卵巢上皮性肿瘤组织及患者血清CA125检测

目的:比较卵巢上皮性肿瘤组织及患者血清中CA125表达水平.方法:选取65例卵巢上皮性癌、10例卵巢交界性肿瘤、10例卵巢良性肿瘤及10例正常卵巢组织标本,采用免疫组织化学SP法检测组织中CA125的表达情况;同时应用化学发光法检测患者血清CA125水平.结果:卵巢上皮性癌患者卵巢组织及血清中CA125水平均高于正常、良性和交界性卵巢上皮性肿瘤者(P<0.01).癌组织及血清中CA125表达水平与卵巢上皮性癌患者的肿瘤大小、临床分期、组织学分级、腹水量多少、有无淋巴结转移、组织学类型等有关(P<0.05).卵巢癌组织与血清中CA125表达的相关系数为0.636(P=0.002).结论:卵巢上皮性癌患者血清CA125水平与卵巢癌病灶CA125水平变化一致,是卵巢上皮性癌较好的肿瘤标记物.     

卵巢上皮性癌组织中闭合蛋白-3和闭合蛋白-4蛋白的表达

目的:探讨卵巢上皮性癌组织中闭合蛋白(Claudin)-3和Claudin-4蛋白的表达及其相关性.方法:采用免疫组化方法检测65例卵巢上皮性癌、12例交界性卵巢肿瘤、15例良性卵巢肿瘤和10例正常卵巢组织中Claudin-3和Claudin-4蛋白的表达情况,并分析Claudin-3和Claudin-4蛋白表达与卵巢上皮性癌患者临床病理特征的关系以及2者的相关性.结果:①卵巢上皮性癌组织中Claudin-3蛋白的阳性表达率高于交界性卵巢肿瘤组织、良性卵巢肿瘤组织和正常卵巢组织(λ2=35.443,P＜0.05);卵巢上皮性癌组织和交界性卵巢肿瘤组织中Claudin-4蛋白的阳性表达率高于良性卵巢肿瘤组织和正常卵巢组织(λ2=40.258,P＜0.05).②卵巢上皮性癌中、低分化组Claudin-3和Claudin-4的表达高于高分化组(λ2分别为14.249和9.991,P＜0.05);有淋巴结转移组Claudin-3和Claudin-4的表达高于无淋巴结转移组(λ2分别为4.710和4.065,P＜0.05).③在卵巢上皮性癌组织中Claudin-3与Claudin-4的表达呈正相关(rP=0.588,P＜0.05).结论:Claudin-3和Claudin-4的高表达与卵巢上皮性癌的发生发展及侵袭转移密切相关.     

卵巢上皮性癌组织中水通道蛋白3的表达

目的:检测卵巢上皮性癌组织中水通道蛋白3(AQP3)的表达,探讨其在卵巢上皮性癌发病中的意义.方法:取66例卵巢上皮性肿瘤(恶性46例,交界性10例,良性10例)、12例正常卵巢组织,应用免疫组织化学SP法检测AQP3的表达.结果:AQP3主要在卵巢上皮性癌癌细胞的胞质中和部分胞膜上表达,在良性卵巢上皮性肿瘤和交界性肿瘤部分肿瘤细胞胞质中、少量间质细胞胞质中也有表达.AQP3在交界性和恶性卵巢上皮性肿瘤组织中表达水平高于良性肿瘤组织和正常组织(P＜0.05).组织学分级为G2、G3的卵巢上皮性癌组织中AQP3的表达高于G1者,Ⅲ～Ⅳ期卵巢癌组织AQP3表达高于Ⅰ～Ⅱ期(P<0.05),腹水量超过1 000 mL者AQP3表达水平高于1 000 mL以下者(P<0.05),伴淋巴结转移的卵巢癌组织中AQP3表达水平高于无淋巴结转移者(P<0.05).结论:AQP3可能通过增加肿瘤上皮细胞和血管内皮细胞的水通透性,增强卵巢上皮性癌的侵袭和转移能力.     

自噬相关蛋白 LC3-Ⅱ在上皮性卵巢癌中的表达及临床意义

目的：本研究检测微管轻链Ⅰ蛋白3-Ⅱ型(LC3-Ⅱ)在不同卵巢肿瘤组织中的表达情况,探讨其与浆液性卵巢癌及粘液性卵巢癌发生、发展的相关性和意义。方法选取204例上皮性卵巢肿瘤标本,其中,卵巢浆液性囊腺瘤46例,交界性浆液性肿瘤28例,浆液性囊腺癌40例,黏液性囊腺瘤32例,交界性黏液性囊腺瘤30例,黏液性囊腺癌28例,另选取正常卵巢上皮组织28例作为对照。使用 SP 法检测正常卵巢上皮组织、上皮性卵巢肿瘤组织中 LC3-Ⅱ的表达,并结合浆液性癌、黏液性癌临床病理因素进行分析。结果①正常卵巢上皮中 LC3-Ⅱ无表达,卵巢良性浆液性囊腺瘤、交界性浆液性肿瘤及浆液性癌中 LC3-Ⅱ的阳性率分别为4．5%、71．0%、95．0%,交界性浆液性肿瘤和浆液性癌中 LC3-Ⅱ的表达明显高于良性浆液性囊腺瘤,差异有统计学意义(P <0．01)。卵巢良性黏液性囊腺瘤、交界性黏液性肿瘤及黏液性癌中 LC3-Ⅱ的阳性率分别为6．7%、66．7%、92．9%,交界性浆液性肿瘤和浆液性癌中 LC3-Ⅱ的表达明显高于良性浆液性囊腺瘤,差异有统计学意义(P <0．01);②在40例卵巢浆液性癌、28例卵巢黏液性癌中,LC3-Ⅱ表达与患者年龄、FIGO 分期及病理学分级等临床病理特征均无关。结论 LC3-Ⅱ在卵巢上皮性交界性肿瘤、癌中表达增高,自噬活性增强,可能与卵巢上皮性恶性肿瘤的进展有关。     

KLK7蛋白在卵巢上皮性癌组织中的表达及临床意义

目的 探讨KLK7蛋白在卵巢上皮性癌组织中的表达及其临床意义.方法 采用Western-blot技术检测34例卵巢上皮性癌、19例卵巢交界性上皮性肿瘤、32例卵巢良性上皮性肿瘤及37例正常卵巢组织中KLK7蛋白的表达,并分析其与各临床病理指标的相关性.结果 KLK7蛋白在卵巢上皮性癌及卵巢交界性上皮性肿瘤组织中的阳性表达率(分别为79.4%、47.4%)及表达水平(分别为0.85±0.15、0.53±0.09)均显著高于卵巢良性上皮性肿瘤及正常卵巢组织(分别为15.6%、16.2%和0.20±0.13、0.22±0.11,P均<0.05);且KLK7蛋白在卵巢上皮性癌组织中的阳性表达率和表达水平均与手术病理分期和淋巴结转移有明显的相关性(P<0.05).结论 KLK7蛋白在卵巢上皮性癌组织中呈高表达,其不同程度的表达增强与卵巢上皮性肿瘤可能有关.     

基质金属蛋白酶MMP-9及其组织抑制剂TIMP-1mRNA在卵巢上皮性肿瘤中的表达及其临床意义

目的 探讨基质金属蛋白酶(MMP-9)及其组织抑制物(TIMP-1)mRNA与卵巢上皮性癌的发生、发展的关系.方法 采用RT-PCR技术检测69例卵巢上皮性肿瘤(38例恶性、15例交界性、16例良性)及11例正常卵巢组织中MMP-9及TIMP-1 mRNA的表达,并分析其与各临床病理特征的关系.结果 MMP-9 mRNA在卵巢上皮性癌及交界性肿瘤组织中的阳性表达率(分别为76%、44%)及表选水平[分别为(154.14±4.42)、(96.87±3.04)]均显著高于良性肿瘤及正常卵巢组织[分别为13%、9%和(8.26±2.67)、(2.34±1.02);P<0.05];且MMP-9mRNA在晚期卵巢上皮性癌组织中的阳性袁达,率和表达水平明显高于早期癌组织(p<0.05).TIMP-1 mRNA在卵巢上皮性癌及交界性肿瘤组织中的阳性表达率(分别为68%、38%)及表达水平[分别为(126.35±3.81)、(90.62±5.54)]均显著高于良性肿瘤及正常卵巢组织[分别为13%、9%和(8.32±2.02)、(2.63±1.35);P<0.05];TIMP-1 mRNA在卵巢上皮性癌组织中的阳性表达率和表达水平与各临床病理特征均无相关性(P0.05).结论 MMP-9mRNA的高表达及MMP-9/TIMP-1平衡的调节失衡导致卵巢上皮性肿瘤的发生、侵袭和转移;MMP-9 mRNA的高表达对卵巢上皮性癌有预后意义.     

在卵巢上皮性癌中PTEN及Survivin的表达及相关性

目的 研究在卵巢上皮癌中抑癌基因PTEN及凋亡抑制因子Survivin的表达及二者是否相关.方法 应用免疫组化SP法,检测PTEN、Survivin蛋白在46例良性上皮性卵巢肿瘤、40例正常卵巢组织、76例上皮性卵巢癌中的表达.结果 在卵巢上皮性癌中PTEN蛋白的表达水平明显低于卵巢良性肿瘤及正常卵巢组织,差异有显著性(P＜0.05);Survivin蛋白的表达与PTEN蛋白相反,在卵巢上皮性癌中的表达明显高于卵巢良性肿瘤及正常卵巢组织,差异有显著性(P＜0.05),两者的表达呈负相关(r=-0.527,P=0.001).二者的表达与年龄及病理类型无关(P＞0.05),与临床分期、分化程度及是否转移相关(P＜0.05).结论 Survivin蛋白及PTEN的表达与卵巢上皮性癌的发生、发展有关;二者的联合检测有助于判断卵巢上皮性癌的恶性程度及预后.     

卵巢上皮性癌组织中PAX2基因的表达及临床意义

目的 探讨PAX2 mRNA和蛋白在卵巢上皮性癌中的表达及临床意义.方法 采用逆转录聚合酶链反应和免疫组化方法检测PAX2 mRNA和蛋白在31例卵巢上皮性癌、11例卵巢上皮性交界性肿瘤、10例卵巢上皮性良性肿瘤和11例正常卵巢组织中的表达,并分析其表达与卵巢上皮性癌临床病理学指标的关系.结果 正常卵巢表面上皮无PAX2的表达,PAX2 mRNA和蛋白在卵巢上皮性癌组织中的表达显著高于卵巢交界性肿瘤组织、卵巢良性肿瘤组织及正常卵巢组织,差异均有统计学意义(P＜0.01);卵巢交界性肿瘤组织、卵巢良性肿瘤组织及正常卵巢组织中PAX2mRNA和蛋白表达的差异无统计学意义(P＞0.05).在晚期(Ⅲ～Ⅳ)及低分化的卵巢上皮性癌中PAX2 mRNA和蛋白的表达高于早期(Ⅰ～Ⅱ)及高中分化者,差异均有统计学意义(P＜0.05).结论 PAX2在卵巢癌的发生发展中起一定作用,可能对卵巢癌恶性程度的评估有指导意义.     

水通道蛋白5和水通道蛋白9在卵巢上皮性肿瘤中的表达及意义

目的 研究水通道蛋白5(AQP5)、水通道蛋白9(AQP9)蛋白及mRNA在卵巢上皮性肿瘤中的表达及意义.方法 采用免疫组织化学和原位杂交方法检测10例正常卵巢组织,80例卵巢上皮性肿瘤组织中AQP5、AQP9蛋白及mRNA的表达,分析其表达与临床病理特征的关系.结果 卵巢上皮性恶性肿瘤组织中AQP5、AQP9蛋白及mRNA的阳性表达高于正常和良性肿瘤组织(P＜0.05),交界性肿瘤中AQP5蛋白表达的高于正常组(P＜0.05),且交界组AQP5和AQP9 mRNA的阳性表达高于正常和良性肿瘤组织(P＜0.05);随着FIGO分期的增高、组织学分级的降低、伴淋巴结转移及腹水的增多,卵巢上皮性肿瘤组织中AQP5、AQP9蛋白及mRNA的表达增高,差异均有统计学意义(均P＜0.05);AQP5、AQP9蛋白及mRNA在卵巢上皮性肿瘤组织中的表达呈正相关(r =0.610,0.594,均P=0.000).结论 AQP5、AQP9蛋白及mRNA在卵巢上皮性肿瘤组织中的表达均上调,其表达上调可能与卵巢上皮性肿瘤的发生及发展有关,有望成为卵巢上皮性肿瘤检测及治疗的潜在靶点.     

Wilms瘤基因在卵巢上皮性癌组织中的表达及临床意义

目的探讨卵巢癌上皮性组织中Wilms瘤基因蛋白（WT1）表达以及与上皮性卵巢癌发生、发展及预后的关系。方法应用免疫组化SP法检测30例正常卵巢组织、30例卵巢良性上皮性肿瘤（囊腺瘤）、40例卵巢交界性上皮性肿瘤（交界性囊腺瘤）及80例卵巢恶性上皮性肿瘤（上皮性卵巢癌）标本中WT1蛋白的表达。结果上皮性卵巢癌组织和卵巢交界性囊腺瘤组织中wT1阳性表达率明显高于正常卵巢组织及卵巢囊腺瘤组织;在上皮性卵巢癌中,浆液性囊腺癌WT1蛋白的阳性表达率明显高于其他亚型,低分化组的WT1蛋白表达率高于高、中分化组。上述差异均有统计学意久（均P〈0．05）;WT1蛋白的阳性表达率随FIGO分期的进展升高（P〈0．05）,但与是否存在淋巴结转移无明显相关性。结论WT1可能对上皮性卵巢癌的发生、发展及预后起着一定的作用,有可能成为上皮性卵巢癌鉴别诊断的客观辅助指标。     

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.