleens in ovariectomized mice and explore the possible mechanisms.Methods The mice splenic T lymphocytes were isolated and divided into ten groups: young group, sham- ovariectomized group, ovariectomized group, ovariectomized plus estradiol(10-11, 10-10, 10-8 and 106groups, ovariectomized plus estradiol (10-10mol/L) plus 1CI182 780 (10-7tool/L) group, ovariectomized plus estradiol(10-10mol/L) plus 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPP, 10-6mol/L) group, ovariectomized plus estradiol(10-10mol/L) plus pyrroline dithiocarbamate(PDTC, 10-6mol/L) group. The apoptosis rates were determined by flow eytometry using Annexin V-FITC/ PI and the protein levels of ERa, ERβ, Bax, Bcl-2 and P65 were detected by Western blot. Results The apoptosis rate of ovariectomized group was(19. 4±2.5)%, which was higher than that of young group [(14.6±2.4%) 3 and sham-ovariectomized group [p (14.5±2.3)%], and the levels of Bcl-2 and nuclear P65 were lower than the young group [(0. 25±0. 05, 0. 09±0. 01) vs. (0. 40± 0.07,0. 15±0. 02), P<0.01]. The ovariectomized plus estradiol (10-10tool/L) group had lower apoptosis rate and higher Bcl-2 and P65 levels compared to the ovariectornized group[(16.6±1.8)% vs.(19.4±2.5)%,P<0.05;0.36±0.03 vs. 0.25～0.05, 0.14±0.01 vs. 0.09±0.01, P< 0. 01)], while the ovariectomized plus estradiol(10-8mol/L, 10-6tool/L) groups had higher apoptosis rates than the ovariectomized group[(22. 55±2. 5)% vs. (19. 4±2. 5)% ,P<0. 05;(27.8±3.1)% vs. (19.4 4±2. 5)%,P<0. 01, respectively]. The 2protein levels of ERa and ERβ of ovariectomized group were 0. 23±k0.01 and 0. 22±0. 03, respectively, which were lower than those of young((0. 27±0. 02) and (0. 29±0.04)] and sham-ovariectomized group [(0. 28±0. 03) and (0. 29±0.02)]. The ovariectomized plus estradiol(10-1110-1010-8tool/L) groups had higher while ovariectomized plus estradiol(10-6mol/L) group had lower ERα and ERβ protein levels (0. 09±0. 01,0. 14±0.02) than the ovariectomized group(P<0. 01). There was no significant difference between ovariectomized plus estradiol(10-10mol/L) plus ICI182 780 group or ovariectomized plus estradiol(10-10tool/L) plus PDTC group and ovariectomized group [(19.4±1.6)% vs. (19.4±2. 5)%, (21.0±2. 9)% vs. (19.4d±2. 5)%, P>0. 05). There were also no significant difference between ovariectomized plus estradiol(10-10mol/L) plus MPP group and ovariectomized plus estradiol (10-10mol/L) grou p[(16.9±2.2)% vs. (16.6±1.8)%, P>0.05]. Conclusions The ovariectomy of mice leads to increased apoptosis rates of splenic T lymphocytes. The effects of estradiol on the apoptosis of T lymphocytes in ovariectomized mice are dependent on doses: physiological dose of estradiol inhibits while higher dose of estradiol exacerbats the apoptosis of T lymphocytes in ovariectomized mice.Physiological dose of estradiol may act on Rice T lymphocytes via ERβ and NFkB signaling.

The levels of triglyceride(TG)and free fatty acid(FFA)in serum,liver,skeletal muscle,and pancreas of lipoprotein lipase gene knockout heterozygous(LPL+/-)mice and C57 mice were determined.Intraperitoneal glucose tolerance test(IPGTT)was performed to evaluate insulin sensitivity and β-cell function.The results showed that the Iipid content in 16 weeks LPL+/- group did not increase significantly.The TG and FFA contents in 28 weeks LPL+/- group were significantly higher than those in control and 16 weeks LPL+/-group(all P<0.05).In 50 weeks LPL+/- group,FFA levels in serum and pancreas,and TG content in pancreas increased significantly compared with other three groups(all P<0.05).The IPGTT result showed that the blood glucose levels increased from 15 to 120 min,not at 0 and 5 min.The blood glucose levels during 30-120 min increased significantly in 50 weeks LPL+/- group compared with other three groups(P<0.05).Fasting insulin(FINS),homoestasis assessment of insulin resistance(HOMA-IR)and pancreatic β cell function also increased gradually with age.FINS and HOMA-IR in 28 weeks LPL+/- group were higher than those in control and 16 weeks LPL+/- group.These results suggest that LPL is a key enzyme in lipid metabolism and plays a crucial role in the development of insulin resistance and diabetes.

Objective To investigate the value of high-frequency ultrasound in diagnosis of thyroid carcinoma by comparative analysis of high-frequency ultrasound and spiral CT imaging results. Methods The imaging results of patients with thyroid carcinoma proved by postoperative pathology or biopsy results were reviewed.High-frequency ultrasound and spiral CT were used to examine the 35 patients in The Tumor Hospital of Harbin Medical University between 2007 and 2009. Results Diagnosis of thyroid carcinoma by application of Highfrequency ultrasound were 27 cases, diagnosis rate was 77.1%(27/35);by spiral CT were 25 cases, diagnosis rate was 71.4% (25/35);comparison of the two methods showed no significant difference (x2= 0.3, P ＞ 0.05). Combined application of high-frequency ultrasound and spiral CT diagnosed 33 patients with thyroid carcinoma, diagnosis rate was 94.3%(33/35), which was significantly higher than that of high-frequency ultrasound alone or that of spiral CT alone(compared with high-frequency ultrasound, x2 = 4.2, P ＜ 0.05;and spiral CT, x2 = 6.4, P ＜ 0.05). Conclusion Combined application of high-frequency ultrasound and spiral CT can improve the diagnosis rate of thyroid carcinoma.

Objective To investigate the prognostic factors regarding overall survival in locally advanced stage of esophageal squamous cell carcinoma (ESCC) patients after receiving concurrent chemoradiotherapy (CRT).Methods Each of 80 patients with locally advanced ESCC was treated by doxtel 135-175 mg/m2 d1 and cisplatin 40 mg/m2 d2,3 combined with radiotherapy 60 Gy.ECOG (0-1),tumor locations,tumor sizes,TNM classifications as well as the levels of CA199,SCC-Ag were detected before concurrent treatments and 4 weeks after treatment.The relationship wasanalyzed between the prognosis of disease and CA199,SCC-Ag levels.Each index was studied by Cox statistical regression analysis and P value was determined.Results All patients had completed 4 cycles' treatments successfully.The major adverse effects included neutrophilic granuloaytopenia,calvities,nausea,emesis and diarrhea.The severe effect was Ⅲ degree neutrophilic granuloaytopenia for 2 cases (2.5 ％),all the side-affect had recovered after symptomatic treatments.The median survival time were 50 months and 72.5 months in the patients who were greater than 60 year-old and less than or equal to 60 year-old,respectively (P =0.004).Regarding to 5-year overall survival,the figures were 73.3 ％,69.4 ％,41.7 ％ and 0 in the patients with cT1-2N1M0,cT3N1M0,cT4NoM0 and cT4N1M0 classification,respectively (P =0.024),they were 42.9 ％,70.0 ％,and 60.9 ％ in the patients with upper thoracic esophagus,middle thoracic esophagus,and lower thoracic esophagus,respectively (P =0.971),they were 100 ％ in the patients with ECOG 0 and 54.1％ in the patients with ECOG 1 (P =0.044),they were 86.7 ％ in the patients with CA199≤37 kU/L,and 52.0 ％ in the patients with CA199 more than 37 kU/L (P =0.008),they were 95.5 ％ in the patients with SCC-Ag≤ 1.9 μg/L,and 53.4 ％ with ＞1.9 μg/L (P =0.012).Conclusion For ESCC patients treated with CRT,the age,TNM stage,ECOG,CA199 and SCC-Ag levels are independent forecasting factors regarding their overall survival.

【Objective】 To determine the volume range of suspended erythrocyte and establish its internal control standard. 【Methods】 The theoretical value of suspended erythrocyte volume was calculated according to the screening criteria of healthy blood donors and Quality Requirements for Whole Blood and Blood Components. A total of 2 410 bags of 1 U and 2 U suspended erythrocyte were randomly selected and weighed, and the volume range were formulated by ±2S and ±10% respectively and then compared to determine the volume range in line with the actual situation of our center. 【Results】 The theoretical volume range of 1 U and 2 U suspended erythrocyte were 117-160 mL vs 234-320 mL, and the actual volume range were 142-180 mL vs 276-393 mL. The volume range of 1 U and 2 U suspended erythrocyte formulated by ±2S were 145-181 mL vs 298-358 mL, and by ±10% were 147-179 mL vs 295-361 mL. The hematocrit and hemoglobin content of suspended erythrocyte within the actual volume range met the quality requirements. There were fluctuations in the volume of suspended erythrocyte from different regions. 【Conclusion】 Based on the actual situation of our center and the sampling results of suspended erythrocytes in recent two years, 163 mL±10% and 328 mL±10% were determined as the internal control standards of 1 U and 2 U suspended erythrocyte, respectively. Blood centers should establish accurate and feasible standard of suspended erythrocyte according to the actual situation.

【Objective】 To establish a new method for the determination of fibrinogen content in cryoprecipitated antihemophilic factor. 【Methods】 Fibrinogen (Fib) could bind with sheep anti-human fibrinogen (anti-Fib) specifically and further form antigen-antibody complex. When the Fib was present in the solution, the fluorescence of fluorescein isothiocyanate (FITC) labeled on the anti-Fib (FITC-anti-Fib) was quenched due to the formation of immune complex. The fluorescence quenching degree of FITC-anti-Fib was positively correlated with Fib concentration (cFib) in a certain concentration range. 【Results】 The linear relationship between fluorescence quenching degree [(I0-I)/I0] of FITC-anti-Fib and ln(cFib) was (I0-I)/I0=15.53ln(cFib)+ 80.79 (R²=0.99) when the cFib was in the range of (0.007 8-0.560 0) g/L. The recovery of Fib was (96.77-102.43) %. When the method was applied to determine Fib at high, medium, and low concentrations, the obtained intra-day variation coefficients were 0.31%, 0.56%, and 0.49%, respectively, and the inter-day variation coefficients were 3.81%, 3.06%, and 4.13%, respectively. There was no significant difference between the results measured by fluorescence quenching method and coagulation method (t=-0.075, P>0.05). 【Conclusion】 In this work, a new fluorescence method for the determination of Fib in cryoprecipitated antihemophilic factor was successfully established based on the specific combination of fib and FITC-anti-Fib. The method is simple and rapid. The obtained results were accurate and reliable by using this method to determine Fib.

ObjectiveTo observe the cells of frontal recess region with multi-detector CT muhiplanar reconstruction(MPR).MethodsOne hundred patients without the disease of frontal sinus and frontal recess region underwent axial multi-detector CT scan with axial,coronal and sagittal multiplanar reconstruction.ResultsIn 100 cases(200 sides),the agger nasi cell is present in 186 sides(93.0%),the frontal cells were identified in 88 sides(44.0%),the prevalence of type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ cells were 51 sides(58.0%),23 sides(26.1%),14 sides(15.9%)and 0 sides,respectively. The suprabullar cells,the frontal bullar cells and the supraorbital ethmoid cells were identified in 130 sides (65.0%),23 sides(11.5%)and 11 sides(5.5%),respectively.The interfrontal septal cells were identified in 36 sides(18.0%).There was no significant difference between males and females,as well as between left and right side(P＞0.05).Conclusion With MPR imaging,doctors could better understand the frontal recess region,which is helpful to the endoscopic frontal sinus surgery.