厄贝沙坦抑制肾皮质JAKs-STATs信号通路的实验研究

目的 探讨肾脏Janus激酶/信号转导子/转录激活子(JAKs-STATs)基因表达在高血压肾损害中的作用和血管紧张素Ⅱ受体拮抗剂(ARB)的肾脏保护作用.方法 应用病理检查、放射免疫、逆转录-聚合酶链式反应和蛋白印迹杂交等方法,检测自发性高血压大鼠(SHR)应用厄贝沙坦(SHR-Ⅰ组)对肾脏局部血管紧张素Ⅱ(Ang Ⅱ)水平、肾皮质组织JAK1,2及STAT1,3 mRNA和蛋白表达.同时设SHR组及对照Wistar-Kyoto(WKY)组.结果 SHR-Ⅰ组肾皮质组织匀浆液Ang Ⅱ水平为(79.4±14.8)pg/mg,SHR组为(83.4±8.2)PS/mg,WKY组为(43.2±13.6)pg/mg(P＞0.05).SHR-Ⅰ组和SHR组肾皮质组织匀浆液Ang Ⅱ水平均比WKY组显著增加(均P＜0.01).SHR-Ⅰ组肾皮质JAK1,2及STAT1,3 mRNA和蛋白表达含量明显比SHR组下降(均P＜0.01),与WKY组相比,差异无统计学意义(均P＞0.05).结论 JAKs-STATs信号通路可能参与了高血压肾脏损害过程,厄贝沙坦肾脏保护作用部分是通过减少肾脏内的JAKs-STATs表达,使JAKs-STATs信号通路受到抑制有关.     

SHR及SHR伴糖尿病大鼠肾皮质RAS研究

目的观察白发性高血压人鼠(SHR)及伴有糖尿病大鼠(SHR-DM)肾皮质血管紧张素Ⅱ1型受体(AT1)mRNA和血管紧张素转换酶(ACE)mRNA的表达,以及血管紧张素Ⅱ(AngⅡ)对肾小球系膜细胞增殖的直接作用.方法采用反转录-多聚合链式反应、细胞培养和3H-胸嘧啶核苷掺入技术.结果 1.SHR肾皮质AT1mRNA和ACEmRNA明显高于WKY(WistarKyoto)(P<0.05).2.SHR-DM的AT1mRNA和ACEmRNA与WKY接近,而较SHR明显降低(P<0.01).3.SHR血浆AngⅡ浓度和ACE活性明显低于WKY,SHR-DM与SHR比较血浆AngⅡ存在异常增高.4.AngⅡ对SHR肾小球系膜细胞具有明显刺激增殖的作用,并且呈剂量依赖关系.结论SHR肾皮质局部肾素血管紧张素系统存在过度兴奋状态,AngⅡ有直接参与肾小球结构改变、促进肾小球受损的作用.     

血管紧张素Ⅱ及其受体拮抗剂对肝星状细胞Ⅲ型胶原合成的影响

目的 观察血管紧张素Ⅱ及其受体拮抗剂对体外培养的肝星状细胞Ⅲ型胶原蛋白合成及其mRNA表达的影响.方法 采用HSC-T6肝星状细胞系作为活化的肝星状细胞的研究模型.将培养的肝星状细胞随机分为对照组、血管紧张素Ⅱ(AngⅡ)组、受体拮抗剂(AT1RA)组和血管紧张素Ⅱ 受体拮抗剂(AngⅡ AT1RA)组.采用ELISA法检测细胞培养上清液中Ⅲ型胶原蛋白的含量;RT-PCR法检测肝星状细胞中Ⅲ型胶原mRNA的表达.结果 细胞培养上清液中Ⅲ型胶原蛋白的含量对照组、AngⅡ组和AngⅡ AT1RA组分别为(6.301±0.432)ng/ml、(7.356±0.237)ng/ml和(6.263±0.236)ng/ml,AngⅡ组高于对照组(P＜0.05),AngⅡ AT1RA组显著低于AngⅡ组(P＜0.05).肝星状细胞Ⅲ型胶原mRNA的表达水平对照组、AngⅡ组和AngⅡ AT1RA组分别为2.317±0.015、2.643±0.057和2.330±0.036,AngⅡ组高于对照组(P＜0.05),AngⅡ AT1RA组显著低于AngⅡ组(P＜0.05).结论 血管紧张素Ⅱ能够促进肝星状细胞Ⅲ型胶原蛋白的合成及其mRNA的表达,而血管紧张素Ⅱ1型受体拮抗剂能够明显抑制这一作用.     

依那普利对SHR肾皮质RAS系统mRNA表达的影响

目的通过对自发性高血压大鼠(SHR)和正常血压大鼠(WKY)肾皮质中ACE和AT1mRNA表达水平的检测,以及分别用转换酶抑制剂(ACEI)--依那普利干预治疗后检测肾皮质中ACE和AT1mRNA表达水平的变化,探讨局部RAS组分在SHR发病机制中所起的作用,以及ACEI对局部RAS的影响.方法用RT-PCR方法,分别对服用依那普利SHR和对照组各6例,以及11例服药WKY组和9例对照组的肾皮质中ACE和AT1mRNA表达水平进行检测.同时对各组大鼠外周血中的ACE和AngⅡ进行生化检测.结果发现SHR服药组肾皮质中ACEmRNA表达明显低于对照组(P<0.05),AT1mRNA表达在SHR服药组和对照组无显著差别.在未服药对照组中SHR肾皮质ACE和AT1mRNA表达均明显高于WKY组(两组P<0.05).同时发现各组大鼠外周血ACE和AngⅡ生化数值与组织中相应mRNA表达水平无相关性(P>0.05).结论组织中RAS组分可能与SHR发病有关,ACEI可影响局部RAS的作用,而外周血ACE和AT1水平均不能反映这种变化.从而进一步阐明局部RAS在原发性高血压发病中的作用.     

自发性高血压大鼠肾脏血管紧张素转换酶2的表达

目的  观察不同月龄的自发性高血压大鼠(SHR)的肾脏血管紧张素转换酶2(ACE2)的mRNA和蛋白质表达水平,探讨ACE2与血压状态的内在联系。  方法  12周龄雄性自发性高血压大鼠(SHR)18只和12周龄Wistar-Kyoto(WKY)大鼠18只。随机分为SHR组和WKY组,每组抽取各9只处死后与喂养12周后处死的24周龄大鼠一并进行ACE2的检测。采用实时定量RT-PCR法检测ACE2 mRNA的表达,免疫组织化学检测ACE2蛋白的表达。  结果  与同周龄WKY组比较,SHR组大鼠的血压显著增加(P均＜0.001),ACE2 mRNA表达显著降低(P均＜0.001);与12周龄SHR组比较,24周龄SHR的血压显著增加(P＜0.01),ACE2 mRNA表达显著降低(P＜0.01);与同周龄的WKY组比较,SHR组肾脏ACE2免疫染色表达显著减少。 结论  肾脏ACE2 mRNA和蛋白质的表达与血压升高相关。     

血管紧张素Ⅱ及其2型受体在大鼠肾脏中表达的增龄性变化

目的:阐明血管紧张素Ⅱ(AngⅡ)及其2型受体(AT2)在大鼠肾脏增龄过程中的表达变化,探讨AngⅡ及AT2在肾脏衰老过程中的作用机制. 方法:分别观察新生(1 d)、成年(8 wk)及老年(20 mo)3组大鼠肾脏皮质中AT2 mRNA的表达及其增龄性变化,并测定肾皮质中AngⅡ水平. 结果:新生大鼠肾皮质中AT2 mRNA的表达水平较高,而在成年(0.29±0.05)及老年(0.32±0.04)大鼠肾皮质中的表达水平明显低于新生(0.85±0.07)大鼠(P<0.05). AngⅡ水平(ng/g)在新生组(2092±153) 和成年组(2125±107)均明显高于老年组(1876±80,P<0.05). 结论:AT2水平的降低可能参与了肾脏衰老的调控.     

培多普利对高血压大鼠左心室肥厚的影响

目的:探讨培多普利对原发性高血压大鼠左心室肥厚重构及进程中血管紧张素II(Ang-II)和肌浆网钙ATP酶的影响。方法:原发性高血压大鼠分成模型组、培多普利治疗组[SHR-t1mg/(kg)·d],WKY大鼠为正常对照组(WKY)。电镜观察左心室肥厚的超微结构,并分别测定心肌指数(左室重/体质量,LV/WT),血、心肌Ang-II水平和肌浆网钙ATP酶的活性变化。结果:SHR-t组的血AngII水平无明显改变,SHR组的血压、LV/WT(3.98±0.32)mg/g、Ang-II(16.72±5.24)pg/mg水平显著升高(P<0.01),电镜下可见心肌相对缺氧及代偿性细胞功能活跃表现。SHR-t组血压、LV/WT(3.38±0.31)mg/g、Ang-II(12.94±1.63)pg/mg明显下降(P<0.05),且未见上述心肌超微结构改变;但SHR-t组的LV/BW与WKY组(2.29±0.49)mg/g相比仍有显著差异(P<0.01);SHR组肌浆网钙ATP酶活性明显下调[0.52±0.11μmol/(g·min),P<0.05],治疗后恢复[0.82±0.11μmol/(g·min),P<0.05],但仍未达正常。结论:ACE-I主要通过抑制局部肾素-血管紧张素系统通路,对高血压大鼠左心室肥厚重构起了很好的逆转作用,但不可能完全阻断左心室肥厚的进程。     

血管紧张素Ⅱ与转化生长因子—β1对高血压心肌纤维化的影响

目的观察阻断肾素-血管紧张素系统(RAS)对自发性高血压大鼠(SHR)心肌局部血管紧张素Ⅱ(AngⅡ)、转化生长因子-β1(TGF-β1)及对心肌胶原代谢的影响,探讨AngⅡ与TGF-β1在高血压心肌重构中的作用.方法以Wis-tar-Kyoto(WKY)大鼠为非高血压对照,15周龄SHR经氯沙坦(Los)或/和卡托普利(Cap)治疗15周,放免法测定AngⅡ、双抗体夹心ELISA法检测心肌TGF-β1水平、苦味酸天狼猩红染色VIDAS图像分析计算胶原容积分数(CVP)和血管周围胶原面积(PVCA)、放射性底物测定法检测心肌基质金属蛋白酶-1(MMP-1)的活力.结果在SHR心肌中,AngⅡ、TGF-β1、CVP、PVCA明显高于WKY大鼠,而MMP-1活力降低(P＜0.01).阻滞RAS的不同水平均降低AngⅡ、TGF-β1、CVP、PVCA,升高MMP-1活力.SHRLos+Cap或SHRLos降低TGF-β1水平、升高MMP-1活力明显优于SHRRCap(P＜0.05).心肌AngⅡ水平与TGF-β1、CVP、PVCA正相关(P＜0.01),AngⅡ、TGF-β1与MMP-1活力呈负相关(P＜0.01).结论AngⅡ可能通过AT1受体调控TGF-β1促进胶原合成、抑制胶原分解.氯沙坦在抑制TGF-β1水平方面明显优于卡托普利,合用未优于单用氯沙坦.     

肾炎宁对 IgA 肾病大鼠肾脏局部肾素-血管紧张素系统的影响

目的 探讨肾炎宁对 IgA 肾病大鼠肾脏局部肾素-血管紧张素系统的影响。方法 将 SD 大鼠随机分为4组：对照组、模型组、阳性对照组 (贝那普利+氯沙坦)、肾炎宁组。按各组相应药物剂量 ig 给药,于第15周末行 IgA 免疫荧光检测,并用放射免疫法检测大鼠肾组织 AngⅡ 的量,采用紫外分光光度法测定血管紧张素转换酶 (ACE) 活性,采用原位杂交法测定 AT-1R 的表达。结果 肾炎宁组、阳性对照组与模型组比较 IgA 免疫荧光强度、AngⅡ量、ACE 活性和 AT1R 的表达均显著下降 (P ＜0.05)。结论 肾炎宁可能通过抑制肾脏局部肾素-血管紧张素系统,发挥对 IgA 肾病的治疗作用。     

津力达颗粒对糖尿病大鼠肾及心血管组织肾素-血管紧张素系统的影响

目的 观察津力达颗粒(JLG)对实验性糖尿病大鼠肾脏、心脏和腹主动脉组织肾素-血管紧张素系统(RAS)的影响,探讨JLG保护糖尿病患者肾脏及心血管的可能机制.方法 采用随机数字表法将大鼠分为糖尿病模型组20只和正常对照组(CON组)10只.CON组喂以普通饲料;糖尿病模型组喂以高脂饲料,喂养4周后用30 mg/kg链脲佐菌素(STZ)腹腔注射诱导糖尿病模型.诱导糖尿病模型成功后,再随机分成糖尿病津力达治疗组[DM+JLG组:JLG3g/(kg·d)灌胃]和糖尿病未治疗组(DM组),每组10只.8周后取肾、心脏及腹主动脉,采用ELISA法测定各组织匀浆血管紧张素Ⅰ(Ang Ⅰ)、血管紧张素Ⅱ(AngⅡ)水平,蛋白质印迹分析法检测血管紧张素Ⅱ1型受体(AT1 R)、血管紧张素Ⅱ2型受体(AT2 R)的表达.结果 与CON组相比,DM组大鼠双肾质量/体质量、心脏质量/体质量、血糖、24 h尿蛋白增加(P＜0.05),体质量减少(P＜0.05),肾脏、心室肌和腹主动脉组织AngⅠ、AngⅡ、AT1R、AT2R水平升高(P＜0.05).与DM组相比,DM+JLG组大鼠双肾质量/体质量、血糖、24 h尿蛋白降低(P＜0.05),体质量增加(P＜0.05),肾脏、心室肌和腹主动脉组织Ang Ⅰ、AngⅡ、AT1R、AT2R水平降低(P＜0.05).结论 JLG能降低实验性糖尿病大鼠肾脏、心脏及腹主动脉组织血管紧张素及其受体水平,有利于保护肾脏及心血管系统.     

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.