乳腺癌患者血清中20种氨基酸的检测及在乳腺癌筛查中的意义

目的 考察乳腺癌患者与正常体检者血清中氨基酸水平的差异,并探讨其在乳腺癌筛查中的意义.方法 招募2019年4-6月重庆大学附属肿瘤医院病理科确诊的女性乳腺癌患者59例作为乳腺癌组,以正常女性体检者53例作为对照组.采用高效液相色谱-质谱法(HPLC-MS)检测招募者血清中20种氨基酸水平,分析乳腺癌组与对照组间、乳腺癌不同分子亚型组间、早期乳腺癌组与晚期乳腺癌组间氨基酸水平的差异.采用ROC曲线对差异血清氨基酸在乳腺癌筛查中的效能进行评估.结果 乳腺癌组血清中丙氨酸(Ala)、天冬酰胺(Asn)、瓜氨酸(Cit)、谷氨酸(Glu)、组氨酸(His)、异亮氨酸(Ile)、亮氨酸(Leu)、赖氨酸(Lys)、鸟氨酸(Orn)、苯丙氨酸(Phe)、脯氨酸(Pro)、苏氨酸(Thr)、酪氨酸(Tyr)、缬氨酸(Val)的水平均高于对照组(P均<0.05),精氨酸(Arg)水平低于对照组(P=0.003).ROC曲线分析表明,在乳腺癌患者血清中升高的14种氨基酸中,Ala和Pro单独筛查乳腺癌的效能较高,AUC均为0.75;Ile单独筛查乳腺癌时有最高的灵敏度,达0.82;Lys单独筛查乳腺癌时有最高的特异度,达0.94;这14种氨基酸联合检测时能够提高乳腺癌的筛查效能,AUC为0.88,灵敏度为0.69,特异度为0.94.早期乳腺癌(TNM分期Ⅰ期和Ⅱ期)患者血清Val水平高于晚期(TNM分期Ⅲ期和Ⅳ期)患者(P=0.044),其他19种氨基酸水平在早期和晚期乳腺癌患者之间差异均无统计学意义(P均>0.05).20种血清氨基酸水平在Luminal A型、Luminal B型、三阴性型、人表皮生长因子受体2(HER2)阳性型乳腺癌组间差异均无统计学意义(P均>0.05).结论 乳腺癌患者血清中15种氨基酸水平与正常体检者相比存在差异,有助于乳腺癌筛查;14种在乳腺癌患者血清中升高的氨基酸的联合检测有利于提高乳腺癌筛查效能,是有潜力的生物学标志物.     

血清缬氨酸、甲硫氨酸浓度水平与乳腺癌临床特征及风险的相关性

  目的  比较健康人群、乳腺良性肿瘤患者和乳腺癌患者的血清Val、Met浓度差异,探究血清缬氨酸和甲硫氨酸与乳腺癌临床特征及风险的关系。  方法  采用液相色谱-串联质谱法测定38名乳腺良性肿瘤患者,87名乳腺癌患者的血清Val、Met浓度,同时选择91名健康人群作为对照组。经Kruskal-Wallis H检验比较不同分组间的血清Val、Met浓度差异,分析不同化疗方案及手术方式对乳腺癌患者血清Val、Met浓度的影响。再通过二元Logistic回归分析、计算优势比和95%置信区间（CI）来评估血清Val、Met与乳腺癌的风险关系并绘制ROC曲线评估血清Val及Met对乳腺癌的诊断效能。  结果  与健康对照组相比,乳腺癌（BC）组的血清Val浓度水平高于乳腺良性肿瘤（BE）组和健康对照组,BC组和BE组的Met水平都高于健康对照组,差异有统计学意义（P < 0.05）。不同TNM分期及接受不同化疗方案的乳腺癌患者血清Val、Met浓度,差异无统计学意义（P > 0.05）,但不同分子分型组间乳腺癌患者的血清Val浓度,差异有统计学意义（P < 0.05）。另外,血清Val浓度水平和乳腺癌风险无明显关系,但血清Met会显著影响乳腺癌的发生（P < 0.001）,血清Met的浓度越高,乳腺癌的患病风险就越高,并且Met的浓度水平每增加一个单位,乳腺癌患病风险就增加24%（OR = 1.24 95% CI:1.15～1.34）。并且血清Met（P < 0.001）对乳腺癌的诊断具有统计学意义。其AUC为0.83、敏感度及特异性分别为69%和90.1%,临界值为19.76 μmol/L。  结论  乳腺癌患者的血清Val浓度高于乳腺良性肿瘤患者及健康人群;与健康人群相比,乳腺癌患者及乳腺良性肿瘤患者的血清Met浓度水平也有所升高。血清Val浓度水平和乳腺癌风险无明显关系,但血清Met与乳腺癌风险呈负相关,并且血清Met对乳腺癌诊断具有一定的诊断效能。     

哮喘患者IL-4R基因多态性与sIL-4R、TIgE水平相关性研究

目的：探讨白细胞介素4受体（IL-4R）Ile50 Val多态性与哮喘患者血浆可溶性白细胞介素4受体（sIL-4R）、血浆IgE（IgE）水平及其相关性.方法：用等位基因特异性聚合酶链反应（Allele-speccifc PCR）检测哮喘与对照组位点多态性,用酶联免疫分析法（ELSIA）测定哮喘与对照组血浆IgE、可溶性白细胞介素4受体（sIL-4R）水平.结果：IL-4Rα链Ile50Val位点等位基因在哮喘组及对照组间分布的差异有显著性（P＜0.01）,等位基因Ile携带者其哮喘患病危险性较非携带者高2.64倍（P＜0.01）,三种基因型的分布在两组间的分布有显著性差异（P＜0.01）.在同一组内,Ile/Ile基因型血浆IgE水平高于Ile/Val及Val/Val基因型（P均＜0.01）,对血浆sIL-4R的影响相反.Ile/Val基因型血浆IgE、sIL-4R水平与Val/Val基因型之间无显著差异（P＞0.05）.结论：IL-4Rα链Ile50Val基因多态性是影响哮喘的重要候选基因.     

不同甲状腺功能患者血清氨基酸水平的临床研究

目的: 了解不同甲状腺功能患者血清氨基酸水平，探讨其与甲状腺功能的相关性。 方法: 收集25例甲状腺功能减退(甲减) 患者，35例甲状腺功能亢进(甲亢) 患者及48例正常体检人群的血清，用氨基酸分析仪测定血清氨基酸水平，用放射免疫法对血清T3、T4进行同步检测，进行对比分析。结果　甲亢组与正常对照组比较Glu、Val、Leu、Tyr、Phe、His浓度升高，差异有统计学意义（P < 0. 05）；甲减组与正常对照组比较Met 、Ile、Tyr浓度降低，Val浓度升高，差异有显著性( P < 0. 05；)；甲亢组患者血清Cys 与T3 呈负相关（P < 0. 05），Tyr、Phe 与T4呈正相关（P < 0. 05），Arg与T3呈负相关（P < 0. 05），Orn与T4呈负相关（P < 0. 05）。结论: 甲亢甲减患者均存在氨基酸代谢异常，联合检测血清氨基酸和T3、T4对于判断患者甲亢甲减患者病情及早期诊断甲状腺损伤的部位和程度具有一定的临床意义。     

XPC基因Lys939Gln和Ala499Val多态性与乳腺癌易感性的关联研究

目的:探讨着色性干皮病基因组C(xeroderma pigmentosum group C,XPC)的2个常见单核苷酸多态性(single nucleotide polymorphism,SNP)Lys939Gln和Ala499Val与乳腺癌发病风险的相关性.方法:采取以自然人群为基础的病例对照研究设计,按相同居住地与年龄(±5岁)进行1:1匹配,最终纳入分析的有173例乳腺癌患者和171例健康对照者.XPC Lys939Gln和Ala499Val多态性位点的基因分型采用聚合酶链反应-限制性内切酶片段长度多态性(polymerase chain reactionrestriction fragment length polymorphism,PCR-RFLP)分析方法.非条件Logistic回归模型被用以估计各SNP基因型与乳腺癌发病风险间的关联,单体型分析则采用R软件的Haplo.Stats程序包进行,而基因-环境联合作用则由叉生分析完成.结果:病例组和对照组月经初潮年龄分布差异有统计学意义(P=0.039).多因素Logistic回归模型提示已绝经妇女乳腺癌的发病风险较未绝经妇女高(OR=2.76,95%CI=1.32-5.80).但调整年龄、月经初湖年龄和绝经状态等变量后,却未能发现XPC的各个SNP基因型及单体型与乳腺癌发病风险问存在统计学意义的关联.叉生分析结果显示,Lys939Gln多态性与绝经状态之间存在有统计学意义的交互作用(P=0.032).结论:XPC基因Lys939Gln、Ala499Val多态性位点及其单体型与乳腺癌的发病风险间未发现显著性关联,而XPC Lys939Gln多态行位点与绝经状态可能存在交互作用.     

MnSOD基因Val-16Ala多态性与前列腺癌易感性关系的Meta分析

目的 评价锰超氧化物歧化酶(MnSOD)基因Val-16Ala多态性与前列腺癌易感性的关系.方法 计算机检索PubMed、中国生物医学文献数据库、中国知网和万方数据库,按照纳入与排除标准选择相关的病例对照实验,检索时限均为建库至2016年1月1日.在提取资料和评价质量后,采用Stata 12.0软件进行Meta分析.结果 共纳入13项病例-对照研究,其中病例组4377例,对照组7123例.Meta分析结果显示,MnSOD基因Val-16Ala多态性与前列腺癌易感性相关,Val/Ala+ Ala/Ala vs Val/Val OR=1.101,95％CI:1.007 ～1.203,P =0.035.根据种族类型的亚组分析,该基因多态性与高加索人种前列腺癌易感性显著相关,Ala vs Val OR=1.067,95％ CI:1.004～1.135,P =0.038;Ala/Val+ Ala/Ala vs Val/Val OR=1.118,95％ CI:1.011 ～1.236,P=0.029;Ala/Ala vs Val/Val OR=1.142,95％CI:1.009 ～1.291,P=0.035.结论 MnSOD基因Val-16Ala多态性与前列腺癌易感性相关,可作为该肿瘤诊断、筛查标记物.     

外周血红细胞分布宽度、血清同型半胱氨酸和糖类抗原15-3水平单独或联合诊断乳腺癌的价值

目的 探讨外周血红细胞分布宽度(RDW)、血清同型半胱氨酸(Hcy)和糖类抗原15-3(CA15-3)水平单独及联合诊断乳腺癌的价值。方法 纳入90例乳腺癌患者(乳腺癌组)、88例乳腺良性肿瘤患者(乳腺瘤组)、80例健康体检者(健康对照组)。比较3组外周血RDW、血清Hcy、血清CA15-3水平，并分析三者与乳腺疾病类型的相关性。采用受试者工作特征(ROC)曲线评估外周血RDW、血清Hcy、血清CA15-3水平单独及联合诊断乳腺癌的效能。结果 乳腺癌组、乳腺瘤组和健康对照组的血清Hcy、外周血RDW和血清CA15-3水平依次降低(均P<0.05)。血清Hcy、外周血RDW和血清CA15-3水平与乳腺疾病类型均呈正相关(均P<0.05),即血清Hcy、外周血RDW和血清CA15-3水平越高，患者患乳腺癌的可能性越大。血清Hcy、外周血RDW和血清CA15-3单独诊断乳腺癌的曲线下面积(AUC)分别为0.746、0.762、0.797,三者差异均无统计学意义(均P>0.05);血清Hcy、外周血RDW和血清CA15-3联合诊断乳腺癌的AUC为0.867,大于任意一指标单独...     

细胞色素P450 1A1基因多态性与宫颈癌的相关性

 目的 探讨细胞色素P450 1A1(cytochrome P4501A1,CYP 1A1)基因MspⅠ酶切位点多态性及Ile/Val多态性与宫颈癌遗传易感性的关系。方法 采用聚合酶链式反应限制性片段长度多态性分析(PCR restriction fragment length plogymorphism,PCR RFLP)和等位基因特异性PCR(allele specific PCR,as PCR)检测宫颈癌患者(病例组,n=176)和同期体检女性健康人群(对照组,n=112)CYP 1A1基因MspⅠ酶切位点多态性和Ile/Val多态性。结果 比较病例组和对照组CYP 1A1基因MspⅠ酶切位点基因型及等位基因T和C频率分布,差异无统计学意义(P=0.09);比较两组间CYP 1A1 Ile/Val多态性发现,病例组3种基因型Ile/Ile、Ile/Val、Val/Val频率分布分别为19.3%、68.8%、11.9%,等位基因Ile、Val频率分布分别为53.7%、46.3%,与对照组比较差异有统计学意义(P=0.04)。结论 细胞色素CYP 1A1基因MspⅠ位点多态性与宫颈癌发病易感性无关联性,CYP 1A1基因Ile/Val多态性与宫颈癌发病易感性有关联性。     

乳腺癌患者血清GH和IGF-I水平及其临床意义

目的：探讨生长激素（GH）、胰岛素样生长因子-I（IGF-I）在乳腺癌患者血清中的表达情况及其临床意义。方法：采用酶联免疫吸附试验（ELISA）检测乳腺癌组、乳腺良性病变组、对照组的血清GH、IGF-I水平。结果：①乳腺癌组、乳腺良性病变组和对照组血清GH、IGF-I表达差异无统计学意义（P〉0.05）;②血清IGF-I表达乳腺癌组绝经前高于绝经后（P=0.005）;③GH表达与肿块大小和雌激素受体（ER）表达有关（P=0.002,P=0.006）,IGF-I表达和肿块大小有关（P=0.010）。④IGF-I表达与肿块〉2cm呈负相关（r=-0.393,P=0.022）,血清GH、IGF-I表达与乳腺癌年龄和ER表达无相关关系（P〉0.05）。结论：血清GH、IGF-I的表达可能与乳腺癌增殖和进展有关。     

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.