维吾尔族和汉族弥漫性大B细胞淋巴瘤临床特征与免疫学亚型的相关性

目的 分析维吾尔族、汉族弥漫大B细胞淋巴瘤(DLBCL)免疫学亚型与临床特征的相关性.方法 收集经病理确诊为DLBCL的患者167例,利用免疫组织化学法-Hans法则分为生发中心B细胞型(GCB)和非生发中心B细胞型(non-GCB)两类免疫亚型,采用x2检验分析临床资料与免疫亚型的相关性.结果 维吾尔族中GCB亚型占34.4％ (22/64),non-GCB亚型65.6％(42/64).汉族中GCB亚型占33.0％(34/103),non-GCB亚型占67.0％ (69/103).维、汉族DLBCL患者免疫亚型分布的差异无统计学意义(P =0.856).汉族DL-BCL年龄、IPI评分与免疫学亚型有关(P＜0.05),Non-GCB亚型的维、汉DLBCL患者临床特征在年龄、B症状、IPI评分方面差异有统计学意义(P＜0.05).结论 汉族DLBCL不同亚型中年龄、IPI评分比较有差异;Non-GCB亚型中维、汉在年龄、IPI评分、B症状方面比较有差异.     

HBV相关弥漫大B细胞淋巴瘤临床特征、BCL-2、CMYC表达及预后分析

目的 探讨乙型肝炎病毒(HBV)相关弥漫大B细胞淋巴瘤(DLBCL)临床特征、BCL-2、CMYC表达的相关性及预后分析.方法 回顾性分析94 例DLBCL患者病例资料.利用免疫组化法检测其肿瘤组织石蜡切片中BCL-2、CMYC蛋白表达的情况,分析HBV相关DLBCL患者的临床特征、蛋白表达及预后比较.结果 ① 94例DLBCL患者中乙肝感染率(HbsAg+)为27.66%,明显高于普通人群(7.18%);HbsAg(+)组DLBCL患者与HbsAg(-)组相比:疾病分期更晚(P=0.032)、国际预后指数(IPI) 评分更高(P=0.047)、脾脏更易受累(P=0.02);在性别分布、年龄、免疫学亚型、化疗疗程方面无显著差异;② 两组在BCL-2、CMYC蛋白表达方面:HbsAg(+)组BCL-2蛋白表达明显高于HbsAg(-)组(84.6% vs 58.8%,P=0.018),在CMYC蛋白表达、BCL-2/CMYC "双表达"方面无显著差异;③ 单因素生存分析显示乙肝病毒感染、BCL-2阳性、CMYC阳性、CMYC/BCL-2双表达、IPI高危组均为总生存期(OS)和无疾病进展生存期(PFS)的不良预后因素;Cox多因素分析显示,CMYC/ BCL-2双表达、IPI 高危组均为OS、PFS独立的不良预后因素.结论 HBV相关弥漫大B细胞淋巴瘤具有独特的临床特征;HBV感染、BCL-2、CMYC、BCL-2/CMYC双表达、IPI均与DLBCL预后相关;HBV感染可能通过调控BCL-2作用影响DLBCL发生发展及预后.     

C反应蛋白/白蛋白比值在弥漫大B细胞淋巴瘤患者中的预后价值

目的：探究C反应蛋白/白蛋白比值（C?reactive protein?to?albumin ratio,CAR）在弥漫大B细胞淋巴瘤（diffuse large B?cell lymphoma,DLBCL）中的预后价值。方法：回顾性分析南京医科大学第一附属医院2009年12月—2018年12月收治的初诊DLBCL患者的临床资料。使用Kaplan?Meier方法分析影响无进展生存期（progression?free survival,PFS）和总生存期（overall survival,OS）的因素,使用Cox比例风险回归模型进行单变量及多变量分析。结果：314例患者纳入分析,截至2019年6月,中位随访50个月,中位PFS和OS均未达到。生存分析显示CAR增高具有更差的PFS和OS（P均<0.001）,且CAR是影响PFS（P=0.006）及OS（P=0.009）的独立预后因素。此外,将CAR与美国国家综合癌症网络国际预后指数（National Comprehensive Cancer Network International Prognostic Index,NCCN?IPI）结合后对DLBCL的PFS和OS的预测和判别能力优于NCCN?IPI（P=0.010和P=0.002）。结论：CAR为简单易行的参数,可作为预测DLBCL临床预后的良好指标。     

CDC6 mRNA在弥漫大B细胞淋巴瘤中表达及其临床意义的研究

目的 研究弥漫大B细胞淋巴瘤组织中细胞分裂周期蛋白6(CDC6)表达情况,分析CDC6 mRNA表达与弥漫大B细胞淋巴瘤临床病理特征、预后的关系和意义。方法 收集2012年1月～2018年12月期间我院60例DLBCL病例,以同期20例淋巴结反应性增生组织作为对照,采用实时荧光定量RCR(real-time PCR)检测其CDC6mRNA的表达水平,并分析CDC6 mRNA与DLBCL患者临床病理特征及预后的关系。结果 CDC6 mRNA在DLBCL中的表达量(0.441±0.070)较淋巴结反应性增生组织(0.113±0.029)显著增高(P0.05);CDC6 mRNA在DLBCL中的上调与Hans分型中non-GCB亚型存在相关性(P=0.001);单因素分析显示,高表达CDC6 mRNA、临床分期Ⅲ+Ⅳ期、IPI评分3～5分、LDH升高(245 U/L)、贫血(Hb100 g/L)、Hans分型non-GCB亚型均与DLBCL患者不良预后有关;多因素Cox分析显示,高表达CDC6 mRNA、贫血、non-GCB亚型是影响DLBC预后的独立危险因素(P=0.006;0.001;0.022)。结论 CDC6 mRNA表达与淋巴瘤关系密切,高表达CDC6 mRNA可能与DLBCL患者不良预后有关,可作为DLBCL患者预后的独立危险因素。     

51例滤泡淋巴瘤3A级与3B级患者的临床特征及预后分析

目的：探讨滤泡淋巴瘤（follicular lymphoma,FL）3A级与FL 3B级的临床生物学特征、对治疗的反应以及预后差异。方法：收集51例初诊FL 3级患者的临床资料,分析临床特征和预后差异。结果：51例FL 3级患者包括FL 3A级34例（67%）、FL 3B级17例（33%）,其中20例合并弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）成分。FL 3B级合并DLBCL患者的比例显著高于FL 3A级。相关性分析显示：FL 3A级和BCL2阳性（P=0.046）表达显著相关,而FL 3B级则与MUM1阳性表达（P=0.002）和较早的Ann?Abor分期（P=0.046）显著相关。经含利妥昔单抗方案的一线化疗,2组患者对治疗的反应无显著差异。生存分析显示FL 3B级是FL 3级患者的无进展生存期（progression free survival,PFS）的独立危险因素（P=0.048,HR=3.271,95% CI：1.012~10.573）,但对总生存期（overall survival,OS）无显著影响。FL 3级合并DLBCL具有较短的PFS（P=0.003）和OS（P=0.04）,且合并DLBCL是影响FL 3级患者PFS和OS的独立危险因素（PFS：P=0.012,HR=4.291,95%CI：1.373~13.405;OS：P=0.013,HR=2.392,95%CI：1.199~4.771）。结论：FL 3A级和FL 3B级在临床生物学特征和预后上存在显著差异。FL 3B级患者具有较短的PFS。FL 3级合并DLBCL提示预后不良。     

198例弥漫大B细胞淋巴瘤临床特征及预后因素分析

目的 探讨弥漫大B细胞淋巴瘤(DLBCL)的临床特征及预后影响因素。方法 以198例初诊DLBCL患者为研究对象,对基本临床特征、免疫学亚型、CD5、Bcl-2、Ki-67表达情况进行分析,确定相关因素与预后的关系。结果 161例行免疫学亚型检测,非生发中心样B细胞(non-GCB)型发病率(67.08%)显著高于生发中心样B细胞(GCB)型(32.92%)。134例行Bcl-2检测,阳性表达率为73.88%。84例行CD5检测,阳性表达率为19.05%。165例行Ki-67检测,其中有92.73%的患者Ki-67表达>50%。GCB型与non-GCB型患者在相关临床特征及肿瘤细胞CD5、Bcl-2、Ki-67表达方面进行比较,差异均无统计学意义(P>0.05)。年龄、B组症状、PS评分、临床分期、乳酸脱氢酶(LDH)水平、国际预后指数(IPI)、免疫学亚型、CD5及是否应用利妥昔单抗均影响DLBCL患者的生存时间。PS评分、IPI、免疫学亚型、是否应用利妥昔单抗治疗是影响DLBCL预后的独立因素。结论 DLBCL肿瘤细胞来源与临床特征无相关性;PS评分、IPI、免疫学亚型及是否应用利妥昔单抗治疗是影响DLBCL患者预后的独立因素。     

锌-α2-糖蛋白在食管鳞癌组织中的表达及预后意义

目的 研究锌-α2-糖蛋白(Zn-alpha2-glycoprotein,ZGP1)在食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)组织中的表达及AZGP1蛋白表达水平对患者预后的影响.方法 采用免疫组织化学方法检测1 12例食管鳞癌组织及25例癌旁正常食管黏膜组织中AZGP1蛋白的表达.分析食管鳞癌组织中AZGP1蛋白表达与临床病理特征的关系及对患者预后的影响.结果 ESCC组织中AZGP1蛋白高表达率低于癌旁正常食管黏膜组织(47.3％ vs 76.0％,x2=6.741,P=0.008);在高-中分化(60.9％)、T1 ～3分期(61.7％)及临床分期Ⅰ期+Ⅱ期(58.3％)食管鳞癌组织中AZGP1蛋白高表达多(P＜0.05);生存分析表明,AZGP1蛋白高表达组较低表达组具有生存优势,无进展生存期(progression-free survival,PFS)及总生存期(overall survivaL,OS)均延长,差异有统计学意义(P＜0.05).结论 AZGP1蛋白高表达可能对ESCC有抑制作用,AZGP1蛋白表达水平可预测ESCC患者的预后.     

弥漫性大B细胞淋巴瘤免疫表型分型的预后意义

目的 探讨弥漫性大B细胞淋巴瘤(DLBCL)两种主要亚型生发中心B细胞样(GCB)和非生发中心B细胞样(non-GCB)与 DLBCL预后的关系.方法 采用免疫组化方法检测DLBCL 患者CD10、bcl-6、MUM-1三种蛋白的表达, 以Hans等的分型原则将其划分为GCB和非GCB亚型,比较GCB亚型与非GCB亚型DLBCL的OS.结果 70例DLBCL中,17例(24.3%)CD10阳性,24例(34.3%)bcl- 6阳性,41例(58.6%)MUM-1阳性.GCB 25例(35.7%),ABC 45例(64.3 %).GCB亚型DLBCL的OS明显高于非GCB亚型(P= 0.003).结论 免疫表型亚分型可作为预测DLBCL患者预后的指标,并可有效指导治疗.     

胃肠道弥漫大B细胞淋巴瘤CD10、Bcl-6和VEGF与预后的相关性研究

目的：探讨原发于胃肠道的弥漫大 B 细胞淋巴瘤（PGI-DLBCL）的临床特征,CD10、Bcl-6和 VEGF 表达,分析其与预后的相关性。方法收集66例病理确诊原发 PGI-DLBCL 患者的临床资料,采用免疫组化法检测肿瘤组织CD10、Bcl-6及 VEGF 表达水平;应用 Hans 分型法、Kaplan-Meier 法、Log-rank 检验对患者进行分型,分析临床特征、CD10、Bcl-6及 VEGF 表达与无进展生存期（ PFS）相关性。结果66例患者,原发胃部36例（54.5%）,原发肠道30例（45.5%）。生发中心型（GCB）39例（59.1%）,非生发中心型（non-GCB 型）27例（40.9%）。肿瘤分期、国际预后指数（IPI）评分与 PFS 呈负相关性（P <0.05）。GCB 中位 PFS 为21.50个月,non-GCB 中位 PFS 12.00个月。Bcl-6阳性表达29例（43.9%）,CD-10阳性表达23例（34.8%）,VEGF 阳性表达29例（43.9%）;单因素分析结果提示 CD10、Bcl-6阳性表达与 PFS 呈正相关性（ P <0.05）,而 VEGF 阳性表达与PFS 呈负相关性（P <0.05）;CD10、Bcl-6、VEGF 表达与临床特征之间无明显相关性。Cox 多因素预后分析提示治疗结果、Bcl-6及 VEGF 为影响生存时间的独立影响因素。结论PGI-DLBCL 是一类高侵袭性、高特异性的恶性肿瘤,Hans分型、肿瘤分期、IPI 评分、VEGF、CD10、Bcl-6表达均与其预后有相关性。     

弥漫大B细胞淋巴瘤两种亚型中多药耐药蛋白的表达差异及临床意义

目的:研究3种多药耐药蛋白P-gp、LRP、MRP1在初治的弥漫大B细胞淋巴瘤(DLBCL)两种亚型中的表达差异。方法:选择我院经病理证实的DLBCL初治患者,采用免疫组化方法检测组织标本中CD10、Bcl-6、MUM-1的表达,将其分为GCB和non-GCB两种亚型。免疫组化检测P-gp、LRP、MRP1在每个组织标本中的表达,采用卡方检验的方法比较其在GCB和non-GCB两组中的表达差异。结果:共收集DLBCL患者37例,免疫组化检测分为GCB亚型17例,non-GCB亚型20例。P-gp、LRP、MRP1在DLBCL的表达率分别高达62.2%、94.6%、62.2%,在两组亚型中的表达均没有统计学差异(P=1.0,P=0.49,P=1.0)。结论:初治的DLBCL中GCB和non-GCB两种亚型的预后差异与P-gp、LRP、MRP1这3种多药耐药蛋白的表达无关。     

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.