男性肥胖者高胰岛素血症对血清睾酮水平的影响

检测了男性肥胖患者空腹血清胰岛素与睾酮水平.结果显示,血清睾酮水平明显下降(P<0.05),而空腹血清胰岛素水平明显上升(P<0.01),且男性肥胖者的空腹血清胰岛素浓度与睾酮水平之间呈明显负相关(r=-0.7989.P<0.001),提示男性肥胖者空腹胰岛素血症可能参与性激素代谢的调节。     

IGF-1及SHBG与2型糖尿病视网膜病变的相关关系

目的:探讨血清胰岛素样生长因子-1(IGF-1)及性激素结合球蛋白(SHBG)与2型糖尿病视网膜病变(DR)的相关关系.方法:根据是否存在视网膜病变,将185例2型糖尿病(T2DM)患者分为糖尿病视网膜病变组(DR组,n=87)组和非糖尿病视网膜病变组(NDR组,n=98);另选80名同期口服葡萄糖耐量试验(OGTT)血糖正常者作为正常对照组(NC组).比较三组空腹血清IGF-1及SHBG水平差异,分析二者及其与年龄、体重指数(IBM)、IGF-1、SHBG、空腹血糖(FBG)、OGTT 2h血糖、糖化血红蛋白(HAb1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、空腹C肽、餐后2h C肽(2h C肽)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等指标的相关性.结果:DR组及NDR组空腹血清IGF-1及SHBG水平均低于NC组(均P<0.05),且DR组IGF-1水平低于NDR组,SHBG水平高于NDR组(均P>0.05).相关性分析结果显示,IGF-1与空腹C肽、2 h C肽呈正相关(r=0.327、r=0.207,P<0.05);与年龄、SHBG、OGTT 2 h血糖呈负相关(r=-0.275、r=-0.372、r=-0.184,P<0.05);SHBG与IGF-1、BMI、HbA1c、FBG、空腹C肽、TG呈负相关(r=-0.372、r=-0.437、r=-0.214、r=-0.313、r=-0.419、r=0.291,P<0.05).多元线性回归分析结果显示,IGF-1与SHBG呈负相关(β=-0.321,P=0.017).结论:DR血清IGF-1及SHBG水平降低,且二者及其与他多种因素存在相关性,可能在DR的发生发展中有一定作用.     

老年男性2型糖尿病合并冠心病患者血清睾酮和脂联素水平变化的临床研究

目的 探讨老年男性2型糖尿病合并冠心病患者血清脂联素和睾酮水平的变化及临床意义.方法 2014年11月至2015年9月在青海省人民医院糖尿病科及心内科住院的60岁以上的男性2型糖尿病患者78例,其中单纯2型糖尿病(T2DM组)40例,2型糖尿病合并冠心病(CHD组)38例;对照组为同期常规体检的60岁以上的健康男性44例.检测患者血糖、糖化血红蛋白(HbAlc)、血脂、血清脂联素(APN)、血清睾酮(T)、血清胰岛素水平,按稳态模式评估法计算胰岛素抵抗指数(HOMA-IR),比较3组各指标的差异,分析APN与各指标的相关性.结果 与对照组相比较,T2DM组、CHD组的APN、T水平明显降低,且以CHD组下降最为明显(P＜0.05);FPG、FINS、TG、LDL-L水平及HOMA-IR均明显升高,CHD组升高最为明显(P＜0.05).血清APN分别与TG(r=-0.363)、LDL-C(r=-0.417)、HOMA-IR(r=-0.602)呈负相关,与HDL-C(r=0.485)、T(r=0.624)呈正相关;而血清T分别与LDL-C(r=-0.457)、HOMA-IR(r=-0.643)呈负相关,与HDL-C(r=0.478)呈正相关.结论 APN、T可能参与了2型糖尿病冠状动脉粥样硬化的发生和发展.     

中老年男性性激素与血脂水平的相关性研究

目的探讨我同中老年男性性激素与血脂代谢的相关性。方法收集2013年1月—2014年12月常规体检的40岁以上男性644例,年龄40~82岁。测定其血清性激素水平,包括卵泡刺激素(FSH)、黄体生成索(LH)、雌二醇(E_2)、总睾酮(TT)、性激素结合球蛋白(SHBG)、游离睾酮(FT),以及血脂水平,包括高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固酵(LDL-C)、总胆同醇(TC)以及三酰甘油(TG)。并分析性激素各项指标与血脂指标之间的相关性。结果随着年龄的增加,FSH,LH及SHBG水平逐渐上升(P<0.01),FT逐渐降低(P<0.01)。51~60岁组,61~70岁组TT、HDL-C水平明显高于40~50岁组及>70岁组人群(P<0.01)。TG水平随年龄增加呈大致降低趋势(P<0.01)。相关性分析发现,各项激素与血脂水平呈现普遍的相关性,校正年龄和BMI后,FSH、SHBG与HDL-C仍呈正相关(r=0.08、0.18,P<0.01或P<0.05),LH、SHBG与TC仍呈负相关(r=-0.08、-0.08,P<0.01)。TT、SHBG与TG仍呈显著负相关(r=-0.16、-0.20,P<0.05)。多元线性回归分析发现,FSH、SHBG与HDL-C均呈正相关(β=0.010,P=0.001;β=0.004,P=0.02),LH与HDL-C呈负相关(β=-0.020,P=0.001),TT与TG呈负相关(β=-0.080,P=0.01)。结论在中老年男性中,低浓度的FSH和SHBG,以及高浓度的LH有增加血脂异常(低HDL-C血症)的风险,而低TT也有增加血脂异常(高TG血症)的风险。     

中老年男性2型糖尿病患者性激素结合球蛋白与非酒精性脂肪性肝病的相关性研究

目的探讨血清性激素结合球蛋白(SHBG)与中老年男性2型糖尿病(T2DM)患者合并非酒精性脂肪性肝病(NAFLD)的相关性。方法选取2016年1-12月在新疆维吾尔自治区人民医院内分泌科住院的中老年男性T2DM患者106例,根据是否合并NAFLD分为两组:一组为非NAFLD组共54例,平均年龄(54.19±11.58)岁;另一组为NAFLD组共52例,平均年龄(52.12±9.60)岁。采用化学发光法测定睾酮(TT)、SHBG、空腹血糖(FBG)、餐后2小时血糖(PBG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ谷氨酰胺(γ-GT)水平,采用高效色谱法测定糖化血红蛋白水平(HbA1C),采用放免法测定游离睾酮(FT)水平。正态分布计量资料组间比较采用t检验,非正态分布的计量资料组间比较采用秩和检验,分析中老年男性T2DM患者血清SHBG水平与NAFLD之间的相关性采用偏相关分析。结果两组间SHBG、HDL-C差异有统计学意义(P0.05)。NAFLD组SHBG水平低于非NAFLD组(t=-2.273,P0.05),校正体质指数(BMI)、睾酮因素后,相关性分析显示,T2DM合并NAFLD组患者SHBG与ALT呈负相关(r=-0.376,P0.05)。结论 SHBG水平的降低与中老年T2DM合并NAFLD患者可能存在一定的相关性。     

血清睾酮水平对男性冠心病患者的影响

目的:探讨血清激素水平与男性冠心病冠状动脉病变程度的关系.方法:因胸痛行冠状动脉造影的男性患者109例,根据造影结果分为冠心病组和对照组;冠脉病变程度由病变血管支数表示,以化学发光免疫法测定血清睾酮、雌二醇水平,用酶联免疫吸附法测定总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸、空腹血糖浓度.结果:血清睾酮水平与年龄、体重指数呈负相关关系(t=-3.20,P＜0.05;t= -2.29,P＜0.05);剔除糖尿病病人,校正年龄、体重指数和低密度脂蛋白胆固醇的影响后,冠心病组睾酮水平明显低于对照组(3.98±0.16 μg/L与4.63±0.26 μg/L,F=6.131,P＜0.01),不同病变血管支数间比较睾酮水平差异有统计学意义(F=2.52,P＜0.05),且随病变支数增加,睾酮水平呈下降趋势.结论:冠心病病人血清睾酮水平降低,且随血清睾酮水平逐渐下降,冠脉病变程度逐渐加重.     

1166例成年男性肥胖与血清睾酮水平的关系

目的 探讨社区成年男性肥胖与血清睾酮水平的关系.方法 以社区为单位分层整群抽取遵义市20岁及以上男性居民共1 166例行问卷调查和体格检查,空腹抽取肘静脉血检测血清总睾酮(TT)、性激素结合球蛋白(SHBG)和黄体生成素(LH),计算游离睾酮(cFT)、游离睾酮指数(FTI)和睾酮分泌指数(TSI).结果 1 166例成年男性血清TT、SHBG、eFT、FTI、TSI、LH水平分别为(16.83±4.90) nmol/L、(42.15±20.21) nmol/L、(0.31±0.10) nmol/L、0.46=±0.19、3.40±2.04、(6.77±5.14)IU/L.Pearson相关分析显示腰围身高比(WHtR)、体质量指数(BMI)、腰围(WC)分别与TT、SHBG、TSI和LH呈负相关,与FTI呈正相关;WHtR与cFT呈负相关,BMI和WC与LH呈负相关,差异均有统计学意义(P＜0.05).多元线性回归分析显示WHtR与TT、SHBG、TSI、LH均呈负相关;与FTI呈正相关,差异均有统计学意义(P＜0.01).结论 成年男性向心性肥胖可能与血清TT、SHBG、TSI、LH下降及FTI上升有关.     

性激素与老年男性冠心病患者冠状动脉狭窄程度的关系

目的观察老年男性冠心病患者性激素,包括雌二醇(E2)、睾酮(T)、孕酮(P)及E2/T的水平,探讨性激素与冠状动脉血管狭窄程度的相关性。方法收集接受冠状动脉造影检查并诊断为冠心病的老年男性患者164例,根据冠状动脉狭窄的Gensini评分结果将入选患者分为低分组(n=89)和高分组(n=75),分析性激素水平的变化及与Gensini评分的关系。结果老年男性冠心病患者高分组的E2/T高于低分组(P<0.05),T水平低于低分组水平(P<0.05);T水平的降低、E2/T水平的升高是高冠脉Gensini评分的独立危险因素;在老年男性冠心病患者中,T水平与Gensini评分具有负相关性(r=-0.562),E2/T水平与Gensini评分具有正相关性(r=0.676)。结论老年男性冠心病患者的T和E2/T水平与冠状动脉狭窄具有相关性,两者对病情严重程度具有提示意义。     

血清性激素水平与男性冠心病患者冠状动脉病变的关系

目的:探讨血清性激素水平与男性冠心病患者冠状动脉病变程度的相关性.方法:89例接受冠状动脉造影的男性患者,根据冠脉造影结果分为冠心病组和冠脉正常对照组,依据冠状动脉狭窄程度进行积分,以化学发光免疫法检测血清睾酮(testosterone,T)、雌二醇(estradiol,E2)水平.结果:冠心病组T水平明显低于对照组(3.93±1.31 vs 4.75±1.04 μg/L,t=3.11,P＜0.01),E2和E2/T差异无统计学意义;校正年龄、体重指数和LDL-C的影响后,冠心病组T水平仍明显低于对照组(P＜0.01);T与病变积分呈负相关关系(r=-0.51,P＜0.01);E2和E2/T与病变积分无相关关系.低T水平、高胆固醇血症和老龄是冠心病发病的危险因素.结论:男性冠心病病人血清T水平低,且随T水平降低,病变程度趋于严重;T水平降低可能是男性冠心病发病的危险因素.     

血清睾酮水平与2型糖尿病合并骨质疏松症的相关性研究

目的 探讨血清睾酮水平与2型糖尿病(type 2 diabetes mellitus, T2DM)合并骨质疏松症的相关性.方法 回顾性分析2015年9月至2016年5月于四川大学华西医院住院的T2DM合并骨质疏松症患者53例(DO组)、单纯性骨质疏松症患者60例(OP组)和骨量正常者42例(N组),分析比较3组患者之间的骨密度、血清总睾酮(TT)、性激素结合球蛋白(SHBG)和血清游离睾酮(FT)水平.结果 与N组比较,DO组和OP组患者腰椎(L1-L4)、股骨颈部、W-三角和粗隆的骨密度均降低,差异有统计学意义(P<0.05);血清SHBG水平显著降低,差异有统计学意义(P<0.05);血清总睾酮和游离睾酮水平无明显改变,差异无统计学意义(P>0.05).与OP组比较,DO组患者骨密度、血清TT、SHBG和FT水平比较,差异均无统计学意义(P>0.05).线性回归分析发现,性别与总睾酮(r=-21.339,P<0.001)和游离睾酮(r=-22.8,P<0.001)呈负相关.亚组分析发现,女性DO患者FT水平明显高于女性OP患者,差异有统计学意义(P<0.05);但骨密度比较,差异无统计学意义(P>0.05).男性DO患者Ward-三角及粗隆骨密度明显升高,差异有统计学意义(P<0.05);血清TT水平DO组高于OP组,差异有统计学意义(P<0.05).结论 血清睾酮水平与2型糖尿病合并骨质疏松的关系可能存在性别差异.对于男性可能是保护因素,对于女性则可能是危险因素.     

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.