基于三级信息系统的儿童先天性心脏病筛查的临床研究

目的充分利用廊坊市妇幼保健信息系统平台,提高对儿童先天性心脏病（congenital heart disease,CHD）的筛查质量,分析研究本地区儿童CHD发病率及影响因素,为当地政府决策提供可靠依据。方法采用望诊、听诊和彩色多普勒超声心动图相结合的方法对辖区内儿童进行监测。对确诊阳性患儿采用1∶2配对的病例对照研究方法、通过单因素分析和多因素条件logistic回归分析逐步筛选危险因素。结果廊坊市儿童CHD发病率为2.299%,其中孕早期感冒（OR=4.983）、妊娠合并症（OR=5.32）、孕早期情绪状况（OR=7.9）、孕早期接触农药（OR=7.812）、孕期被动吸烟（OR=5.23）是危险因素,孕前检查（OR=0.167）、孕期服用多种维生素（OR=0.033）是保护因素。结论母亲孕早期感冒、情绪差、接触农药、妊娠合并症、被动吸烟可增加新生儿患CHD的危险,而母亲孕前检查、及孕早期服用多种维生素则可以降低婴儿患CHD的危险。     

先天性心脏病危险因素1∶1配对病例对照研究

目的：探讨先天性心脏病（congenital heart disease,CHD）发生的危险因素,为研究CHD的病因及其科学的预防措施提供参考依据。方法：采用以医院为基础的1∶1配对病例对照研究,对CHD组和对照组儿童的父母进行统一的问卷调查。对所有研究因素经单因素分析和多因素条件Logistic回归分析,筛选出与CHD发生相关的危险因素。结果：研究分析了260对CHD患儿和对照的资料,按a=0.05水准,用单因素Logistic回归分析对研究因素进行单因素分析,初步筛选出21个可疑危险因素,用多因素条件Logistic回归模型进行多因素综合分析,最终筛选出与CHD发生相关的5个因素,包括3个危险因素：母亲年龄（＞35岁：OR=3.075,P=0.010;＜20岁：OR=5.084,P=0.012）、被动吸烟（少量：OR=1.728,P=0.040;经常：OR=3.903,P=0.000）、孕早期感冒（OR=1.787,P=0.023）,2个保护因素：规律服用叶酸（OR=0.447,P=0.004）、食用肉类（≥4次/周：OR=0.293,P=0.001;1~3次/周：OR=0.372,P=0.008）。结论：孕早期是胎儿心脏发育的关键时期,母亲高龄或低龄、接触烟草、孕早期感冒会增加胎儿发生CHD的风险,而规律服用叶酸、多食用肉类则对胎儿有保护作用。     

西藏自治区318名孕妇妊娠期高血压疾病发病率和影响因素调查分析

目的探究并分析西藏自治区孕妇妊娠期高血压疾病发病率和影响因素,旨在为采取针对性的预防干预措施提供参考依据。方法采用自编问卷收集西藏自治区人民医院妇产科2011年3月～2012年3月定期产检并分娩的318例孕妇的临床资料,再对收集到的资料进行整理和分析后,应用SPSS 18.0统计软件进行描述性统计和二分类Logistic回归分析以找出孕妇妊娠期高血压疾病情况和影响因素。结果孕妇妊娠期高血压疾病发生率为7.23%（23/318）。多因素Logistic回归分析发现：年龄（OR=5.934,P=0.000）、基础体重指数（OR=3.241,P=0.000）、焦虑情绪（OR=7.457,P=0.000）、抑郁情绪（OR=8.945,P=0.000）和高油膳食（OR=5.596,P=0.000）是妊娠期高血压疾病发病的危险因素,每日饮水量（OR=0.033,P=0.000）是患妊娠期高血压疾病的保护因素。结论孕妇妊娠期高血压疾病发生率较高,其发生受多方面因素影响。     

先天性心脏病危险因素1:1配对病例对照研究

目的:探讨先天性心脏病(congenital heart disease,CHD)发生的危险因素,为研究CHD的病因及其科学的预防措施提供参考依据。方法:采用以医院为基础的1∶1配对病例对照研究,对CHD组和对照组儿童的父母进行统一的问卷调查。对所有研究因素经单因素分析和多因素条件Logistic回归分析,筛选出与CHD发生相关的危险因素。结果:研究分析了260对CHD患儿和对照的资料,按α=0.05水准,用单因素Logistic回归分析对研究因素进行单因素分析,初步筛选出21个可疑危险因素,用多因素条件Logistic回归模型进行多因素综合分析,最终筛选出与CHD发生相关的5个因素,包括3个危险因素:母亲年龄(>35岁:OR=3.075,P=0.010;<20岁:OR=5.084,P=0.012)、被动吸烟(少量:OR=1.728,P=0.040;经常:OR=3.903,P=0.000)、孕早期感冒(OR=1.787,P=0.023),2个保护因素:规律服用叶酸(OR=0.447,P=0.004)、食用肉类(≥4次/周:OR=0.293,P=0.001;1~3次/周:OR=0.372,P=0.008)。结论:孕早期是胎儿心脏发育的关键时期,母亲高龄或低龄、接触烟草、孕早期感冒会增加胎儿发生CHD的风险,而规律服用叶酸、多食用肉类则对胎儿有保护作用。     

原发性闭角型青光眼发病影响因素调查研究

目的探讨原发性闭角型青光眼患者发病影响因素,并为早期采取针对性的预防措施提供参考依据。方法采用发病影响因素自编问卷收集2010年12月~2012年12月浙江嘉兴武警医院眼科收治的56例原发性闭角型青光眼患者和同期112例健康体检者的临床资料,采用描述性统计和二分类Logistic回归分析原发性闭角型青光眼患者发病影响因素。结果多因素Logistic回归分析显示,高龄（OR=5.644,P=0.002）、高血压病（OR=12.947,P=0.000）、糖尿病（OR=12.869,P=0.000）、A型行为模式（OR=6.193,P=0.000）、血液黏稠度异常（OR=12.855,P=0.000）、睫状体与晶状体间的距离短（OR=7.124,P=0.000）、浅前房（OR=13.850,P=0.000）、角膜小（OR=8.352,P=0.000）、晶状体较厚（OR=4.391,P=0.000）、眼轴较短（OR=8.159,P=0.000）和虹膜与晶体接触距离增大（OR=5.523,P=0.001）是原发性闭角型青光眼患者发病的危险因素,而近距离看电视（OR=0.421,P=0.000）是原发性闭角型青光眼患者发病的保护因素。结论原发性闭角型青光眼的发病受多种因素影响,应关注高危人群,采取针对性措施降低原发性闭角型青光眼的发病率,改善预后。     

孕前体质指数与早产的关系

目的：探讨孕前体质指数（body mass index, BMI）与早产的关系。方法： 以在北京市海淀区妇幼保健院住院分娩的174例早产儿为病例,382例足月儿为对照,收集孕妇身高、孕前体重、分娩前最后一次体重、孕周、家族史、疾病史以及孕期并发症等信息,运用多因素Logistic回归模型调整混杂因素,分析孕前BMI等因素与早产的关系,并估计调整后的比值比（odds ratio,OR）和95%可信区间（confidence interval,CI）。结果： 通过对早产相关因素的Logistic回归分析,发现孕前肥胖是早产的危险因素,调整后的OR值为2.461（95% CI：1.174~5.159, P=0.017）,未发现孕前超重或孕前偏瘦与早产的关联;妊娠期糖尿病、妊娠期高血压和早产儿家族史是早产的危险因素,调整后的OR值分别为1.781（95% CI：1.025~3.095, P=0.040）、3.831（95% CI：2.044~7.180, P<0.001）和3.675（95% CI：1.358~9.942, P=0.010）。结论： 孕前肥胖是早产的危险因素,为了降低早产的发病率,孕妇需要加强孕前保健,在备孕期应控制孕前BMI在正常范围内。     

超声筛查胎儿先天性心脏病的价值及其危险因素分析

目的探讨并总结产前超声筛查胎儿先天性心脏病（CHD）的应用体会,分析影响CHD发生的独立危险因素。方法回顾分析6129例采用六切面顺序分段法进行产前胎儿心脏超声检查孕妇的临床资料。对经超声心动图检查或引产后尸体解剖确诊CHD的胎儿进行Logistic回归分析,以确定引起CHD的独立危险因素。结果 101例经产前超声诊断CHD,其中1例失访,其余100例均获得随访;12例产后超声心动图检查有10例证实,2例误诊为房间隔缺损;另外88例引产后经尸解证实。CHD检出率为1.6%（98/6129）。发现CHD家族史、母亲结缔组织病或糖尿病、不良妊娠史、染色体异常、羊水量异常、孕早期致畸物接触史和心外畸形等7个因素是引发CHD的独立危险因素（P〈0.05）。6 129例胎儿中,4 107例筛查无高危因素胎儿,35例发现患有CHD,检出率0.9%（35/4 107）;2 022例筛查有高危因素胎儿,64例发现患有CHD,检出率3.2%（64/2022）。结论彩色多普勒超声心动图是产前筛选CHD的有效方法;对于有高危因素的孕妇,应早期筛查、及时诊断和干预,以减少CHD患儿的出生和不良预后。     

不同先天性心脏病类型的环境危险因素分析

目的：探索不同类型先天性心脏病（congenital heart defects, CHD）的环境危险因素,为深入研究CHD表型的危险因素提供方向,为预防CHD积累证据。方法：使用广东省CHD监测网2004年至2012年登记的来自于17个地市、34家医疗机构的3 038例CHD活产儿及其1∶1对照儿数据,先后采用单因素分析、多因素条件Logistic回归,分析6类CHD的环境危险因素。结果：左向右分流类CHD的危险因素包括低出生体重（OR=2.63,95%CI：2.04~3.39）或巨大儿（OR=2.21,95%CI：1.47~3.32）,早产（OR=1.95,95%CI:1.53~2.49）,多胎（OR=1.99,95%CI： 1.22~3.26）,产母教育程度低、产母为工厂工人（OR=1.62,95%CI:1.32~1.98）,产次≥2（OR=1.38,95%CI:1.13~1.69）,有异常生育史（OR=2.29,95%CI： 1.75~3.01）,孕早期3个月曾有发烧（OR=2.38,95%CI： 1.26~4.48）,病毒感染（OR=1.80,95%CI： 1.29~2.51）,使用药物（OR=1.73,95%CI： 1.11~2.69）,被动吸烟（OR=1.69,95%CI： 1.26~2.29）,接触化学制剂（OR=8.71,95%CI： 2.33~32.58）,居住装修6个月内的居室（OR=2.56,95%CI： 1.60~4.09）或居室距主要马路<50 m（OR=1.40,95%CI： 1.14~1.72）,父亲为工厂工人（OR=1.46,95%CI： 1.23~1.73）。肺动脉流出道梗阻类CHD的危险因素包括活产儿低出生体重（OR=5.98,95%CI： 2.88~12.44）或巨大儿（OR=6.56,95%CI： 1.19~36.26）,产母教育程度低、产次≥2（OR=2.08,95%CI： 1.03~4.22）,孕早期病毒感染（OR=4.30,95%CI： 1.27~13.45）。左心室流出道梗阻类CHD危险因素为父亲为工厂工人（OR=6.01,95%CI： 1.05~34.59）。大动脉转位（transposition of the great arteries, TGA）的危险因素包括活产儿低出生体重（OR=12.93,95%CI： 1.14~146.26）,产母教育程度低、职业为工厂工人（OR=3.69,95%CI： 1.53~8.91）。合并心内分流型CHD的危险因素包括产次=2（OR=3.45,95%CI： 1.42~8.38）。其他类CHD的危险因素包括巨大儿（OR=4.87,95%CI： 1.19~19.94）、产母既往有异常生育史（OR=2.96,95%CI： 1.14~7.68）、孕早期3个月有病毒感染（OR=4.92,95%CI： 1.56~15.47）、用药（OR=4.90,95%CI： 1.22~19.77）、被动吸烟（OR=10.31,95%CI: 1.25~85.05）。结论：不同CHD类的危险因素存在差异,深入研究CHD的相关环境危险因素及其影响机制需有针对性,预防CHD需特别注意避免影响多类CHD或临床治疗效果较差CHD类的环境危险因素暴露,并加强已暴露人群的产前检查。     

孕早期睡眠状况对妊娠期糖尿病影响的前瞻性研究

目的 调查分析孕妇孕早期睡眠状况,探讨其对妊娠期糖尿病（GDM）的影响。方法 选取成都市区妇幼医疗机构产前门诊542例孕早期妇女为研究对象进行前瞻性研究,通过问卷调查收集孕妇孕早期睡眠时间、失眠、孕前体质量及其基本信息,于24～28孕周进行糖耐量筛查试验（OGTT）,根据中国妊娠合并糖尿病诊治指南（2014）诊断GDM,并测量体质量。采用多因素非条件logistic回归方法分析孕妇孕早期睡眠状况对GDM发生率的影响。结果 孕早期睡眠不足组、睡眠正常组、睡眠过多组人数分别为16例（2.95%）、268例（49.45%）和258例（47.60%）,GDM发病率分别为62.50%（10/16）、25.75%(69/268)、22.09%(57/258),三组比较差异有统计学意义（χ2=11.280,Pχ2值分别为8.410和11.218,均Pχ2=4.813,P<0.05）。调整可能混杂因素后〔孕妇年龄、文化程度、孕前体质量指数（BMI）、孕早中期增重、孕妇2型糖尿病家族史、孕次、产次、吸烟、饮酒、锻炼、就业〕,多因素非条件logistic回归分析显示:孕妇孕早期睡眠不足是GDM发生的独立危险因素,比值比（95%可信区间）为7.38(2.25~24.17),未观察到孕早期失眠对GDM的影响。结论 孕妇孕早期睡眠状况与GDM发生密切相关,孕早期睡眠不足是GDM发生的危险因素,失眠对GDM的影响有待研究。     

早产儿听力筛查结果及多因素Logistic回归分析

目的探讨早产儿听力筛查未通过的高危因素。方法运用Logistic回归分析对本院279例新生儿科住院的早产儿耳声发射听力筛查情况进行回顾性分析。结果多因素Logisuc回归分析显示,早产儿听力筛查未通过有5个独立危险因素：出生体重〈1500g（P〈0.05,OR=1.27）、高胆红素血症（P〈0.01,OR=4.66）、宫内感染（P〈0.05,OR=3.03）、先天畸形／染色体疾病（P〈0.01,OR=2.61）和耳聋家族史（P〈0.01,OR=1.88）。结论出生体重〈1500g、高胆红索血症、宫内感染、先天畸形／染色体疾病和耳聋家族史是早产儿听力筛查未通过的独立高危因素,应早期采取有效措施进行干预。     

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.