类风湿关节炎患者脂肪因子水平及其与DAS28的相关性

目的 了解类风湿关节炎(rheumatoid arthritis，RA)患者脂肪因子水平，并探讨其与DAS28的相关性。 方法 选取2017年3-8月金华市中心医院治疗的RA患者126例为观察组，选取同期接受健康体检者100名为对照组，比较2组研究对象血清内脂素、脂联蛋白、抵抗素水平。根据患者疾病活动度将126例RA患者分为高度活动组47例，中低度活动组79例，采用酶联免疫吸附法(ELISA)测定所有研究对象血清标本中内脂素、脂联蛋白、抵抗素水平，采用Pearson相关性分析法分析患者血清内脂素、脂联蛋白、抵抗素水平与DAS28的相关性。 结果 观察组血清内脂素(6.68±1.25)ng/L、脂联蛋白(11.36±3.29)μg/mL、抵抗素(13.78±4.21)ng/mL，对照组血清内脂素(4.13±1.16)ng/L、脂联蛋白(6.57±1.38)μg/mL、抵抗素(6.85±2.34)ng/mL，观察组患者血清内脂素、脂联蛋白、抵抗素水平明显高于对照组(P<0.05)；高度活动组内脂素(4.81±1.95)ng/L、脂联蛋白(22.64±8.96)μg/mL、抵抗素(15.72±7.97)ng/mL，中低度活动组内脂素(4.05±1.66)ng/L、脂联蛋白(19.35±9.62)μg/mL、抵抗素(13.28±5.96)ng/mL，高度活动组患者血清内脂素水平明显高于中低度活动组(P<0.05)，2组患者血清脂联蛋白、抵抗素水平比较差异无统计学意义(P>0.05)。Pearson相关性分析显示，血清内脂素、脂联蛋白、抵抗素水平与患者DAS28评分均呈正相关(P<0.05)。 结论 RA患者血清中脂肪因子水平显著升高，且在疾病活动度较高的患者中水平更高，与DAS28评分呈正相关，提示脂肪因子可能参与了RA的炎症免疫反应，可作为RA患者疾病活动程度的判断指标之一。      

高尿酸血症患者血清炎症介质水平与胰岛素抵抗

目的探讨高尿酸血症患者血清炎症介质超灵敏C反应蛋白(hs-CRP)水平与机体胰岛素敏感性、胰岛素分泌功能的关系。方法运用高灵敏酶联免疫吸附法检测41例高尿酸血症患者和20名健康对照者的血清hs-CRP水平,同时检测血糖和血清胰岛素水平,并计算稳态模型胰岛素抵抗指数(HOMA IR)和胰岛B细胞分泌指数(HOMA IS)以反映胰岛素敏感性和胰岛细胞功能。结果高尿酸血症患者的血清hs-CRP水平(2.18±0.95 mg/L vs 0.89±0.45mg/L,P<0.01)和HOMA IR指数(1.61±0.18 vs 0.92±0.09,P<0.01)显著高于正常对照组,HOMA IS指数低于正常对照组(85.1±14.9 vs 127.6±9.8,P<0.01)。进一步将患者分为合并痛风组和无症状高尿酸血症组后发现,痛风组的血清hs-CRP水平显著高于无症状高尿酸血症组(2.82±1.09 mg/L vs 1.77±0.87 mg/L,P<0.01)。线性相关分析显示,高尿酸血症患者的血清hs-CRP水平与体重指数(BMI)(r=0.44,P<0.01)、血尿酸(r=0.49,P<0.01)2、4 h尿尿酸(r=0.37,P<0.01)和HOMA IR指数(r=0.48,P<0.01)呈显著正相关。结论高尿酸血症患者血清hs-CRP水平高于正常人,并与其胰岛素抵抗的发生、发展有密切的关系。     

子痫前期患者血浆脂联素水平的变化

目的 了解血浆脂联素浓度与子痫前期的关系.方法 采用酶联免疫吸附法(ELISA)对46例正常妊娠、19例子痫前期及15例健康对照者的血浆脂联素浓度进行检测.结论 健康对照组妇女血浆脂联素浓度[(34.48±2.61) ng/mL]与正常妊娠早期[(34.45±3.02) ng/mL]及中期[(34.76±2.97) ng/mL]比较,差异无统计学意义(P＞0.05);正常妊娠晚期妇女血浆脂联素浓度[(38.10±1.01) ng/mL]高于健康对照组(P＜0.001)、妊娠早期(P＜0.001)及中期(P＜0.05),且与孕前体重指数(BMI)呈负相关(r=-0.65, P＜0.001).子痫前期患者血浆脂联素浓度[(33.40±1.88) ng/mL]低于正常妊娠晚期(P＜0.001),与孕前BMI无相关性.结论 正常晚期妊娠血浆脂联素浓度升高,而子痫前期患者血浆脂联素浓度降低,提示脂联素可能参与了子痫前期的发病机制.     

瘦素、脂联素与子痫前期-子痫关系的研究

目的：探讨子痫前期（PE）患者血清瘦素、脂联素水平的变化及其意义。方法：选择38例子痫前期孕妇作为研究组,其中子痈前期轻度患者16例（B组）,子痫前期重度患者22例（C组）;选择同期分娩的正常孕妇40例作为对照组（A组）。采用放免法检测血清瘦素水平,采用ELISA法检测血清脂联素水平。同时检测患者尿蛋白、肾功能（BUN、Cr）水平。结果：（1）PE重度组患者血清瘦素水平（29．45±7．93）ng／ml,最高;PE轻度组患者血清瘦素水平（16．64±5．29）ng／ml,居中;对照组血清瘦素水平（10．51±3．16）ng／ml,最低,三者两两相比,差异有统计学意义（P〈0,05）。PE重度组患者血清脂联素水平（1．06±0．35）mg／L,最低;PE轾度组患者血清脂联素水平（2．33±1．46）mg／L,居中;对照组脂联素水平（4．21±0．96）mg／L,最高,三者两两相比,差异有统计学意义（P〈0．05）。（2）子痫前期患者血清瘦素和脂联素呈高度负相关（r=0．825,P〈O．01）。结论：瘦素、脂联素在PE的发病过程中可能起一定的作用,高瘦素血症和低脂联素血症可能与PE的发生、发展有关。     

血脂联素和肿瘤坏死因子-α与原发性高血压的关系

目的检测原发性高血压（essential hypertension,EH）患者血浆中脂联素（adiponeetin）和肿瘤坏死因子－α（TNF－α）,探讨脂联素和TNF—α与EH的关系。方法67例新发现且未经过治疗的轻、中度EH患者和42例正常人,记录年龄、性别,检测体重指数（BMI）、空腹血糖（FPG）、血脂谱及血压,用放射免疫分析法测定空腹胰岛素（FINS）、血浆脂联素及TNF—α水平。结果①EH组血浆脂联素水平为（17．05±3．08）ng／ml,对照组为（23．05±3．08）ng／ml,EH组较对照组显著降低（P〈0．01）。②EH组血浆TNF—α水平为（26．55±2．55）fmol／ml,显著低于对照组（24．62±2．70）fmol／ml（P〈0．01）。③Pearson相关分析表明,EH组血浆脂联素水平与TNF—α、年龄、PP及SBP呈显著负相关（P〈0．05）。结论低脂联素血症、炎症因子共同作用,可能部分参与了EH的发病过程。     

福辛普利保护高尿酸血症性肾病大鼠的疗效分析

目的：分析研究福辛普利对高尿酸血症性肾病大鼠血浆血管紧张素Ⅱ(AngⅡ）和醛固酮(ALD）水平的表达及肾间质纤维化的影响,从而探讨其在高尿酸血症性肾病大鼠中的保护作用。方法2014年6月一2015年6月间在厦门大学医学院动物实验中心选取清洁型SD大鼠80只,随机分为造模组60只,对照组20只;高尿酸血症性肾病大鼠模型的建立采用腺嘌呤＋盐酸乙胺丁醇灌胃法,造模成功后将造模组动物随机分为模型组28只、福辛普利干预组28只。于实验第45﹑60天分别检测3组大鼠血浆AngII、ALD的表达,免疫组化法测定肾脏组织a-平滑肌肌动蛋白(a-SMA）的表达。结果①实验第60天福辛普利干预组治疗后血浆AngⅡ(68.75±20.56）pg/mL、ALD(246.56±59.69） pg/mL与同期模型组(86.56±23.30)pg/mL、(346.64±86.78) pg/mL比较有下降(P<0.05);②福辛普利干预组治疗后实验第45 d、60 d肾组织中a-SMA的浓度(0.27±0.16)、(0.33±0.56)与模型组(0.52±0.12）、(0.63±0.42）比较均有明显下降(P<0.05)。结论福辛普利可能通过下调高尿酸血症性肾病大鼠模型血浆AngⅡ、ALD水平的表达,抑制肾脏炎症及肾素-血管紧张素系统活化,从而防治高尿酸血症性肾间质纤维化。     

哮喘患者脂联素水平的变化及意义

目的 测定哮喘急性发作期和哮喘缓解期患者脂联素水平,探讨脂联素在哮喘发病机制中的作用.方法 收集2010年10月至2011年9月期间在上海市闵行区中心医院就诊的哮喘患者97例,其中急性发作期50例,缓解期47例,另选同期非吸烟健康体检者27例作为对照.用ELISA法检测血清脂联素与肿瘤坏死因子α(TNF-α)水平,同时测定肺功能(FEV1％pred、RV％ pred),分析脂联素水平和TNF-α、肺功能之间的相关性.应用SPSS 19.0软件进行统计学分析,多组数据间比较采用单因素方差分析,采用Pearson相关分析进行相关性检验.结果 哮喘急性发作期组血清脂联素浓度[(2.46±1.21) ng/mL]低于缓解期组[(3.79±0.96) ng/mL]和健康对照组[(9.64±4.88) ng/mL](P均＜0.01),哮喘缓解期组血浆脂联素浓度低于健康对照组(P＜0.01).哮喘急性发作期组及缓解期组血清脂联素与TNF-α、RV％ pred呈负相关(P＜0.01),与FEV1％ pred呈正相关(P＜0.01).结论 哮喘患者血清脂联素水平降低,脂联素在哮喘中可能起保护作用.     

血清瘦素及脂联素水平对子宫内膜癌的临床价值探讨

目的 探讨血清中瘦素浓度及脂联素浓度与子宫内膜癌的关系以及联合检测两者对子宫内膜癌诊断的价值。 方法 利用ELISA（酶联免疫吸附法）测定41例正常健康妇女（对照组）、40例子宫内膜良性病变患者（良性组）及38例子宫内膜癌患者（恶性组）血清瘦素及脂联素的含量。 结果 恶性组在治疗前血清瘦素含量（8.40±2.88 ng/mL）显著高于良性组（4.97±1.90 ng/mL）、对照组（4.78±2.12 ng/mL）（P<0.01）。恶性组治疗前血清脂联素含量（2.50±1.76 μg/mL）显著低于良性组（5.12±2.20 μg/mL）、对照组（5.18±2.19 μg/mL）（P<0.01）。患者的血清瘦素与脂联素比值检测敏感度及特异度优于单一检测瘦素或脂联素时的敏感度及特异度。血清瘦素、脂联素浓度水平与子宫内膜癌患者的临床手术分期、病理分化程度有关（P<0.05）。血清中出现瘦素水平升高及血清脂联素水平降低是子宫内膜癌发病的独立危险因素。 结论 子宫内膜癌患者血清中出现瘦素水平升高的同时伴有脂联素水平的降低。血清中出现瘦素水平的升高及脂联素水平的降低为子宫内膜癌患病的独立危险因素。联合测定血清脂联素及瘦素可为子宫内膜癌的诊断提供相应的参考价值。     

新疆维吾尔族高尿酸血症患者内脂素水平的变化及其影响因素的分析

目的 探讨维吾尔族高尿酸血症患者血清内脂素水平的变化以及与体质量、血糖、血脂、等因素的关系.方法 选择219例维吾尔族高尿酸血症患者作为病例组,208例雏吾尔族健康人为对照组,以标准方法和全自动生化仪测得体格检查指标和生化指标,采用酶链免疫吸附试验(ELISA)测定空腹血清内脂素.结果 病例组空腹血清内脂素水平明显高于对照组[(43.65±33.49)ng/mL vs(33.62±22.08)ng/mL,P＜0.01].血清内脂素水平与尿酸及三酰甘油呈显著正相关(r=0.144、0.195,P＜0.01),多元线性逐步回归分析显示,三酰甘油与尿酸为独立相关因素.结论 高尿酸病例组血清内脂素水平升高,提示其可能参与高尿酸血症的发生发展过程.     

单纯性肥胖患者血清瘦素、抵抗素和脂联素水平的研究

目的：探讨单纯性肥胖患者血清瘦素、抵抗素和脂联素水平的变化及意义。方法：分别测定单纯性肥胖组患者和正常对照者的体质指数（BMI）、腰围（WC）、臀围、空腹胰岛素（FINS）、空腹血糖（FBG）、血脂、瘦素、抵抗素和脂联素的水平，计算胰岛素抵抗指数（HOMA-IR）。结果：①与正常对照组相比，单纯性肥胖组脂联素水平明显降低，瘦素及抵抗素水平明显升高（P〈0．01）。②瘦素和抵抗素均与BMI、WC、FINS和HOMA-IR呈正相关，与脂联素呈负相关；脂联素则仅与高密度脂蛋白呈正相关，与BMI、WC、FBG、FINS、HOMA-IR、三酰甘油、低密度脂蛋白呈负相关；瘦素与抵抗素呈正相关，而脂联素与瘦素及抵抗素呈负相关。③脂联素和抵抗素能较好地预测BMI和WC。结论：脂联素降低、瘦素和抵抗素升高易导致中心性肥胖和胰岛素抵抗。脂联素、抵抗素水平可能是肥胖发生的预测指标。     

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.