2型糖尿病合并急性冠脉综合征血脂代谢分析

目的研究2型糖尿病(DM)和2型糖尿病合并急性冠脉综合征(ACS)患者血脂水平的变化,探讨血脂在2型DM合并ACS发生中的作用。方法测定68例2型DM无合并ACS患者(无合并ACS组)、68组2型DM合并ACS患者(合并ACS组),68例健康对照组血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL—C)、低密度脂蛋白胆固醇(LDL—C)、载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)水平。结果①糖尿病组与对照组比较,血清TC、TG、LDL—C、ApoB水平显著升高(P<0.05),HDL—C、ApoAI显著降低(P<0.05)。②2型糖尿病并发ACS组与无并发ACS组比较,血清TC、TG、LDL—C、ApoB水平显著升高(P<0.05),ApoAI显著降低(P<0.05),HDL—C无显著差异(P>0.05)。结论2型DM患者存在血脂代谢异常,且2型DM合并ACS者血脂代谢异常进一步加剧,血脂代谢异常是2型DM发生ACS的主要危险因素之一。     

2型糖尿病胰岛素抵抗与脂代谢紊乱关系探讨

目的 :探讨2型糖尿病患者 (T2DM )胰岛素抵抗 (insulinresistance ,IR)、糖化血红蛋白 (HbA1c)、空腹胰岛素 (FINS)与血脂水平改变的相关关系。方法 :检测114例新诊断的T2DM患者血HbA1c、空腹血糖 (FPG)、空腹血胰岛素 (FINS)、甘油三酯 (TG)、胆固醇 (CHO)、高密度脂蛋白 (HDL)和低密度脂蛋白 (LDL)。稳态模型法计算胰岛素抵抗指数 ,Homa -IR=FINS×FPG/22.5;并分别进行HbA1c、FINS、Homa-IR与TG、CHO、HDL和LDL间的相关性分析 ;设51例正常人为对照组。结果 :T2DM患者血Homa -IR、FINS、HbA1c与TG、CHO和LDL水平升高 ,HDL水平降低 ,与正常对照组有显著差异 (P<0.01) ;HbA1c与TG升高显著正相关 (P<0.01) ,与LDL升高显著正相关 (P<0.05) ;FINS与TG呈显著正相关 (P<0.05) ,与HDL呈显著负相关 (P<0.05) ;Homa -IR与TG、LDL呈显著正相关性 (P<0.05) ,与HDL有一定负相关性 ,但无统计学意义 (P>0.05)。结论 :初诊T2DM患者血HbA1c水平与TG和LDL升高正相关 ;FINS与TG正相关 ,与HDL负相关 ;Homa -IR与TG、LDL升高正相关     

瑞舒伐他汀对2型糖尿病视网膜病变患者血清PEDF、IL-6水平的影响

目的探讨瑞舒伐他汀对2型糖尿病视网膜病变(DR)患者血清PEDF、IL-6水平的影响。方法选取60例2型糖尿病视网膜病变患者,随机分为实验组(瑞舒伐他汀治疗)30例和空白对照组(仅常规降血糖治疗)30例,疗程为3个月。分析两组患者治疗前后血清PEDF、IL-6、TC、TG、LDL、HDL、FPG、2h PG、Hb A1c水平以及DR分期的变化情况。结果实验组血清IL-6、TC、TG、LDL、FPG、2h PG、Hb A1c水平及DR分期与治疗前比较明显下降,血清PEDF、HDL水平与治疗前比较明显升高,差异均有统计学意义(P<0.01)。空白对照组中FPG、2h PG、Hb A1c水平较治疗前明显下降(P<0.01),其余各指标与治疗前比较,差异均无统计学意义(P>0.05)。实验组治疗前后的差值(ΔPEDF、ΔIL-6、ΔDR分期、ΔTC、ΔTG、ΔLDL、ΔHDL)与对照组治疗前后的差值比较,差异均有统计学意义(P<0.01)。结论瑞舒伐他汀能显著降低DR患者血清IL-6水平,升高血清PEDF水平,从而延缓了DR患者的病情进展。     

睾酮对睾丸切除大鼠血清性激素及血脂的影响

目的:探讨不同剂量外源性睾酮对双侧睾丸切除雄性大鼠性激素及血脂水平的影响.方法:成熟雄性SD大鼠28只,随机分成4组(n=7):对照组、单纯睾丸切除组、小剂量睾酮(TU)组(睾丸切除后肌注TU13.7 μg/g,每月1次)和大剂量TU组(睾丸切除后肌注TU625 μg/g,每月1次).30 d后测量血清总睾酮(TT)、雌二醇(E2)及高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、甘油三酯(TG).结果:单纯睾丸切除组血清TT 水平显著低于对照组(P<0.01);而小剂量TU组接近于对照组(P>0.05);大剂量TU组明显高于对照组和小剂量TU组 (P<0.01).血清E2水平对照组最低,单纯睾丸切除组和小剂量TU组相近,大剂量TU组最高.E2/ TT比值对照组和小剂量TU组相近,单纯睾丸切除组最大,大剂量TU组最小.单纯睾丸切除组LDL,TG和HDL明显升高(P<0.01);LDL/ HDL降低(P<0.05).小剂量TU组的HDL和LDL升高(P<0.05);大剂量TU组HDL降低和LDL上升(P<0.05),LDL/HDL明显上升(P<0.01).结论:雄鼠睾丸切除和睾丸切除后补充不同剂量的外源性睾酮可产生不同水平的E2和E2/TT比值,同时也使TG,LDL,HDL,LDL/HDL发生了变化.     

载脂蛋白CⅢ与2型糖尿病微血管并发症的关系

目的分析2型糖尿病患者血清载脂蛋白CⅢ(apoCⅢ)的含量变化,探讨其与2型糖尿病微血管并发症的关系。方法将120例2型糖尿病患者分为单纯2型糖尿病组,糖尿病肾病组,每组各60例。检测各组患者血压、体质指数、血清空腹血糖(FBG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)和apoCⅢ含量。按照ETDRS的标准对所有患者的视网膜病变进行评分。结果所有2型糖尿病患者的收缩压、体质指数、血清FBG、TG、VLDL、HbA1c、apoCⅢ水平明显升高(P<0.05),HDL水平明显下降(P<0.01);所有2型糖尿病肾病患者的舒张压,血清TC、LDL水平也明显升高(P<0.05);与单纯2型糖尿病患者比较,2型糖尿病肾病患者血清FBG、HbA1c、TG、TC、LDL、VLDL水平有升高趋势,但差异无统计学意义(P>0.05),而收缩压、舒张压以及apoCⅢ水平明显升高(P<0.01)。血清apoCⅢ与TG、VLDL、尿微量白蛋白(MAU)水平及ETDRS评分呈正相关(P<0.05),与HDL水平呈负相关(P<0.05)。apoCⅢ(β=0.17,P<0.05)决定MAU;apoCⅢ(β=0.18,P<0.05)决定ETDRS评分。结论 apoCⅢ含量异常是2型糖尿病患者代谢紊乱的特征,同时可能是预测糖尿病微血管病变的重要指标。     

长期小剂量阿托伐他汀联合非诺贝特对脂代谢异常高危人群血脂的影响

目的:观察冠心病及其等危征、代谢综合征等脂代谢异常的高危患者,小剂量阿托伐他汀联合非诺贝特对其血脂的影响及用药安全性。方法:冠心病及其等危征、代谢综合征等脂代谢异常患者82例,随机分为阿托伐他汀联合非诺贝特组(联合组)40例,给予阿托伐他汀10mg,非诺贝特200 mg;单用阿托伐他汀组(单用组)42例,予阿托伐他汀10mg,共12月。结果:治疗6周后两组中TC、TG及联合组中LDL水平均较治疗前降低(P<0.01),单用组LDL及联合组Lp(a)较治疗前降低(P<0.05),联合组HDL水平升高(P<0.05);治疗12月后两组TC、TG、LDL水平均较治疗前显著降低(P<0.01),单用组Lp(a)显著降低(P<0.05),联合组Lp(a)显著降低(P<0.01);单用组HDL水平显著升高(P<0.05),联合组HDL水平显著升高(P<0.01)。两组间比较:治疗6周后,联合组TC、TG、LDL、HDL、Lp(a)均与单用组有差异(P<0.01);治疗12月后,联合组TG、Lp(a)下降均优于单用组(P<0.01);联合组TC、LDL下降均优于单用组(P<0.05),HDL升高优于单用组(P<0.05)。横纹肌损害无明显差异(P>0.05);肝功能损害无明显差异(P>0.05);其他不良反应无明显差异(P>0.05)。结论:长期小剂量阿托伐他汀联合非诺贝特治疗安全有效,调脂作用优于单用阿托伐他汀。     

血清甘油三酯、总胆固醇含量与HDL亚类分布的关系

目的　探讨血甘油三酯 (TG) ,总胆固醇 (TC)水平对 HDL亚类组成及含量的影响。方法　采用双向电泳 -免疫印迹检测法按血 TG、TC水平分层分析了 2 89例受试者血清 HDL 亚类组成及含量。结果　受试者按血TG水平分层时 ,随着 TG逐渐升高 ,小颗粒的 preβ1 - HDL、 preβ2 - HDL、 HDL3b及 HDL3a含量均有升高趋势 ,而大颗粒的 HDL2 a、HDL2 b含量有降低趋势 ,与 TG正常组比较 ,TG高组及 TG极高组 preβ1 - HDL、HDL3b含量均显著升高(P<0 .0 1或 P<0 .0 5 )。而 HDL2 b含量显著降低 (P<0 .0 1)。此外 ,TG极高组 HDL3a含量亦显著升高 (P<0 .0 5 )。受试者按血 TC水平分层时 ,随着 TC逐渐升高 ,preβ1 - HDL ,preβ2 - HDL、 HDL3c及 HDL3b含量亦有升高趋势 ,HDL2 b含量有所降低。其中 ,与 TC合适水平组比较 ,TC高组 preβ1 - HDL、HDL3c及 HDL3b含量均显著升高 (P<0 .0 5 )。结论　随着血 TG或 TC水平升高 ,HDL颗粒呈变小趋势 ,且血 TG水平变化可能是较 TC变化更为重要的影响HDL 亚类组成的因素。     

2型糖尿病合并甘油三酯异常患者血清游离脂肪酸水平分析

目的 观察2型糖尿病和2型糖尿病合并甘油三酯异常患者血清游离脂肪酸(FFA)的水平变化,探讨其与2型糖尿病合并血脂异常的关系.方法 抽取144例2型糖尿病患者血样,根据中华医学会糖尿病学分会(CDS)建议代谢综合征的诊断标准(TG≥1.70mmol/L),将研究对象分为甘油三酯异常组(A1组)61例与甘油三酯正常组(A2组)83例,抽取正常人群160例为对照组,分别测定空腹血糖(FBG)总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、游离脂肪酸(FFA)糖化血红蛋白(HbA1c),并与对照组做比较.结果 A1组、A2组和对照组比较,FFA、FBG、TC、TG、HbA1c的浓度明显高于对照组(P<0.01,HDL、LDL的浓度与对照组比较无统计学意义(P>0.05);A1组与A2组比较,FFA的浓度显著升高(P<0.05).FFA的浓度和TG、HbA1c呈正相关(P<0.01或P<0.05).结论 FFA的结果在2型糖尿病合并TG异常患者中显著升高,FFA水平增高与2型糖尿病合并TG异常密切相关,可能在2型糖尿病发病过程中起重要作用.     

急性冠状动脉综合征患者血清C-反应蛋白及脂质变化的研究

目的探讨急性冠状动脉综合征(ACS)患者急性期血清C-反应蛋白(CRP)、血清低密度脂蛋白(LDL)、总胆固醇(TC)、甘油三酯(TG)浓度变化及其相关性.方法测定ACS患者和对照组血清CRP浓度及LDL、TC、TG含量.结果ACS患者CRP浓度显著升高,其中UAP52.38±4.98、NQMI79.36±8.14、AMI102.58±9.16,与对照组7.50±1.48比较,有显著差异(P＜0.01),ACS患者CRP浓度和LDL、TC、TG含量呈同步升高,与对照组比较差异显著(P＜O.05,P＜0.01),CRP与LDL、CRP与TC、CRP与TG呈显著正相关(P＜0.01).结论血清CRP浓度升高与ACS有极大的相关性,调节血脂水平,达到降低CRP水平的目的是防治ACS发生、发展的有效措施.     

2型糖尿病200例脂代谢分析

对 2 0 0例 2型糖尿病患者进行血脂分析。分为总组和对照组 ,HbAlc≤ 7.0mmol/L组与HbAlc >7.0mmol/L组 ,高血压组与非高血压组。分别观察TC、TG、HDL C、LDL C、APO A1、APO B及比值等指标。结果显示 ,2型糖尿病总组TG增高、HDL C降低、LDL C增高、APO A1降低、APO B增高 (均P <0 .0 1或 <0 .0 5 ) ;高血压组TC增高、HDL C降低 (均P <0 .0 5 ) ,HbAlc>7.0mmol/L组TG增高、APO B增高 (均P <0 .0 5 )。表明该组患者完全符合 2型糖尿病的脂质三联征特点。     

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.