糖尿病足感染的病原菌特征及耐药性分析

目的:探讨糖尿病足感染（DFI）患者不同感染级别的病原菌特征及耐药特点。方法:选取2020年5月—2021年2月天津医科大学朱宪彝纪念医院糖尿病足科住院的212例DFI患者,对感染的病原菌类型及耐药特点进行回顾性分析,并依据DFI严重程度的分级标准将患者分为中度DFI组和重度DFI组,比较两组间病原菌特征及耐药情况。结果:212例患者足分泌物标本中共分离出287株病原菌,前3位为鲍曼不动杆菌（11.50%）、肺炎克雷伯菌（11.15%）、金黄色葡萄球菌（10.80%）。革兰阳性菌以金黄色葡萄球菌为主,对万古霉素、利奈唑胺、奎奴普丁/达福普汀敏感率均为100%。革兰阴性菌中,中度DFI以鲍曼不动杆菌为主,且多为碳青霉烯类耐药菌株（CR-AB）,仅对替加环素敏感;重度DFI以肺炎克雷伯菌为主,对阿米卡星、碳青霉烯类、哌拉西林/他唑巴坦均100%敏感。与中度DFI患者比较,重度DFI患者中混合感染的比例升高（44.68% vs.29.09%,P<0.05）。检出的多重耐药菌中革兰阴性菌总体耐药率（19.46%）高于革兰阳性菌总体耐药率（11.96%）,以CR-AB和产超广谱β-内酰胺酶（ESBLs）大肠埃希菌为主。结论:DFI患者感染的病原菌以革兰阴性菌为主,但中、重度感染菌群分布不同。随着感染程度分级的加重糖尿病足混合感染的比例升高。检出的多重耐药菌以CR-AB和产ESBLs大肠埃希菌为主。     

2009～2011年AE-COPD患者病原菌分布及耐药分析

目的：研究慢性阻塞性肺疾病急性加重期患者（AE-COPD）下呼吸道病原菌的分布及耐药性,为临床应合理用药物提供参考。方法回顾性分析AE-COPD住院患者痰标本细菌培养及药敏结果,对142例患者下呼吸道痰标本分离的病原菌用VITEK-32全自动细菌鉴定仪进行鉴定,采用K-B纸片法进行体外药物敏感试验。结果共分离出病原菌142例,革兰阴性菌、革兰阳性菌、真菌分别占70.4%、19.7%、9.9%;革兰阴性菌中以铜绿假单胞菌、大肠埃氏菌、肺炎克雷伯杆菌、鲍曼不动杆菌多见,分别占31.7%、11.9%、9.9%、9.9%;革兰阳性菌以金黄色葡萄球菌为主,占8.5%;真菌以白色念珠菌为主,占8.5%,革兰阴性菌对头孢哌酮/舒巴坦、阿米卡星、亚胺培南最敏感,革兰阳性菌对万古霉素和替考拉宁最敏感。结论 AE-COPD患者病原菌以革兰阴性杆菌为主,耐药率偏高,依据病原菌分布及耐药性监测结果指导抗菌药物的合理应用,是治疗AE-COPD的重要手段。     

RICU呼吸机相关性肺炎病原菌的构成及耐药性分析

目的：分析呼吸内科监护病房（RICU）住院患者呼吸机相关性肺炎（VAP）的病原菌的分布及耐药性特点，为临床抗感染治疗提供依据。方法回顾性分析230例机械通气患者的VAP感染率、病原菌分布及耐药性特点。结果从65例确诊为VAP患者的痰液中共检出246株病原菌，以革兰阴性菌为主，占61.8%（152株），其中排在前四位的分别是铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌；革兰阳性菌占27.2%（67株），排在前两位的分别是金黄色葡萄球菌和肺炎链球菌；真菌占11.0%（27株），且均为白色假丝酵母菌。药敏结果显示，分离得到的病原菌对临床常用抗生素耐药情况严重，革兰阳性菌对万古霉素最为敏感，革兰阴性菌对亚胺培南最为敏感，哌拉西林/他唑巴坦次之。结论 VAP患者混合感染现象及病原菌耐药情况严重，临床应重视病原学检测及耐药性分析，有针对性地进行抗感染治疗。     

721例耐多药肺结核合并感染情况及耐药性分析

目的 了解耐多药肺结核合并感染患者病原菌分布和耐药情况,指导临床正确治疗和用药.方法 对我院收治的721例患者进行痰细菌培养,并对阳性标本中的659株细菌进行鉴定及药敏试验.结果 感染以革兰阴性菌为主,共检出革兰阴性菌403株（61.2%）,革兰阳性菌97株（14.7%）,真菌159株（24.1%）.革兰阴性菌对阿米卡星、环丙沙星、头孢他啶较为敏感;革兰阳性菌对万古霉素较敏感.结论 加强耐多药结核患者病原菌感染和细菌耐药性监测,为临床提供更全面的资料,指导患者合理用药,减少感染和耐药性的发生.     

血液透析患者股静脉留置导管相关性菌血症菌群分布及药敏分析

目的了解我院血液透析患者股静脉留置导管相关性菌血症常见细菌分布和对抗生素耐药情况。方法对33例股静脉留置导管相关性菌血症患者血培养细菌及药敏情况进行回顾性分析。结果 33例标本中分离出17种病原菌,葡萄球菌属15例（45.5%）,其他革兰阳性球菌7例（21.2%）,革兰阴性菌6例（18.2%）,真菌5例（15.2%）。检出的葡萄球菌中9株MRS阳性,革兰阴性菌中1株ESBL阳性。葡萄菌属、肠球菌等革兰阳性菌对万古霉素、喹奴普汀/达福普汀敏感,革兰阴性菌对亚胺培南、美罗培南敏感。结论我院血液透析患者股静脉留置导管相关性菌血症菌群以革兰阳性菌为主,经验性治疗可选用万古霉素,同时警惕革兰阴性菌的院内感染和真菌感染。     

骨外科感染患者伤口病原菌分布及耐药性分析

目的：分析骨外科感染患者伤口病原菌分布及耐药性。方法：回顾性分析2018年5月至2019年4月沈阳市骨科医院骨外科收治的212例伤口感染患者的临床资料。采集患者伤口分泌物进行病原菌分离培养,分析病原菌分布情况及主要病原菌对常用抗生素的药敏试验结果。结果：212例患者共检出243株病原菌,其中革兰阴性菌132株（54.32%）、革兰阳性菌110株（45.27%）、真菌1株（0.41%）。革兰阳性菌中,金黄色葡萄球菌对青霉素、氨苄西林、红霉素的耐药率较高（均超过80%）,对万古霉素、氯霉素及利福平的敏感性较高;凝固酶阴性葡萄球菌对青霉素、氨苄西林的耐药率较高,均达到100%,对万古霉素、氯霉素的敏感性较高。革兰阴性菌中,大肠埃希菌对氨苄西林、氨曲南的耐药率较高（均超过70%）,肺炎克雷伯菌对氨苄西林的耐药率达100%,二者对亚胺培南、哌拉西林的敏感性均较高;鲍曼不动杆菌对头孢噻肟、头孢曲松的耐药率较高（均超过65%）,铜绿假单胞菌对头孢噻肟、头孢曲松及头孢他啶的耐药率较高（均超过70%）,二者对亚胺培南、多黏菌素、哌拉西林的敏感性均较高。结论：骨外科伤口感染患者的病原菌分布以革兰阴性菌为主...     

呼吸机相关性肺炎常见致病菌及其耐药性分析

目的：调查呼吸机相关性肺炎（VAP）患者菌群分布及耐药特点,为临床VAP防治提供可行性依据。方法：回顾分析54例呼吸机相关性肺炎患者的病原菌谱,耐药性及其临床特征。结果：VAP平均发病时间为机械通气后6.3 d,总病死率为44.4%,共分离出病原菌102株,其中革兰阴性菌80株（占78.4%）,革兰阳性菌18株（占17.6%）,真菌4株（占3.9%）。革兰阴性菌中占前3位的分别是肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌,革兰阳性菌主要是金黄色葡萄球菌,其中耐甲氧西林的金黄色葡萄球菌（MRSA）对万古霉素有100%的敏感性。结论：VAP的主要病原菌为革兰阴性杆菌,常为多重耐药的致病菌,为避免耐药率的升高,临床需合理使用抗生素。     

成人胸腔感染病原菌特征及预后分析

  目的  分析引起成人胸腔感染的病原菌特征及其与患者预后的关系,为该类疾病的预防和治疗提供依据。  方法  回顾性分析四川大学华西医院2014年1月至2017年12月期间收治的成人胸腔感染患者的临床资料和实验室数据,研究病原菌菌种分布和耐药表型以及不同病原菌感染患者的住院死亡率。  结果  纳入339例胸腔感染患者,共分离出病原菌371株,包括革兰阴性菌189株（50.9%）、革兰阳性菌137株（36.9%）、真菌23株（6.2%）和分枝杆菌22株（5.9%）。革兰阴性菌以鲍曼不动杆菌（44/189,23.3%）、大肠埃希菌（34/189,18.0%）及肺炎克雷伯菌（29/189,15.3%）为主,革兰阳性菌以屎肠球菌（25/137,18.2%）、金黄色葡萄球菌（17/137,12.4%）和星座链球菌（17/137,12.4%）为主。鲍曼不动杆菌多重耐药菌占90.9%（40/44）,其中耐碳青霉烯类菌株占84.1%（37/44）,产超广谱β内酰胺酶的大肠埃希菌和肺炎克雷伯菌分别占61.8%（21/34）和27.6%（8/29）,耐甲氧西林金黄色葡萄球菌占58.8%（10/17）,未查见耐万古霉素屎肠球菌。革兰阴性菌、革兰阳性菌、真菌和分枝杆菌感染患者的住院死亡率分别为31.2%（59/189）、18.2%（25/137）、17.4%（4/23）和4.5%（1/22）,组间差异有统计学意义（P=0.004）。  结论  引起成人胸腔感染的病原菌以革兰阴性菌为主,主要菌种为鲍曼不动杆菌、大肠埃希菌和肺炎克雷伯菌。革兰阴性菌感染患者死亡率高,应进一步关注该类细菌引起胸腔感染的影响因素。     

细菌培养及耐药性分析对结肠癌根治术后切口感染患者抗菌药物合理使用的影响

目的 探讨结肠癌根治术后切口感染患者病原菌及耐药性,以期指导临床正确合理应用抗菌药物。方法 选取2016年1月至2020年11月方城县人民医院结肠癌根治术后切口感染患者46例,取切口部位分泌物或引流液进行细菌培养与抗菌药物耐药性分析。结果 (1)细菌培养结果：本组结肠癌根治术后切口感染患者46例共分离出病原菌71株,其中革兰阴性菌占58%(41/71)、革兰阳性菌占38%(27/71)、真菌占4%(3/71)。(2)主要革兰阴性菌耐药性分析：革兰阴性菌中大肠埃希菌对头孢拉唑、庆大霉素耐药性较低;肺炎克雷伯菌对头孢哌酮等耐药性均高达92%,对头孢拉唑等耐药性较低（8%）;铜绿假单胞菌对阿米卡星、亚胺培南耐药性均可达100%,对头孢拉唑、庆大霉素耐药性均不足20%。(3)主要革兰阳性菌耐药性分析：革兰阳性菌中表皮葡萄球菌对红霉素等耐药性均高达75%及以上,对利奈唑胺等耐药性均为0;金黄色葡萄球菌对红霉素（78%）、青霉素（100%）耐药性较高,对利奈唑胺、万古霉素耐药性均为0。结论 革兰阴性菌是结肠癌根治术后切口感染患者的主要病原菌,且对部分常用抗菌药物具有较低敏感度,临床实际可参照药敏试...     

2016—2019年老年医学科重症监护室患者血流感染病原菌的分布与耐药性分析

目的：分析某院老年医学科重症监护室患者血流感染病原菌分布及耐药性。方法：收集2016年1月—2019年12月该院老年医学科重症监护室住院患者血培养数据并用WHONET 5.6软件统计分析。将血培养阳性患者按年龄分为老年组（≥60岁）与非老年组（＜60岁）,比较两组患者血流感染病原菌的构成以及耐药性。结果：96例血培养阳性患者共分离到病原菌100株。其中,革兰阴性菌占63.0%,革兰阳性菌占22.0%,真菌占10.0%,厌氧菌占5.0%。革兰阴性菌检出居前3位的依次是肺炎克雷伯菌（25.0%）、大肠埃希菌（13.0%）、鲍曼不动杆菌（11.0%）。革兰阳性菌检出居前3位的依次是肠球菌（8.0%）、金黄色葡萄球菌（7.0%）和α?溶血性链球菌（7.0%）。肺炎克雷伯菌中碳青霉烯耐药肠杆科细菌（carbapenem?resistant Enterobacteriaceae,CRE）占76%,其中检测到1株对头孢他定/阿维巴坦耐药的肺炎克雷伯菌,未检测到对替加环素或多黏菌素B耐药的菌株;鲍曼不动杆菌中碳青霉烯耐药鲍曼不动杆菌（carbapenem?resistant A. baumannii,CRAB）占81.8%,其中检测到1株对替加环素耐药,未检测到对多黏菌素B耐药的菌株;金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌（methicillin?resistant Staphylococcus aureus,MRSA）占57.2%,未发现耐万古霉素和利奈唑胺的金黄色葡萄球菌。此外,检出1 株耐万古霉素屎肠球菌。两组患者分离的病原菌分布构成相似。与非老年组相比,老年组病原菌耐药率更高。结论：该院老年医学科重症监护室血流感染的病原菌以革兰阴性杆菌为主,且对碳青霉烯类药物耐药率高。     

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.