2008年重庆大坪医院细菌耐药性监测

目的 了解本院2008年临床分离病原菌对常用抗菌药物的耐药情况.方法 采用纸片扩散法进行抗菌药物敏感性试验,以WHONET 5.4软件进行数据分析.结果 3 303株临床分离病原菌中,革兰阳性球菌占35.5%(1 173/3 303),革兰阴性杆菌占64.5%(2 130/3 303).非ICU前10位病原菌依次为:铜绿假单胞菌、凝固酶阴性葡萄球菌、大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌、肠球菌属、洋葱伯克霍尔德菌、阴沟肠杆菌、嗜麦芽窄食假单胞菌;ICU前10位病原菌依次为:鲍曼不动杆菌、洋葱伯克霍尔德菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、嗜麦牙窄食假单胞菌、白色念珠菌、阴沟肠杆菌.耐甲氧西林的金黄色葡萄球菌在ICU及非ICU的检出率分别为76.9%、54.9%,而耐甲氧西林的凝固酶阴性葡萄球菌的检出率分别为87.3%、66.3%,均未检出对糖肽类抗生素耐药的革兰阳性球菌.产ESBL大肠埃希菌在ICU、非ICU的检出率分别为77.5%、49.2%;产ESBL肺炎克雷伯菌在ICU和非ICU的检出率为49.0%、38.4%.ICU分离的铜绿假单胞菌和不动杆菌属对大部分抗菌药物的耐药率比非ICU分离株高.结论 本院2008年临床分离的病原菌以革兰阴性杆菌为主,碳青霉烯类抗生素对肠杆菌科细菌保持较高活性,非发酵糖菌数量呈上升趋势,ICU比非ICU分离株耐药性严重,多重耐药菌株检出率高.     

某医院2013-2015年医院感染病原菌及其耐药性分析

目的 了解医院感染病原菌及其耐药情况.方法 回顾性收集2013-2015年某医院院内感染病原菌相关资料,对其分布及耐药性进行分析.结果 2013-2015年医院感染病原菌中,革兰阴性菌分离率逐年升高,而革兰阳性菌分离率逐年下降.革兰阴性菌耐药性较高的是大肠埃希菌,鲍曼不动杆菌和铜绿假单孢菌,3年间大肠埃希菌对氨苄西林的耐药率均大于90.0%;鲍曼不动杆菌对实验常用抗菌药物耐药率大于50.0%;铜绿假单胞菌对β-内酰胺类抗生素耐药率较高.金黄色葡萄球菌对青霉素和氨苄西林的耐药率最高.粪肠球菌对苯唑西林、利福平的耐药率100%.未发现对万古霉素耐药菌株.结论 2013-2015年医院感染病原菌以革兰阴性菌为主,其中以大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌最为常见,革兰阳性菌以金黄色葡萄球菌、屎肠球菌、粪肠球菌和肺炎链球菌最为常见.病原菌对抗菌药物的耐药情况严重.     

ICU病房革兰氏阴性菌耐药性分析

目的了解我院重症监护病房革兰氏阴性菌的分布和耐药情况。方法回顾性分析ICU2009年至2010年的革兰氏阴性菌的细菌培养和药物敏感试验。结果 2009年分离出前5位的革兰氏阴性菌依次为：大肠埃希菌62株（13.81%）、铜绿假单胞菌55株（12.25%）、肺炎克雷伯菌53株（11.80%）、鲍曼不动杆菌45株（10.02%）和阴沟肠杆菌30株（6.68%）。2010年分离出前5位的革兰氏阴性菌依次为：大肠埃希菌76株（14.05%）、铜绿假单胞菌66株（12.20%）、鲍曼不动杆菌60株（11.09%）、肺炎克雷伯菌58株（10.72%）和阴沟肠杆菌31株（5.73%）。碳青霉烯类的亚胺培南对所有肠杆菌科细菌仍保持最高的抗菌活性;非发酵菌对大多数抗菌药高度耐药。结论革兰阴性菌在感染病原菌中仍占主要地位,耐药性仍十分严重,应及时监测病原菌变化及耐药趋势,指导临床合理地使用抗生素。     

678株革兰阴性杆菌耐药监测分析

目的监测2006年本院临床分离的革兰阴性杆菌耐药性。方法采用Micro—Scan4半自动细菌分析仪及MIC药敏试剂对678株革兰阴性杆菌进行耐药性监测，并对结果进行回顾性分析。结果678株革兰阴性杆菌中，肠杆菌科424株（62．54％），较常见的为大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌；不发酵糖的革兰阴性杆菌254株（37．46％），较常见的为铜绿假单胞菌、鲍曼不动杆菌。这些菌株对临床常用抗生素均有不同程度的耐药，且呈多重耐药趋势；亚胺培南是最敏感的抗革兰阴性杆菌的药物之一。结论大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、铜绿假单胞菌、鲍曼不动杆菌是临床感染的主要革兰阴性病原菌，其耐药性呈多重耐药趋势，应合理应用抗生素，并持续有效地开展药敏监测。     

革兰阴性杆菌感染呼吸机相关性肺炎患者病原菌分布及耐药性

目的：分析革兰阴性杆菌感染呼吸机相关性肺炎（VAP）患者病原菌分布及耐药性。方法：选取2020年3月至2022年12月该院收治的134例革兰阴性杆菌感染VAP患者进行前瞻性研究。采集患者下呼吸道分泌物标本,分析革兰阴性杆菌分布及耐药性。结果：134例革兰阴性杆菌感染VAP患者下呼吸道分泌物中检出347株病原菌,其中铜绿假单胞菌检出率最高（101株,29.11%）,其次为肺炎克雷伯菌（62株,17.87%）、大肠埃希菌（52株,14.99%）、鲍曼不动杆菌（49株,14.12%）;肺炎克雷伯菌对阿米卡星、哌拉西林/他唑巴坦、头孢替坦的耐药性为80%以上;鲍曼不动杆菌对左氧氟沙星、氨苄西林/舒巴坦、氨苄西林的耐药性为70%以上;铜绿假单胞菌对阿米卡星的耐药性为81.19%;大肠埃希菌对亚胺培南、美罗培南的敏感性达100.00%。结论：铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌为革兰阴性杆菌感染VAP患者常见病原菌,其耐药性均较高。     

宁夏回族自治区2018—2020年血液标本细菌分布及耐药性分析

目的 了解近2018—2021年宁夏回族自治区临床血液培养标本中细菌分布及耐药性,为血流感染疾病防治提供依据。方法 收集2018—2020年宁夏回族自治区细菌耐药监测网点医院的血培养分离菌及耐药性资料,用WHONET5.6软件进行统计分析。结果 2018—2020年共收集血液标本分离细菌6 757株,其中革兰阴性菌3 697株（占54.7%),革兰阳性菌3 060株（占45.3%)。革兰阴性菌中大肠埃希菌2 074株（占30.7%）、肺炎克雷伯菌696株、铜绿假单胞菌139株和鲍曼不动杆菌121株;革兰阳性菌中凝固酶阴性葡萄球菌1 691株（占25.0%）、金黄色葡萄球菌 442株、链球菌属431株、肠球菌属379株。大肠埃希菌和肺炎克雷伯菌对头孢曲松、亚胺培南耐药率分别为56.6%和22.6%、1.0%和3.7%。铜绿假单胞菌和鲍曼不动杆菌对亚胺培南耐药率为9.0%（12/139）和80.7%（71/121）。耐甲氧西林金黄色葡萄球菌（MRSA）检出率26.8%,耐甲氧西林凝固酶阴性葡萄球菌检出率70%,未发现对万古霉素、利奈唑胺耐药葡萄球菌属细菌。3年仅1株耐万古霉素粪肠球菌,未检出耐利奈唑胺葡萄球菌和肠球菌。结果 宁夏回族自治区临床血液标本分离菌以大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌多见。其中大肠埃希菌和肺炎克雷伯菌对三代头孢菌素的耐药率较平稳,对碳青霉烯类耐药率呈低水平。鲍曼不动杆菌对碳青霉烯类耐药率呈高水平,耐甲氧西林金黄色葡萄球菌检出率有所上升,应密切关注。     

2316份标本中的病原菌及其耐药性分析

目的 探讨本院常见病原菌的构成及其对抗生素的耐药情况。方法 采用法国梅里埃ATBexpression半自动细菌分析仪及其配套的ATB药敏检测条进行细菌检测和药敏试验。结果本院主要病原菌为革兰阳性球菌金黄色葡萄球菌40株、革兰阴性杆菌中肠杆菌科大肠埃希菌103株、肺炎克雷伯菌110株、非发酵菌铜绿假单胞菌141株、不动杆菌66株。金黄色葡萄球菌对利福平、环丙沙星、万古霉素、复方磺胺甲恶唑耐药较少。铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、不动杆菌对三代头孢、复方哌拉西林较敏感,其中肺炎克雷伯菌对氨基糖苷类、喹诺酮耐药较少。结论临床上在应用抗生素时应结合实验室检查,合理使用以减少耐药菌的产生。     

2014～2017年广西常见耐碳青霉烯类革兰阴性杆菌的耐药情况

目的了解广西常见耐碳青霉烯类革兰阴性杆菌的耐药情况。方法收集2014～2017年广西细菌耐药性监测网中43所医院分离并鉴定的耐碳青霉烯类革兰阴性杆菌的耐药性检测结果,采用WHONET 5.6软件对数据进行耐药性分析。采用χ²趋势性检验分析检出数量前5位菌株对亚胺培南、厄他培南、美罗培南耐药性随时间的变化趋势。结果 (1) 43所医院共检出耐碳青霉烯革兰阴性杆菌45 743株,主要来源于呼吸道标本,检出数量前5位的菌株依次为鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌。(2)耐药性分析结果显示,阿米卡星对大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌均有较好的抗菌活性,大肠埃希菌和肺炎克雷伯菌对头孢噻肟的耐药率、阴沟肠杆菌对氨苄西林/舒巴坦的耐药率均最高;鲍曼不动杆菌对大多数药物的耐药率均超过80%,但米诺环素对其具有良好的抗菌活性;铜绿假单胞菌对氨基糖苷类药物具有较好的敏感性。(3)趋势性分析结果显示,2014～2017年,大肠埃希菌对亚胺培南的耐药率呈降低趋势,肺炎克雷伯菌对厄他培南、美罗培南的耐药率,阴沟肠杆菌对亚胺培南、美罗培南的耐药率,鲍曼不动杆...     

肺感方体外抗菌活性的实验研究

目的：观察肺感方对11种临床常见病原菌的体外抗菌作用.方法：使用肉汤微量稀释法测定肺感方对不同菌株的最低抑菌浓度（MIC）及最低杀菌浓度（MBC）.结果：肺感方对标准金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、阴沟肠球菌、铅黄肠球菌的MIC分别为62.5,62.5,125,31.25,250,500 g/L,相应的MBC为：62.5,62.5,250,31.25,500,1 000 g/L;对临床分离菌株鲍曼不动杆菌（多重耐药）、铜绿假单胞菌（多重耐药）的MIC和MBC均分别为250,500 g/L;对粪肠球菌、白色念珠菌、肺炎克雷伯菌（超广谱β内酰胺酶阳性）、大肠埃希菌（超广谱β内酰胺酶阳性）无明显体外抗菌作用.结论：肺感方对金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、铅黄肠球菌、鲍曼不动杆菌（多重耐药）及铜绿假单胞菌（多重耐药）具有体外抗菌作用,其中对肺炎克雷伯菌的抗菌活性最强.     

2019—2022年舟山地区血流感染监测及耐药变化

目的分析2019—2022年舟山地区血流感染病原菌分布情况及耐药趋势变化,为临床使用抗菌药物提供参考。方法选取2019年1月至2022年12月舟山市妇女儿童医院、舟山市中医院、舟山医院血液细菌培养分离得到的病原菌共4312株。参照美国临床实验室标准化协会2021年药敏执行标准,采用WHO推荐的细菌统计软件WHONET5.6对病原菌分布及药敏结果进行分析。结果4312株中革兰阳性菌1814株（42.1%）,革兰阴性菌2429株（56.3%）,真菌69株（1.6%）。检出率最高的菌株分别是大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、肠球菌。其中甲氧西林耐药金黄色葡萄球菌检出率45.2%,未检出青霉素耐药肺炎链球菌和万古霉素耐药粪肠/屎肠球菌。碳青霉烯类药物耐药肠杆菌检出率为3.1%,碳青霉烯类药物耐药铜绿假单胞菌和鲍曼不动杆菌检出率分别为21.6%和28.6%。结论舟山地区血流感染大多由大肠埃希菌、肺炎克雷伯菌和葡萄球菌引起,部分病原菌耐药形势严峻,应持续加强抗菌药物的临床管理,正确规范使用抗菌药物。     

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.