腔隙性梗死患者血管性认知障碍危险因素的 Logistic 回归分析

目的 收集腔隙性梗死患者临床资料,分析其血管性认知障碍（VCI）的危险因素。方法 选 取2016 年5 月—2017 年2 月赤峰学院附属医院收治的156 例腔隙性脑梗死患者的临床和实验室资料,应用 美国国立卫生研究院卒中量表和蒙特利尔认知评价量表（MoCA）对患者神经功能及认知障碍进行评价, 结合患者临床资料及实验室血浆同型半胱氨酸浓度对认知障碍的危险因素进行多因素的Logistic 回归分析。 结果 62.18% 腔隙性脑梗死患者发生不同程度的VCI。多因素Logistic 回归分析结果显示,关键部位梗死 灶[Ol ^ R=5.937（95% CI ：1.086,32.458）,P =0.040]、脑白质高信号[Ol ^ R=5.948（95% CI ：1.234,28.672）, P =0.026] 和血浆同型半胱氨酸浓度（Hcy）[Ol ^ R=4.389（95% CI ：1.039,18.535）,P =0.044] 是腔隙性梗 死患者出现血管性认知损害的影响因素。血浆Hcy 浓度与MoCA 评分呈负相关（r =-0.694,P =0.000）。 结论 关键部位梗死灶、脑白质高信号和血浆同型半胱氨酸浓度是影响腔隙性梗死患者发生血管性认知损害 的主要危险因素。     

血清脑源性神经生长因子、神经元PAS结构域蛋白4和神经元特异性烯醇化酶水平与急性缺血性脑卒中患者认知障碍的关系

目的 探讨血清脑源性神经生长因子(BDNF)、神经元PAS结构域蛋白4(NPAS4)、神经元特异性烯醇化酶(NSE)水平与急性缺血性脑卒中(AIS)患者认知障碍的关系。方法 选择2018年6月至2020年6月重庆市丰都县人民医院收治的AIS患者128例为研究对象。根据患者入院治疗7～10 d时的简易精神状态量表(MMSE)评分结果将患者分为认知正常组(n=60,MMSE评分≥27分)和认知障碍组(n=68,MMSE评分<27分)。入院后1周,抽取2组患者晨起空腹外周静脉血5 mL,采用酶联免疫吸附试验检测血清中BDNF、NPAS4、NSE水平。采用Pearson相关分析BDNF、NPAS4、NSE水平与MMSE评分的关系,采用单因素分析和多因素logistic回归分析AIS患者发生认知障碍的危险因素。结果 认知障碍组与认知正常组患者的年龄、性别、起病至入院时间、脑梗死部位及合并高血压、冠状动脉性心脏病、房颤的比例比较差异均无统计学意义(P>0.05);认知障碍组患者的美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、受教育年限、梗死病灶大小、合并...     

缺血性卒中后早期认知功能恶化的相关危险因素

目的：探索缺血性卒中后早期（3个月内）认知功能恶化的发生率以及相关危险因素。 方法：前瞻性连续入组住院治疗的195例急性缺血性卒中患者。根据卒中急性期(发病14天以内)和卒中后3个月患者简明精神状态量表（MMSE）总分是否降低2分以上,分为认知功能恶化组和非恶化组,并进行组间对比。采用logistic回归分析缺血性卒中后3个月内认知功能恶化的危险因素。 结果：缺血性卒中急性期有117例（60.0%）患者被诊断为卒中后认知障碍（PSCI）。卒中后3个月有37例（19.0%）患者发生了认知功能的恶化。单因素logistic回归分析显示缺血性卒中后3个月内认知功能恶化和年龄、性别、受教育年限、急性期MMSE评分、急性期CDR评分、入院时糖化血红蛋白水平有关( P<0.05) 。多因素logistic回归分析显示,年龄>70岁（RR=2.509,P=0.045）、文盲(RR=3.038,P=0.011)、入院时糖化血红蛋白水平(RR=1.364,P=0.016)是缺血性卒中后3个月内认知功能恶化的危险因素;急性期MMSE评分(RR=0.852,P=0.001)为其保护因素。 结论：缺血性卒中早期认知功能恶化的发生率达19.0%。年龄>70岁、文盲、糖化血红蛋白水平高、卒中急性期存在严重的认知功能障碍是缺血性卒中患者早期认知功能恶化的危险因素。     

急性脑梗死患者血糖调节受损与早期血管性认知功能障碍的相关性研究

目的探讨血糖调节受损对急性脑梗死患者早期血管性认知功能障碍发生的影响。方法共纳入120例非糖尿病急性脑梗死患者,入院后7~10d采用蒙特利尔认知评估（MoCA）量表对患者进行认知功能的评估,MoCA量表评分＜26分纳入认知功能障碍组,MoCA量表评分≥26分纳入认知功能正常组。采用多因素非条件logistic回归分析影响急性脑梗死患者早期发生血管性认知功能障碍的危险因素。结果120例患者中,出现认知功能障碍49例,发生率为40.8%。两组患者血糖调节受损、卒中史、受教育年限比较差异均有统计学意义（均P＜0.05）。多因素非条件logistic回归分析显示,血糖调节受损是急性脑梗死患者早期发生血管性认知功能障碍的独立危险因素（OR=2.608,95%CI：1.162~5.850,P=0.020）。结论血糖调节受损与急性脑梗死患者早期血管性认知功能障碍的发生有关。     

比较简易精神状态量表与蒙特利尔认知评估量表在腔隙性脑梗死认知障碍患者中的应用价值

  目的 比较简易精神状态（MMSE）量表与蒙特利尔认知评估（MoCA）量表（中文版）在腔隙性脑梗死患者认知障碍评估中的应用价值。方法 首先采用中文版MMSE量表对确诊为腔隙性脑梗死患者进行筛选,然后对经过受教育程度矫正后MMSE得分正常的患者采用中文版MoCA量表进行评分,以26分作为分界值。MoCA＜26分者纳入腔隙性脑梗死认知功能障碍 (LI-CI) 组,MoCA≥26分者纳入腔隙性脑梗死认知功能正常 (LI-NC) 组,另选50例健康体检者作为对照（NC）组。比较3组患者MoCA总分及各个认知领域的得分情况。结果 MMSE得分正常的患者中53%（50/94）为MoCA评分＜26分,其认知功能与MoCA评分≥26分的患者比较,差异有统计学意义﹙P＜0.01﹚。LI-CI组在视空间与执行能力、命名、延迟记忆、抽象等认知领域得分低于LI-NC组（P＜0.05）。结论 MMSE评分正常、MoCA评测异常的患者认知损害主要表现在视空间与执行功能、命名、延迟记忆、抽象等方面。MoCA量表在筛查腔隙性脑梗死患者认知障碍方面可能比MMSE量表更敏感。     

轻型动脉瘤性蛛网膜下腔出血介入治疗术后早期认知障碍的危险因素分析

目的：探索轻型动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage,ASAH）患者介入治疗术后早期认知障碍的危险因素。方法：回顾性收集2015年12月至2021年12月轻型ASAH介入治疗术后患者80例,分别于术后1个月、术后3个月随访简易智力状态检查量表（mini-mental state examination,MMSE）及改良Rankin量表（modified Rankin scale,mRS）评分,将患者分为认知正常组及认知障碍组,详细收集2组患者的临床基线资料,单因素及多因素分析认知障碍的危险因素。结果：80例患者中,术后1个月有41例存在认知障碍,占总人数的51.25%。单因素分析显示受教育程度（P=0.000）、年龄（P=0.020）、入院时改良Fisher分级（modified Fisher scale,mFS）(P<0.001)、Hunt-Hess分级（P<0.006）、动脉瘤部位（P=0.023）、合并脑室出血（P=0.043）是术后认知障碍的危险因素（P<0.05）;多因素分析显示mFS、动脉瘤部位、Hun...     

血浆β2微球蛋白水平与老年轻度认知障碍的关系研究

背景　随着我国进入老龄化社会,老年轻度认知障碍（MCI）越来越常见,β2微球蛋白（β2M）作为一种新的生物标志物逐渐进入大众视野,而β2M在衰老和认知调节中的作用尚存在很大争议。目的　探究血浆β2M水平与老年MCI的关系。方法　选取2018年6月至2019年6月在北京大学人民医院老年科住院的233例患者为研究对象。依据蒙特利尔认知评估量表（MoCA）评分将所有患者分为MCI组108例,认知正常（NC）组125例。收集两组患者人口学特征及入院时实验室检查指标。比较两组患者人口学特征、实验室检查指标、MoCA评分,分析MoCA评分与年龄、受教育年限、血浆β2M水平的相关性。采用二元Logistic回归分析探究老年患者发生MCI影响因素。结果　MCI组患者年龄、血浆β2M水平高于NC组,受教育年限少于NC组,MoCA评分低于NC组（P<0.05）。Spearman秩相关分析结果显示,年龄（rs=-0.361,P<0.001）、血浆β2M水平（rs=-0.283,P<0.001）与MoCA评分呈负相关,受教育年限与MoCA评分呈正相关（rs=0.305,P<0.001）。控制年龄为协变量,二元Logistic回归分析结果显示,血浆β2M水平〔OR=1.955,95%CI（1.060,3.606）〕是老年患者发生MCI的危险因素,受教育年限〔OR=0.860,95%CI（0.777,0.951）〕是老年患者发生MCI的保护因素（P<0.05）。结论　血浆β2M水平是老年患者发生MCI的独立危险因素,对血浆β2M水平较高的老年人进行筛查有助于早期识别MCI及预防MCI的发生发展。     

不同影像学类型脑小血管病与认知障碍的关系及影响因素

目的：探讨不同影像学类型的脑小血管病与认知障碍的关系,并分析认知障碍的影响因素。方法：脑小血管病患者82例（观察组）,根据核磁影像学表现分为腔隙性病灶型28例,脑白质疏松型33例,微出血型8例以及血管周围间隙扩大型13例。选取同期门诊无脑血管病者30例为对照组。收集两组年龄,性别,受教育年限,吸烟史,高血压史,糖尿病史以及相关实验室检查结果,以简易智力状态评定量表（MMSE）及蒙特利尔认知量表（MoCA）评定认知障碍,比较各组间认知水平,采用Logistic回归分析认知障碍的危险因素。结果：观察组患者MMSE评分及MoCA评分分别为26.79±2.37分、25.66±3.07分,均低于对照组的27.83±1.88分、26.93±2.59分,差异均有统计学意义（P<0.05）。腔隙性病灶组MMSE评分26.46±2.20分和MoCA评分25.10±2.64分,脑白质疏松组MMSE评分26.33±2.47分和MoCA评分25.30±3.09分,均低于对照组的MMSE评分和MoCA评分,差异均有统计学意义（P<0.05）;而其他各组间两两比较,认知水平差异均无统计学意义（P>0.05）。多因素分析显示,高龄、吸烟、高血压史、高糖化血红蛋白、高LDL-C血症是认知障碍的危险因素,而高HDL-C水平及受教育年限是保护性因素。结论：脑小血管病可以导致认知水平的下降,尤其以影像学表现为腔隙性病灶及白质疏松的患者更易合并认知障碍。针对危险因素采取针对性干预措施,有可能改变疾病的进程及预后。     

认知量表联合颅脑磁共振对维持性透析患者认知功能的评价

目的 探讨简易精神状态量表（MMSE）和蒙特利尔认知评估量表（MoCA）联合颅脑磁共振（MRI）弥散加权成像（DWI）/扩散张量成像（DTI）对透析患者认知功能的评估价值。方法 选择2015年5月至2016年5月于安徽医科大学第二附属医院肾内科进行透析的患者65例,采用MMSE和MoCA评估患者认知功能,MRI扫描脑白质区并计算表观弥散系数（ADC）和部分异向性（FA）量化值;根据MoCA结果分为认知正常组（38例）和认知障碍组（27例）,比较两组患者量表评分、ADC值及FA值的差异性。结果 MoCA检出率高于MMSE,差异有统计学意义（χ²=17.725,P=0.001）,且MMSE和MoCA总分呈正相关（r=0.660,P=0.001）。认知障碍组患者MMSE评分的定向力、记忆力、注意力、语言和总分低于认知正常组,而MoCA评分的执行力、注意力、语言、延迟回忆、定向力和总分均低于认知正常组,差异有统计学意义（P<0.05）;额叶和顶叶ADC值高于正常组,额叶、顶叶、胼胝体及侧脑室FA值低于正常组,差异有统计学意义（P<0.05）。结论 多认知量表联合评估可提高透析患者认知障碍的检出率;且存在认知障碍的透析患者主要表现为执行力、定向力、注意力、语言和记忆力的下降,和大脑额叶、顶叶、胼胝体和侧脑室白质的损伤相对应。     

脑梗死患者认知障碍与脑白质病变相关性分析

目的 探讨脑梗死(CI)患者认知障碍与脑白质病变(WML)的相关性,基于多因素logistic回归分析认知障碍并发WML的危险因素。方法 选取2020年8月至2022年10月医院收治的134例CI患者为研究对象,依据是否发生认知障碍分为发生组(56例)、未发生组(78例)。比较两组一般资料,分析认知障碍与年龄相关性脑白质改变评分(ARWMC)相关性。发生组患者依据是否发生WML病变分为非病变者36例、病变者20例,并分析WML病变者、非病变者血清学指标[视黄醇结合蛋白(RBP)、半乳糖凝集素-3(Galectin-3)、白细胞介素-33(IL-33)]水平。多因素logistic回归分析认知障碍并发WML的危险因素。评价危险因素联合预测认知障碍并发WML的预测价值。结果 CI患者认知障碍与入院时ARWMC评分存在线性关系(P=0.005),且认知障碍与入院时ARWMC评分呈正相关(r=0.485,P<0.001)。病变者年龄、入院时NIHSS评分、重度颈动脉狭窄占比、多梗死灶占比高于非病变者,血清RBP、Galectin-3、IL-33水平高于非病变者(P<0.05)。高龄...     

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.