阻塞性睡眠呼吸暂停综合征患者血清瘦素水平与胰岛素抵抗的关系

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者血清瘦素水平及其与胰岛素抵抗(IR)的关系.方法:测量研究对象的身高、体质量,行多导睡眠图(PSG)检查.根据睡眠呼吸暂停低通气指数(AHI)和体块指数(BMI)将研究对象分为四组:A组肥胖OSAS患者16例(BMI≥27,AHI≥5);B组非肥胖OSAS患者10例(BMI＜25,AHI≥5);C组单纯肥胖10例(BMI≥27,AHI＜5);D组对照10例(BMI＜25,AHI＜5).瘦素及胰岛素测定采用放免法,血糖采用葡萄糖氧化酶法.结果:①A,B,C三组空腹胰岛素水平分别为(15.6±3.6),(11.7±2.3),(11.3±2.5)mU/L,均较D组(9.1±1.8)mU/L升高(P＜0.01),且A组胰岛素也显著高于B,C组(P＜0.01);②A,B,C三组瘦素水平分别为(6.6±1.4),(4.7±0.9),(4.2±0.7)μg/L均较D组(3.4±1.0)μg/L非常显著升高(P＜0.05～0.01),且A组瘦素也显著高于B,C(P＜0.01);③A,B,C三组稳态模式估计法(HOMA)胰岛素抵抗指数(HOMA-IR)分别为(4.0±1.4),(3.0±0.8),(2.8±0.6),均较D组显著升高(2.1±0.6)(P＜0.05～0.01),且A组HOMA-IR也显著高于B,C组(P＜0.01);④OSAS患者血清瘦素水平与空腹胰岛素水平,BMI,HOMA-IR正相关,相关系数分别为:0.4074(P＜0.05),0.7543(P＜0.01),0.4312(P＜0.05),0.4352(P＜0.05).结论:OSAS患者血清瘦素水平及HOMA胰岛素敏感指数明显高于单纯肥胖组及对照组,OSAS患者体内瘦素水平可能与其IR有关.     

阻塞性睡眠呼吸暂停低通气综合征患者血清瘦素水平及与胰岛素抵抗的相关性研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清瘦素水平及与胰岛素抵抗的相关性.方法选择OSAHS患者和健康者(对照组)各50例,分别行多导睡眠图检查,并测定空腹血糖、瘦素和胰岛素水平.结果 (1)OSAHS患者组的血清瘦素、空腹胰岛素水平及胰岛素抵抗指数(HOMA-IR)与对照组间差别均有显著性意义(P＜0.01).(2)OSAHS患者组血清瘦素水平、空腹胰岛素水平、HOMA-IR均与呼吸暂停低通气指数(AHI)、呼吸障碍事件最长时间、微觉醒指数呈正相关,与最低血氧饱和度呈负相关.(3)OSAHS患者血清瘦素水平与空腹胰岛素水平、HOMA-IR呈正相关.结论 (1)OSAHS患者的空腹血清瘦素水平升高,且与OSAHS病情严重程度有关.(2)OSAHS独立于肥胖等混淆因素与胰岛素抵抗存在相关性.(3)OSAHS患者血清瘦素水平与胰岛素抵抗存在相关性.     

nCPAP治疗对OSAHS患者血清瘦素水平的影响

目的评价经鼻持续气道正压通气（nCPAP）治疗对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清瘦素水平及胰岛素抵抗的影响,探讨OSAHS患者血清瘦素水平和胰岛素抵抗的关系.方法对16例中重度OSAHS患者进行nCPAP治疗,治疗前后进行睡眠监测（PSG）,记录睡眠呼吸监测的相关指标,检测空腹血糖（FBG）、空腹血清瘦素及空腹胰岛素水平,采用稳态模型评估法（HOMA）评价并计算胰岛素抵抗指数（HOMA-IR）,对比nCPAP治疗前后各指标的差异,并对治疗后空腹血清瘦素水平的变化及胰岛素抵抗的变化与睡眠各参数的变化进行相关分析.结果 nCPAP治疗前后空腹血清瘦素水平有差异（P〈0.01）,而HOMA-IR、FBG、胰岛素、BMI差异不明显（P〉0.05）,瘦素水平的变化与最低血氧饱和度的变化及AHI的变化呈正相关.结论 nCPAP治疗可降低OSAHS患者的血清瘦素水平,改善睡眠呼吸紊乱,但胰岛素抵抗及空腹血糖无明显变化,治疗后瘦素水平的变化与最低氧饱和度及AHI的改善有关,提示在OSAHS患者中改善睡眠呼吸紊乱的重要性.     

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)和胰岛素抵抗的关系

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的睡眠呼吸紊乱指标与其血清瘦素水平和胰岛素抵抗程度的关系。方法选择未接受任何治疗、经多导睡眠监测仪8 h睡眠监测确诊为OSAHS的男性患者54例,参照OSAHS诊治指南按睡眠暂停低通气指数(AHI)进行病情分度,其中轻-中度组(轻度9例,中度18例)和重度OSAHS组各27例,次日监测结束后空腹外周血瘦素、空腹胰岛素和血糖水平,计算体重指数(BMI)(体重/身高2)和HOMA-IR指数[(空腹血糖×空腹胰岛素)/22.5]。结果重度OSAHS组的平均和最低SpO2皆显著低于轻-中度组,BMI、血清瘦素水平和HOMA指数则明显高于轻-中度组,上述指标在两组间比较皆有显著统计学差异(均P<0.01)。其中瘦素与BMI和AHI成正相关,与平均及最低脉氧饱和度均存在负相关。HOMA-IR指数则和BMI、AHI成正相关,和最低SpO2存在负相关。结论在OSAHS患者中,睡眠呼吸功能紊乱和肥胖、瘦素和胰岛素抵抗有关。     

阻塞性睡眠呼吸暂停低通气综合征对非酒精性脂肪性肝病患者胰岛素抵抗及肝损伤的影响

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对非酒精性脂肪性肝病(NAFLD)患者胰岛素抵抗及肝损伤的影响。方法 收集NAFLD患者共60例,所有患者完善夜间多导睡眠监测,根据呼吸暂停低通气指数(AHI)是否≥5和(或)最低血氧饱和度≤90%,分为OSAHS合并NAFLD组(30例),单纯NAFLD组(30例)。所有受试者均抽取空腹静脉血检测血清胰岛素、血糖、血脂及肝功能。结果 OSAHS合并NAFLD组血胆固醇、三酰甘油、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)水平均高于单纯NAFLD组(均P <0.05)。OSAHS合并NAFLD组AHI指数、空腹血清胰岛素及HOMA-IR指数均高于单纯NAFLD组(均P <0.05),OSAHS合并NAFLD组夜间最低血氧饱和度低于单纯NAFLD组(P <0.05)。OSAHS合并NAFLD组患者中,AHI≥15患者空腹胰岛素水平及HOMA-IR指数均高于AHI <15患者(均P <0.05)。两组患者AHI指数与空腹胰岛素水平、HOMA-IR、ALT及AST均呈正相关(均P <0.05);夜间最低血氧饱和度与空腹胰岛素水平、HOMA-IR、胆固醇、ALT及AST均呈负相关(均P <0.05)。结论 夜间间歇性缺氧会加重NAFLD患者肝功能损伤,增加血脂代谢异常以及增加血清胰岛素及胰岛素抵抗水平,NAFLD患者肝功能损伤及胰岛素抵抗水平随着夜间缺氧加重而加重。     

OSAHS与胰岛素抵抗的相关性研究

目的 研究OSAHS患者的睡眠呼吸紊乱指标与胰岛素抵抗(IR)程度的关系.方法 选择OSAHS患者58例,另选57例非OSAHS患者作为对照.观察经皮血氧饱和度(SpO2),计算睡眠呼吸暂停低通气指数(AHI),次日监测结束后测空腹外周血胰岛素和血糖水平,采用胰岛素抵抗指数(HOMA-IR)评估IR程度.结果 OSAHS组的HOMA-IR明显高于非OSAHS组,OSAHS组平均和最低SpO2明显低于非OSAHS组.OSAHS组HOMA-IR与AHI呈正相关,与最低SpO2呈负相关.结论 OSAHS患者睡眠呼吸功能紊乱与IR有关,OSAHS可能经IR这一途径导致心血管疾病.     

阻塞性睡眠呼吸暂停低通气综合征与胰岛素抵抗的相关性

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与胰岛素抵抗(IR)之间的相关性.方法纳入接受多导睡眠监测的OSAHS伴超重患者75例(A组)、OSAHS患者66例(B组)、单纯超重者25例(C组)和健康成人(D组)26名,测定其呼吸暂停及低通气指数(AHI)、最低血氧饱和度(miniSpO2)值、空腹血糖值、空腹胰岛素值,并计算其胰岛素敏感指数(ISI).结果ISI均值A组为-4.8±0.7,B组为-4.5±0.4,C组为-4.0±0.3,D组为-4.50±0.3.与D组比较,A组、B组和C组的ISI均值皆显著降低(均P＜0.05);与C组比较,A组的ISI均值显著降低(P＜0.05).A组患者及B组患者的ISI与AHI之间均呈负相关(r=-0.352,P＜0.01;r=-0.267,P＜0.05),其ISI与miniSp02之间均呈正相关(r=0.379,P＜0.01;r=0.314,P＜0.05).结论 OSAHS患者体内存在着明显的IR,这种IR与超重、AHI和miniSpO2明显相关.     

阻塞性睡眠呼吸暂停低通气综合征患者内脂素水平的变化

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆内脂素水平的变化及其影响因素.方法 选取经多导睡眠监测仪(PSG)整夜监测诊断为中度、重度及极重度OSAHS(AHI>20次/h)的男性患者50例,对照组20例(AHI<5次/h),两组年龄、性别及体质量指数(BMI)相匹配.入选者均检测空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)和内脂素,测量身高、体重、腰围及臀围,计算BMI、腰臀比和胰岛素抵抗指数(HOMA-IR).结果 OSAHS组血浆内脂素水平明显高于对照组[(45.06±9.17)μg/L vs(36.07±6.53)μg/L,P<0.001];中、重及极重度OSAHS组间血浆脂联素水平差异有显著性(P<0.001);内脂素与腰围、BMI、腰臀比、AHI、血氧饱和度(SaO2)<90%时间百分数、空腹血糖、胰岛素、HOMA-IR、TG及LDL-C均正相关,与平均Sao2、最低Sao2负相关.控制腰围、BMI、腰臀比、空腹血糖、胰岛素、HOMA-IR、TG及LDL-C后,血浆内脂素水平仍与AHI正相关(R'=0.331,P<0.05),与最低SaO2负相关(R'=0.301,P<0.05).多元逐步回归分析表明,AHI是除了腰围以外血浆内脂素的独立影响因素.结论 OSAHS及其严重程度独立影响血浆内脂素水平.     

阻塞性睡眠呼吸暂停低通气综合征与高血压及瘦素的关系

目的 研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压及瘦素的关系,初步探讨睡眠呼吸紊乱及瘦素在OSAHS并发高血压发病中的作用.方法 测定60例OSAHS及40例年龄、体质指数(BMI)相匹配对照组睡前及醒后血压(BP)、醒后心率(HR),血清瘦素(LEp)水平,同时测定BMI、颈围(NC)、腰臀比(WHR)、血清空腹血糖(FBG)、三酰甘油(TG)、胆固醇(Chol)、空腹真胰岛素(TI)水平.对比两组睡前、醒后BP变化;分析睡眠呼吸紊乱参数及瘦素与高血压的相关关系.结果 OSAHS组与对照组睡前血压差异无显著性(P>0.05),但醒后血压尤其是舒张压(89.75±2.04)mmHg显著高于对照组(81.63±1.91)mmHg并独立于年龄和肥胖(P<0.01);OSAHS组DBP与瘦素、呼吸暂停低通气指数(AHI)呈正相关(r=0.282,P<0.05;r=0.318,P<0.01);BMI(P=0.029)、醒后HR(P=0.030)及瘦素(P=0.049)可能是高血压发生的独立相关因素.结论 睡眠呼吸紊乱可能对醒后血压,尤其是醒后舒张压产生独立的效应;而BMI、醒后HR和瘦素可能是高血压的独立相关因素.     

阻塞性睡眠呼吸暂停低通气综合征肥胖患者血清瘦素和胰岛素的变化

根据睡眠呼吸暂停低通气指数和体重指数将56例研究对象分为4组，测定血瘦素和胰岛素水平。结果显示，阻塞性睡眠呼吸暂停低通气综合征（OSAHS）肥胖组、非肥胖组及单纯肥胖组空腹胰岛素、瘦素水平较正常对照组显著升高，且OSAHS肥胖组胰岛素、瘦素显著高于OSAHS非肥胖组及单纯肥胖组。提示OSAHS肥胖患者体内存在瘦素抵抗和胰岛素抵抗，瘦素和胰岛素与OSAHS有独立的相关陛。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.