2型糖尿病肾病患者同型半胱氨酸和叶酸及维生素B（12）水平变化

目的探讨同型半胱氨酸（HCY）和叶酸（FA）及维生素B12（VB12）在2型糖尿病肾病（T2DN）中的变化。方法根据24小时尿白蛋白排泄率（urinary albumin excretion rate,UAER）将122例2型糖尿病（T2DM）患者分为单纯糖尿病（SDM）组、早期糖尿病肾病（EDN）组和临床糖尿病肾病（CDN）组,50例体检健康者作为健康对照组分别检测同型半胱氨酸和叶酸及维生素B12水平。结果与健康对照组比较,T2DM3组患者HCY水平升高（P〈0.05）而叶酸和维生素维生素B12水平降低（P〈0.05）,HCY与FA和VB12均呈负相关,r分别为-0.61和-0.43（P〈0.01）。结论2型糖尿病肾病患者血清HCY水平随着UAER的增加而升高,FA和VB12水平随着UAER的增加而下降,这些指标可能与T2DN的病情进展有关。     

青年缺血性卒中病人病因及危险因素的临床分析

目的：探讨青年性卒中发生的病因及危险因素。方法：对45例45岁以下青年性卒中病人进行个人史、家族史、颈部血管彩超、血糖、血脂水平及HCY、FA、VitB12水平的测定进行分析,并与健康对照组、老年脑梗塞组比较分析。结果：青年缺血性卒中病人患高血压、糖尿病等危险因素的发病率高于正常对照组,血清HCY高于正常对照组,血清叶酸及血清维生素B12水平低于青年对照组。结论：青年性卒中的发病病因多样且复杂,但仍以高血压动脉硬化为主,血清HCY含量高于正常,也是青年缺血性脑血管病的危险因素。     

老年高血压患者血浆同型半胱氨酸测定及其临床意义

目的探讨血浆同型半胱氨酸(HCY)测定在老年高血压及高血压合并2型糖尿病、高血压伴缺血性脑卒中患者中的临床意义.方法将90例老年高血压患者根据病史及体检分为单纯高血压组(30例),高血压伴缺血性脑卒中组(30例),高血压合并2型糖尿病组(30例);30名正常健康者作为对照组,4组患者进行血压、血脂、血糖、血浆HCY检测.结果单纯高血压组患者、高血压合并糖尿病组患者,高血压伴缺血性脑卒中组患者与对照组血浆HCY比较,差异有显著性意义(F=47.24,P＜0.01);高血压合并糖尿病组患者与单纯高血压组血浆HCY比较差异有显著性(t=2.72,P＜0.05);高血压伴缺血性脑卒中组患者与单纯高血压组患者血浆HCY比较差别有非常显著差异意义(t=4.08 P＜0.01);而高血压合并糖尿病组患者与高血压伴缺血性脑卒中组血浆HCY比较差异无显著差异意义(t=1.34,P＞0.05),同时各组血压、血糖、血脂比较差异均无显著性意义(均P＞0.05).结论血浆HCY水平在老年高血压人群,尤其在高血压合并2型糖尿病、高血压伴缺血性脑卒中患者中明显升高,HCY的升高可能参与高血压的发生及造成血管病变,HCY是心脑血管疾病的独立危险因子.     

老年2型糖尿病患者轻度认知功能障碍的危险因素分析

目的：探讨老年2型糖尿病（T2DM ）患者轻度认知功能障碍（MCI）的危险因素。方法以蒙特利尔认知评估量表（MoCA）和临床痴呆分级量表（CDR）作为认知功能的测评工具,筛选老年T2DM合并MCI患者200例（MCI组）,和2型糖尿病无MCI患者60例（对照组）。收集2组患者的病史,检测血压、体质指数（BMI）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、血脂、血肌酐、同型半胱氨酸（HCY）、叶酸、维生素B12。结果 MCI组和对照组患者的年龄、受教育程度、糖尿病病程、HbA1c、高血压病史、高血压病程、收缩压、HCY、叶酸、维生素B12水平比较,差异有统计学意义;而两组患者的性别构成、BMI、舒张压、FPG、血脂、血肌酐水平比较,差异均无统计学意义。相关分析发现受教育程度、叶酸水平与MoCA量表评分呈正相关;年龄、HbA1c、高血压病史,高血压病程、收缩压、HCY水平与MoCA量表评分呈负相关。多元逐步回归分析发现,年龄、HbA1c、高血压病史、HCY水平是MoCA量表评分的独立危险因素。结论高龄、血糖控制不佳、合并高血压、高HCY血症可能是老年T2DM患者发生MCI的危险因素。     

西宁地区87例急性心肌梗死患者血清同型半胱氨酸水平及叶酸、维生素B12水平的研究

目的:研究西宁地区急性心肌梗死患者血HCY水平及与叶酸、维生素B₁₂的相关性。方法:急性心梗患者分为常规治疗组和干预组。常规治疗组给予常规治疗,分别在治疗前和治疗2周进行血清HCY、叶酸和维生素B₁₂水平检测及对比;干预组在常规治疗基础上给予维生素B₁₂、叶酸口服,分别在治疗前和治疗后2周进行血清HCY、叶酸和维生素B₁₂水平检测及对比;同期选择健康体检者作为对照组,进行血清HCY、叶酸和维生素B₁₂水平检测及对比。结果:急性心梗组人群HCY水平明显高于对照组人群HCY水平,有显著性差异（P<0.01）;急性心梗组人群叶酸、维生素B₁₂水平明显低于对照组人群叶酸、维生素B₁₂水平,有显著性差异（P<0.01）;急性心梗组中干预组服药前后HCY水平有显著性降低（P<0.01）,血清叶酸、维生素B₁₂水平均有显著性增加（P<0.01）;常规治疗组治疗前后HCY水平也有降低;血清叶酸、维生素B₁₂水平也有增加,但均较干预组不明显。结论:通过合理补充叶酸与B族维生素,可降低HCY水平,对心血管疾病患者的早期预防与治疗及延缓并发症的发生有重要的临床意义,从而也降低心血管疾病的发生率和病死率。     

同型半胱氨酸与糖尿病微血管病变的相关性及药物干预后的变化

目的探讨同型半胱氨酸与糖尿病微血管病变的相关性及药物干预后的变化。方法2型糖尿病患者200例,根据患者微 血管并发症情况分为无微血管病变组和合并微血管病变组,所有患者治疗前及治疗6个月后进行血脂、血糖、肾功能及血清同 型半胱氨酸测定。另外按年龄和性别匹配的原则选择同期进行体检的健康受试者100例作为正常对照组。结果（1）无血管病 变组和合并微血管病变组患者常规测量收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、血脂测定包括总胆固醇（TC）、低密度脂 蛋白（LDL）、血糖测定包括空腹血糖（FBG）、餐后2 h 血糖（2 h PBG）、糖化血红蛋白（HbA1）、肾功能测定包括血清尿素氮 （SUN）、血清肌酐（Scr）和血浆同型半胱氨酸（HCY）水平均显著高于正常对照组（P<0.01）,HDL水平显著低于正常对照组（P< 0.01）;（2）合并微血管病变组患者的SBP、DBP、SUN、SCr和HCY水平显著高于无血管病变组（P<0.01）;（3）多因素logistic回归 分析显示舒张压、尿素氮、血清肌酐和同型半胱氨酸水平是糖尿病患者发生微血管并发症的危险因素;（4）治疗后无微血管病变 组和合并微血管病变组组患者HCY水平均较治疗前显著降低（P<0.01）。结论高同型半胱氨酸水平是糖尿病微血管病变的高 危因素,经治疗后可降低患者同型半胱氨酸水平。     

高同型半胱氨酸血症与血脂异常及肾素-血管紧张素系统的关系

目的 探讨高同型半胱氨酸(HCY)血症与血脂异常、肾素-血管紧张素系统的关系.方法 选取236例内科住院患者,检测血清HCY水平;再根据HCY升高的发病情况分为高HCY组和正常HCY组.比较两组血脂、空腹血糖、尿酸(UA)及肾素-血管紧张素系统(RAS)指标(血管紧张素Ⅱ、肾素、醛固酮)的差异,并分析两组高血压、糖尿病及心电图异常的发病情况.结果 在所有检测对象中,HCY升高发病率29.2%.高HCY组体重显著高于正常HCY组(P<0.05),三酰甘油、UA水平显著高于正常HCY组(P<0.01,P<0.001),而高密度脂蛋白胆固醇显著低于正常HCY组(P<0.05);肾素活性、血管紧张素Ⅱ、醛固酮水平在高HCY组呈现下降趋势,但仅血管紧张素Ⅱ差异有统计学意义(P<0.01).血脂异常、高UA更多见于高HCY组(P<0.01);高HCY组高血压病发病率显著高于正常HCY组(P<0.05).经维生素B6、叶酸治疗后,高HCY血症患者HCY水平明显降低(P<0.05),但血脂水平治疗前后差异无统计学意义(P>0.05).结论 高HCY血症患者高血压病发病率增高,常合并血脂异常、高UA,高HCY血症与RAS存在一定关联.维生素B6、叶酸能够降低血HCY水平.     

高同型半胱氨酸血症与缺血性脑血管病相关性

目的探讨血浆同型半胱氨酸（Hcy）水平与缺血性脑血管病的关系,并观察叶酸、维生素B6、维生素B12对Hcv的影响.方法对缺血性脑血管病患者123例（其中包括短暂性脑缺血发作47例,脑梗死76例）和正常对照组34例,采用高效液相色谱法测定空腹血浆Hcy浓度,并对高Hcy的58例患者进行叶酸、维生素B6、维生素B12治疗,2周后和6周后复查血浆Hcv浓度. 结果①脑梗死及TIA组血浆Hcy浓度显著高于正常对照组（P＜0.05）;脑梗死组血浆Hcv浓度显著高于TIA组（P＜0.01）.②缺血性脑血管病患者血脂水平与Hcy水平无明显相关.③缺血性脑血管病患者血浆Hcy水平和血压呈正相关（r=0.44,P＜0.05）.④用叶酸、维生素B6、维生素B12治疗,6周后血浆Hcy水平有明显下降. 结论高同型半胱氨酸血症是缺血性脑血管病的独立危险因素,遗传和维生素B6、维生素B12、叶酸缺乏可能是其增高的重要因素.     

MTHFRC677T基因多态性与缺血性脑卒中合并2型糖尿病的相关性研究

目的分析急性缺血性脑卒中（AIS）合并2型糖尿病患者的5,10－亚甲基四氢叶酸还原酶（MTHFRC677T）基因分布特点及血浆同型半胱氨酸（Hcy）水平,探讨两者与缺血性脑卒中合并2型糖尿病的关系。方法选择2015年6月至2017年5月收治的100例急性缺血性脑卒中合并2型糖尿病的患者（AIS+DM组）,100例急性缺血性脑卒中不合并2型糖尿病的患者（AIS组）,100例健康体检者（对照组）。对AIS+DM组及AIS组患者进行类肝素药物治疗急性缺血性脑卒中试验（TOAST）分型。应用聚合酶链反应－限制性内切酶长度多态性方法（PCR-RFLP）检测MTHFRC677T基因多态性,同时检测血浆Hcy、叶酸、维生素B12、血脂、血糖等各项指标。结果AIS+DM组患者的血浆叶酸水平低于AIS组,血浆Hcy水平高于AIS组,差异有统计学意义（均P＜0.01）。AIS+DM组T等位基因频率（56.5%）大于AIS组（50.5%）,但差异无统计学意义（P＞0.05）。在大动脉粥样硬化性卒中亚组水平,AIS+DM组T等位基因频率（64.9%）大于AIS组（43.8%）,差异有统计学意义（P＜0.05）。TT型血浆Hcy水平的比较,AIS+DM组（19.90±4.6）滋mol/L大于AIS组（13.93±3.08）滋mol/L,差异有统计学意义（P＜0.05）。多因素logistic回归分析,MTFHRC677T携带T等位基因的OR值为2.387（95%CI：1.084～5.256,P＜0.05）。结论MTFHRC677T携带T等位基因是缺血性脑卒中合并2型糖尿病的危险因素,发病机制可能与大动脉粥样硬化有关。     

高同型半胱氨酸血症与缺血性脑血管病的相关性

目的：探讨高同型半胱氨酸血症（HHCY）与缺血性脑血管病（ICVD）的相关性。方法：选取2011年9月～2015年12月我院神经内科收治的130例脑梗死（CI）患者、67例短暂性脑缺血发作（TIA）患者以及同期我院体检科确诊的90例非 ICVD 患者（对照组）作为研究对象,采用循环酶法检测所有研究对象的血清同型半胱氨酸（HCY）,分析血清 HCY 水平与 ICVD 病变类型、病情严重度的相关性。结果：①三组研究对象血清 HCY 水平相比差异有统计学意义,对照组血清 HCY 水平显著低于 CI 组与 TIA 组,CI 组与 TIA 组之间血清 HCY 水平相比差异无统计学意义。② ICVD 患者血清 HCY 水平与其美国国立卫生院神经功能缺损量表（NIHSS）评分之间无相关性。③三组研究对象高甘油三酯血症、高胆固醇血症、糖尿病、高血压等危险因素百分率相比差异有统计学意义,对照组上述危险因素百分率均显著低于 CI 组与 TIA 组,CI 组与 TIA 组上述危险因素百分率相比差异无统计学意义。④采用多因素 Logistic 回归分析 ICVD 发生的危险因素,HHCY、高甘油三酯血症、高血压等3个指标具有统计学意义,高胆固醇血症、糖尿病等2个指标无统计学意义。结论：HHCY 是 ICVD 发生的独立危险因素,但 HHCY 与ICVD 病变类型、病情严重度无相关性。     

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.