[Analysis of related factors on effects of uterine artery embolization in the treatment of dysmenorrhea of adenomyosis and the construction and validation of prediction model]

Objective: To investigate the related factors on effects of uterine artery embolization(UAE)in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods: A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People's Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic(ROC)curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results: (1)In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2%(98/127).(2)Age was an independent predictor of effective UAE treatment(HR= 1.129, P=0.026); in the range of this study, the greater the age, the higher the UAE treatment efficiency.(3)The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment(HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1%(37/44)and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1%(26/44).(4)Blood supply of adenomyosisis was an independent predictor of effective UAE treatment(HR=0.313, P=0.001). Type Ⅰ(bilateral predominated)patients, efficiency was 93.5%(43/46); type Ⅱ(bilateral balanced)patients, efficiency was 78.0%(39/50); type Ⅲ(unilateral predominated)patients, efficiency was 51.6%(16/31).(5)UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model's area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5% and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions: (1)Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment.(2)The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.

Chaperone-mediated autophagy substrate proteins in cancer

All intracellular proteins undergo continuous synthesis and degradation. Chaperone-mediated autophagy (CMA) is necessary to maintain cellular homeostasis through turnover of cytosolic proteins (substrate proteins). This degradation involves a series of substrate proteins including both cancer promoters and suppressors. Since activating or inhibiting CMA pathway to treat cancer is still debated, targeting to the CMA substrate proteins provides a novel direction. We summarize the cancer-associated substrate proteins which are degraded by CMA. Consequently, CMA substrate proteins catalyze the glycolysis which contributes to the Warburg effect in cancer cells. The fact that the degradation of substrate proteins based on the CMA can be altered by posttranslational modifications such as phosphorylation or acetylation. In conclusion, targeting to CMA substrate proteins develops into a new anticancer therapeutic approach.

The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention

In the present study, we evaluated the safety and efficacy of immediate surgical bipolar plasmakinetic transurethral resection of the prostate (PK-TURP) for patients with benign prostatic hyperplasia (BPH) with acute urinary retention (AUR). We conducted a retrospective analysis of clinical data of BPH patients who received PK-TURP. A total of 1126 BPH patients were divided into AUR (n = 348) and non-AUR groups (n = 778). After the urethral catheters were removed, the urine white blood cell (WBC) count in the AUR group significantly increased compared with the non-AUR group (P < 0.01). However, there was no significant difference in international prostate symptom score, painful urination, and maximal urinary flow rate. The duration of hospitalization of the AUR group was longer than that of the non-AUR group (P < 0.001). A total of 87.1% (303/348) patients in the AUR group and 84.1% (654/778) patients in the non-AUR group completed all of the postoperative follow-up visits. The incidence of urinary tract infection in the AUR group within 3 months after surgery was significantly higher than that in the non-AUR group (P < 0.01). The incidence of temporary urinary incontinence in the AUR group did not exhibit significant difference. During 3–12 months after surgery, there were no significant differences in major complications between the two groups. Multivariate regression analyses showed that age, postvoid residual, maximal urinary flow rate, diabetes, and hypertension, but not the presence of AUR, were independent predictors of IPSS post-PK-TURP. In conclusion, immediate PK-TURP surgery on patients accompanied by AUR was safe and effective.

[Catastrophic Health Expenditure before and after Compensations from the New Rural Cooperative Medical Scheme in Rural Zigong of Sichuan Province]

OBJECTIVES

To estimate catastrophic health expenditure (CHE) of rural families in Zigong, and to determine the main influencing factors of CHE.

METHODS

CHE was estimated using indicators such as occurrence and average deviations. The influencing factors of CHE were identified through binary logistic regression.

RESULTS

We found 6.37% catastrophic health payment headcount, 1.13% mean catastrophic payment gap, and 17.80% mean positive gap after compensations. Compensations from the new rural cooperative medical scheme (NCMS) led to a reduction of 74.81% catastrophic health payment headcount for hospitalization costs and 48.00% catastrophic health payment headcount for outpatient costs, respectively. The numbers of hospitalizations in a family, presence of patients with chronic diseases, per capita household income, and numbers of family members with a job were found to be predictors of CHE.

CONCLUSIONS

Rural families that have patients with chronic diseases are vulnerable to CHE.The government should develop policies to ease the financial burdens of the families with a high accumulated health expenditure over time.

In situ plasmonic Ag nanoparticle anchored TiO2 nanotube arrays as visible-light-driven photocatalysts for enhanced water splitting

An ultrasonication-assisted in situ deposition strategy was utilised to uniformly decorate plasmonic Ag nanoparticles on vertically aligned TiO2 nanotube arrays (NTAs) to construct a Ag@TiO2 NTA composite. The Ag nanoparticles act as efficient surface plasmon resonance (SPR) photosensitizers to drive photocatalytic water splitting under visible light irradiation. The Ag nanoparticles were uniformly deposited on the surface and inside the highly oriented TiO2 nanotubes. The visible-light-driven hydrogen production activities of silver nanoparticle anchored TiO2 nanotube array photocatalysts were evaluated using methanol as a sacrificial reagent in water under a 500 W Xe lamp with a UV light cutoff filter (λ ≥ 420 nm). It was found that the hydrogen production rate of the Ag@TiO2 NTAs prepared with ultrasonication-assisted deposition for 5 min was approximately 15 times higher than that of its pristine TiO2 NTAs counterpart. The highly efficient photocatalytic hydrogen evolution is attributed to the SPR effect of Ag for enhanced visible light absorption and boosting the photogenerated electron-hole separation/transfer. This strategy is promising for the design and construction of high efficiency TiO2 based photocatalysts for solar energy conversion.

Bioinspired TiO₂ nanostructure films with special wettability and adhesion for droplets manipulation and patterning

Patterned surfaces with special wettability and adhesion (sliding, sticky or patterned superoleophobic surface) can be found on many living creatures. They offer a versatile platform for microfluidic management and other biological functions. Inspired by their precise arrangement of structure and chemical component, we described a facile one-step approach to construct large scale pinecone-like anatase TiO₂ particles (ATP) film. The as-prepared ATP film exhibits excellent superamphiphilic property in air, changes to underwater superoleophobicity with good dynamical stability. In addition, erasable and rewritable patterned superamphiphobic ATP films or three-dimensional (3D) Janus surfaces were constructed for a versatile platform for microfluidic management and biomedical applications. In a proof-of-concept study, robust super-antiwetting feet for artificial anti-oil strider at the oil/water interface, novel superamphiphobic surface for repeatable oil/water separation, and multifunctional patterned superamphiphobic ATP template for cell, fluorecent probe and inorganic nanoparticles site-selective immobilization were demonstrated.

[Low-dose tadalafil for erectile dysfunction following pelvic fracture-induced urethral injury: clinical observation of 42 cases]

OBJECTIVE

To evaluate the efficacy of daily low-dose tadalafil in the treatment of erectile dysfunction (ED) following pelvic fracture-induced urethral injury (PFUI).

METHODS

Based on the length of time between pelvic fracture and the patients' clinic visit, we divided 42 PFUI-caused ED patients into groups A (< 1 month), B (6-24 months) and C (> 24 months). We treated them with tadalafil at 5 mg daily for 12 weeks consecutively, followed by evaluation of the therapeutic effect using IIEF-5 questionnaire and Sexual Encounter Profile (SEP) diaries.

RESULTS

Thirty-four patients (83.3%) completed the investigation and all responded well to tadalafil medication. Group A showed significant differences from B and C in the increase of IIEF-5 scores and the positive rate of SEP.

CONCLUSION

Daily low-dose tadalafil helps penile rehabilitation in ED patients following PFUI, and the earlier the medication is initiated, the better the effect will be.

[Transfection of iNOS suppresses the growth of androgen-independent prostate cancer DU145 cells]

OBJECTIVE

To observe the effect of the inducible nitric oxide synthase (iNOS) gene on androgen-independent prostate cancer DU145 cells in vitro.

METHODS

The iNOS gene was transfected into androgen-independent prostate cancer DU145 cells. The positive cells were selected as the transfected group for amplification, and an empty vector (EV) group and a control group were also set. The mRNA transcription of iNOS was analyzed by RT-PCR. The morphological changes of the cells were observed, the effect of iNOS transfection on the cell growth determined using the MTB method, and the apoptosis of DU145 cells detected by flow cytometry, followed by analysis of the effect of NOS inhibitors on the transfected cells.

RESULTS

DU145 cells transfected with iNOS secreted significantly more nitric oxide ([272.50 +/- 15.82] micromol/L) than those of the EV and control groups ([122.00 +/- 18.93] micromol/L and [121.00 +/- 6.98] micromol/L) (P < 0.05). The rate of cell apoptosis was markedly enhanced in the transfected group as compared with the EV and control groups ([42.78 +/- 2.01]% vs [30.65 +/- 1.46]% and [28.96 +/- 1.50]%, P < 0.05). MTP test indicated a slower growth of the DU145 cells in the former than in the latter two (P < 0.05). NOS inhibitors enhanced their growth, but with no significance (P > 0.05).

CONCLUSION

DU145 cells transfected with iNOS could secrete high-concentration nitric oxide, induce cell apoptosis, and suppress cell proliferation, which may provide a potentially effective gene therapy for advanced androgen-independent prostate cancer.

[Effects of tadalafil on erectile dysfunction: on-demand versus once-daily dosing]

OBJECTIVE

To evaluate the effects of tadalafil administered on demand or once a day in the treatment of erectile dysfunction (ED).

METHODS

We randomly assigned 61 ED patients to three groups to receive tadalafil on demand, at 5 mg once daily, and at 10 mg once daily, respectively. After 42 days of medication, we compared the therapeutic effects among different groups using the patients' sexual encounter profile (SEP) diaries, detected the adverse reactions and assessed the safety of tadalafil.

RESULTS

Fifty-three (86.7%) of the patients completed the investigation, and all responded well to tadalafil medication, with a significantly improved success rate of sexual intercourse and a low rate of mild adverse effects. The mean positive rates of SEP were basically similar between the on-demand and once-daily groups.

CONCLUSION

There are no significant differences in the improvement of penile erection and sexual satisfaction of ED patients treated by on-demand and once-daily administration of tadalafil.

Nitrogen-doped TiO2 nanotube array films with enhanced photocatalytic activity under various light sources

Highly ordered nitrogen-doped titanium dioxide (N-doped TiO(2)) nanotube array films with enhanced photocatalytic activity were fabricated by electrochemical anodization, followed by a wet immersion and annealing post-treatment. The morphology, structure and composition of the N-doped TiO(2) nanotube array films were investigated by FESEM, XPS, UV-vis and XRD. The effect of annealing temperature on the morphology, structures, photoelectrochemical property and photo-absorption of the N-doped TiO(2) nanotube array films was investigated. Liquid chromatography and mass spectrometry were applied to the analysis of the intermediates coming from the photocatalytic degradation of MO. The experimental results showed that there were four primary intermediates existing in the photocatalytic reaction. Compared with the pure TiO(2) nanotube array film, the N-doped TiO(2) nanotubes exhibited higher photocatalytic activity in degradating methyl orange into non-toxic inorganic products under both UV and simulated sunlight irradiation.

[Expression of human testis development related gene 1 in testicular cancer detected by tissue microarray]

OBJECTIVE

To investigate the protein expression of human testis development related gene 1 (TDRG1) in human testicular cancer and its pathological significance.

METHODS

The expression levels of TDRG1 were detected in the testis tissues of testicular cancer patients and normal men by tissue microarray and immunohistochemistry, and the results were analyzed.

RESULTS

Immunohistochemistry exhibited positive expression of the TDRG1 protein in the testis of 73.3% (11/15) of the normal men, 83.3% (10/12) of the patients with embryonal carcinoma, 80.0% (8/10) of those with yolk sac tumor, 26.9% (7/26) of those with seminoma, and 57.1% (4/7) of those with teratoma. The expression levels of TDRG1 in the testis tissues of the seminoma and teratoma groups were shown to be significantly lower than that of the normal control (P < 0.01 and P < 0.05), but those of the embryonal carcinoma and yolk sac tumor groups exhibited no significant differences from that of the latter (P > 0.05).

CONCLUSION

The significantly reduced expression of the TDRG1 protein in patients with seminoma or teratoma indicates that TDRG1 may be a candidate cancer suppressor gene.

[Erectile dysfunction induced by pelvic fracture urethral injury]

OBJECTIVE

To explore the aetiology, diagnosis,and treatment of erectile dysfunction (ED) after a pelvic fracture urethral injury.

METHODS

Rigiscan and Duplex ultrasound were used to determine the causes of ED induced by pelvic fracture urethral injury in 29 patients and the therapeutic means were also analyzed.

RESULTS

Of the 29 patients, 1 was psychological, 28 were physical, 7 vascular, and 15 neurological. Rigiscan and Duplex ultrasound revealed the cause of erectile failure as neurogenic in 15. Twenty-three cases were effective by the therapy. The injection with vasoactive agents (prostagland in E1) was successful in 15, Viagra in 2, Befar in 5, and revascularization of epigastric artery-dorsal artery anastomosis in 1.

CONCLUSION

Disruption of the cavernous nerves lateral to the prostatomembranous urethra is the most likely cause of ED in this injury. Intracavernous injection of prostaglandin E1 is believed to be safe and effective for ED.

[Molecular analysis of polymorphisms for B-LII beta(beta 1 exon) locus in some Chinese native chicken]

Molecular genetic polymorphisms were studied for MHC-B-LII beta(beta 1 exon) locus in ten breeds of chicken by PCR-RFLPs. Thirty-seven genotypes were detected in these chicken. In the 305 bp fragment derived from MHC-B-LII beta(beta 1 exon) locus digested with Hha I, EcoRV, HaeIII, Xba I, there were significant difference with the frequencies of genotype and combined genotype among individuals or breeds. Statistical results showed Hardy-Weinberg equilibrium in polymorphic sites were inconsistent among various breeds. Sequencing results suggested there are more polymorphism at the level of amino acid than at that of nucleotide. Furthermore, as antigen binding site, the highly polymorphisms of beta 1 exon sequence was a reflection to the antigen diversity of immune systems. Moreover, it was implied that there was highly association between genetic polymorphisms of beta 1 exon and reproduction performance in chicken.

Analysis of Oct-4 expression and ploidy in individual human blastomeres

Oct-4, a decisive factor that maintains totipotency in murine embryonic and germ cells, is exclusively expressed in such cells. In mice, different levels of oct-4 expression in blastomeres predict development towards inner cell mass (ICM) (high oct-4) or trophectoderm (TE) (low oct-4). To address whether the mouse model also applies to human embryos, the cytoplasm of individual human blastomeres from normally and abnormally fertilized embryos was tested for Oct-4 expression by reverse transcription-polymerase chain reaction (RT-PCR). The nuclei of the same blastomeres were subjected to fluorescence in-situ hybridization (FISH) to determine ploidy. A significant difference in Oct-4 mRNA levels was revealed between blastomeres. The distribution of blastomeres with high Oct-4 levels varied according to the cleavage stage of the embryo: the more blastomeres, the lower the percentage with high Oct-4 levels. Aneuploid blastomeres did not exhibit lower Oct-4 mRNA levels than diploid ones. Thus, differential Oct-4 expression in individual human blastomeres appears to direct cells towards the ICM or TE lineages without regard to chromosomal status. Oct-4 might be used as a marker in preimplantation genetic diagnosis to identify embryogenic blastomeres.

[Huge benign mesenchymoma in the pharynx-esophagus]

OBJECTIVE

To investigate the diagnosis and management of the benign mesenchymoma in pharynx-esophagus.

METHOD

Records of 2 cases with the benign mesenchymoma, arising from the pharynx-esophagus, were reviewed.

RESULT

These tumors, their pedicle attached to the lateral pharynx or esophageal orifice and the body fall down to the esophagus, were large and solitary. Complete surgical resection is believed to be the most suitable treatment by lateral pharyngotomy.

CONCLUSION

The benign mesenchymoma in pharynx-esophagus is a rare disease which might be misdiagnosis. Diagnosis is based on typical histologic features as well as clinical information. The prognosis is favorable.

Successful outcome with day 4 embryo transfer after preimplantation diagnosis for genetically transmitted diseases

Preimplantation genetic diagnosis was performed in 61 day 3 embryos obtained by in-vitro fertilization from seven patient carriers of haemophilia, Marfan's syndrome, Bloch-Sulzemberg syndrome (incontinentia pigmentosa) or X chromosome-linked immune deficiency, retinitis pigmentosa, and FG syndrome, which is characterized by mental retardation and hypotonia. After multiplex polymerase chain reaction, 16 embryos were diagnosed as being unaffected, and these were transferred to the uterus on the following day (day 4). Of these embryos, six (37.5%) implanted, resulting in the delivery of a singleton and a twin pregnancy, a late second trimester miscarriage (twins at week 20) and a first trimester miscarriage at week 8. All the diagnoses were confirmed by amniocentesis. We report for the first time a late day 4 transfer of biopsied human embryos undergoing preimplantation genetic diagnosis. This transfer schedule allows an extra day to perform genetic analyses on single blastomeres and to monitor any adverse effect of the biopsy procedure.

Preimplantation genetic diagnosis of human embryos for Marfan's syndrome

PURPOSE

Single-cell nested polymerase chain reaction (PCR) and Ddel endonuclease digestion were used to detect the presence of a Marfan's syndrome mutation in human preimplantation embryos derived from in vitro fertilization (IVF). These procedures were conducted to eliminate the possibility of transmission of the affected allele from the father to his offspring. The mutation on chromosome 15 is transmitted as an autosomal dominant trait, and the chance of having a child affected with the disease is 50%.

METHODS

A couple presented to the Program for In Vitro Fertilization, Reproductive Surgery and Infertility for preimplantation genetic diagnosis. IVF was performed and embryo biopsy was done on day 3 embryos. Single blastomeres were removed from embryos and subjected to nested PCR analysis and endonuclease digestion to detect a Marfan's syndrome mutation located on chromosome 15 inherited from the father.

RESULTS

Thirteen oocytes were injected with spermatozoa using intracytoplasmic sperm injection, and nine fertilized normally. Following embryo biopsy and polymerase chain reaction amplification-Ddel endonuclease digestion, five embryos were detected that were positive for the mutation. The four non-affected embryos were transferred to the uterus, resulting in a healthy and normal ongoing pregnancy.

Update in preimplantation genetic diagnosis. Age, genetics, and infertility

PGD has been successfully used for several years. Over 40 babies have been born worldwide by use of these techniques. Unfortunately, a number of misdiagnoses have been made, a distressing consequence of a new frontier. Significant advances have been made to improve the efficiency and accuracy of PCR and FISH. The widespread use of this technology awaits further documentation of safety and accuracy. Other issues must also be addressed. First, the cost-effectiveness of the techniques relative to the traditional alternatives must be evaluated. A number of ethical issues regarding embryo screening must be addressed including what diseases are serious enough to warrant the procedure. Another concern is the use of this technology for nongenetic disorders such as gender selection. Finally, the experimental nature of these procedures must continually be discussed with patients, and long-term follow-up studies must be undertaken. Development of more accurate and less expensive assays coupled with improved IVF success rates may make PGD a more widely used clinical tool. The future awaits these developments.

Simultaneous detection of multiple gene expression in mouse and human individual preimplantation embryos

OBJECTIVE

To detect simultaneously multiple gene expression in mouse and human individual embryos by reverse transcriptase-polymerase chain reaction.

DESIGN

Transcripts involved in the insulin-like growth factor (IGF) system were detected in mouse and human preimplantation embryos.

SETTING

An academic teaching hospital.

MAIN OUTCOME MEASURE(S)

Transcripts of the IGF family genes.

RESULT(S)

In the mouse, genes are expressed differentially and messenger RNA transcripts of maternal origin in nonfertilized ova decline gradually until the initiation of the embryonic genome transcription. Insulin-like growth factor-binding protein-2 (IGFBP)-2, -3, -4, and beta-actin transcripts appear to be initiated at the two- to four-cell stage, whereas IGFBP-1, -5, and -6 transcripts are initiated at later stages. Transcription, once initiated, appears to continue through to the blastocyst stage. In humans, almost all genes of the IGF system were expressed in preimplantation embryos. This is the first report of the assessment of IGF family transcripts in individual embryos, and introduces a novel method for research and clinical diagnosis of preimplantation embryos.

Update in preimplantation genetic diagnosis: successes, advances, and problems

The field of preimplantation genetic diagnosis has undergone significant advances since the report of the first birth from this method in 1990. The first birth in the USA was reported in 1992, as was the first successful diagnosis and delivery of a baby free of a single gene defect disorder (cystic fibrosis and then Tay Sachs). Investigators have now reported approximately 40 births worldwide from preimplantation genetic diagnosis using the polymerase chain reaction and fluorescent in-situ hybridization methods to analyze single cells removed from early cleavage stage preimplantation embryos. The International Working Group on Preimplantation Genetics meets annually to discuss progress and pitfalls in this field. Although preimplantation genetic diagnosis offers hope to patients at risk of transmitting disease, there are many technical hazards of this experimental procedure. Technical difficulties must be overcome in order for preimplantation genetic diagnosis to become a standard clinical tool. This review will highlight some of the recent advances and problems in the field of preimplantation genetic diagnosis.

Biotransformation of alpha- and beta-ionones by immobilized cells of Nicotiana tabacum

Immobilized cells of Nicotiana tabacum reduced the carbon-carbon double bond adjacent to the carbonyl group and then the carbonyl group itself of the dienone compounds, alpha-ionone and beta-ionone. In addition, the selectivity for the reduction of the double bond adjacent to the carbonyl group could be enhanced by performing the biotransformation in medium with a pH near the optimal pH of the enone reductase which specifically catalyses the reduction of the alpha, beta-unsaturated double bond of s-trans-enones.

[Clinical and experimental study on Ligusticum wallichii mixture in preventing and treating bronchial asthma]

To investigate the significance of Ligusticum wallichii Mixture (LWM) and its possible therapeutical mechanism in bronchial asthma, clinical and experimental studies were carried out.

RESULTS

LWM inhibited bronchospasm induced by histamine and acetylcholine in guinea pigs; the plasma level of TXB2 was decreased remarkably and the incubation period from antigen inhalation to asthma attack could be delayed by LWM; the incidence of asthma and its mortality were reduced in guinea pigs, compared with control, P < 0.01. In addition, the prolonged period of induced asthma attack was negatively correlated to the plasma level of TXB2 in guinea pigs (P < 0.01). It was observed that the plasma level of TXB2 was decreased, the forced expiratory volume in 1 sec (FEV1%) was elevated significantly in asthmatic patients after they were treated by LWM. Moreover, the total effective rate was significantly better than that in the control (92% : 62%). It indicated that: (1) The effects of airway allergic inflammation (AAI) might be the important pathological basis for the bronchial asthma, (2) TXA2 might be an important inflammatory mediator in asthma which could be taken as an useful biochemical parameter for evaluating clinical effects, (3) LWM could relax tracheal smooth muscle, improve pulmonary function, inhibit the synthesis and release of TXA2 with no side effects.

Healthy deliveries from biopsied human embryos

Preimplantation genetic diagnosis was performed in 122 embryos obtained by IVF from 11 patients carriers of haemophilia, Duchenne's muscular dystrophy, Barth's syndrome, cystic fibrosis, Pelizaeus-Merzbacher syndrome or Rett's syndrome. After multiplex polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH) analysis with multiple probes, 28 embryos diagnosed as not affected were replaced. Of these, eight implanted (28%) and produced three ongoing pregnancies, three deliveries of four babies and a biochemical pregnancy. However, one case screened for cystic fibrosis was misdiagnosed and the pregnancy was terminated. In order to evaluate the efficiency of multiplex PCR, 55 non-replaced embryos were reassessed by PCR or by FISH. Identical results were obtained in all cases. However, one embryo which had only X-chromosome specific amplification by PCR was found to be XO in all its cells by FISH. Although multiplex PCR is demonstrated to be reliable for sexing of human embryos, FISH has the additional advantages of supplying ploidy assessment while not being affected by contamination.