Due to the special nature of mental patients and psychiatric drugs,we have to recruit mental patients as subjects in psychiatric drug clinical trials.In the process of the experiments,there exist ethical problems.For example,the right of life and health is threatened,the informed consent is insufficient,and the privacy of the subjects cannot be protected.This paper ethically analyzed them,explored the ethical principles,and proposed some objective and feasible countermeasures,in order to promote the development of medicine and health care and protect the rights of mental patients in psychotropic drug clinical trials.

Objective To compare the effects of laparoscopy and open operations on high ligation of internal spermatic veins for varicocele. Methods A retrospective study was conducted to look into the clinical data of 38 cases having undergone laparoscopic high ligation of internal spermatic veins and 46 cases having undergone open operations for high ligation. Results The two methods presented no significant differences in bleeding , operation time and hospital stay (P > 0.05);Both groups were fast in postoperative recovery, without any recurrence, atrophy of testis and hydrocele. Conclusions The endoscopic high ligation of internal spermatic veins is equal to open operations for varicocele.

Objective To study the single nucleotide polymorphisms (SNPs) in IL-23R gene in Chinese Han population with ankylosing spondylitis (AS). Methods SNPs rs11209026, rs1343151, rs11209032 and another three SNPs near them based on their physical distances were genotyped by PCR-directed sequencing. Hardy-Weinberg equilibrium, genotypes and allele frequency analysis were analyzed by SPSS 13.0. Linkage disequilibrium and haplotype analysis were carried out by SHEsis software. Results The difference of genotypes of rs11209032 and the difference of genotypes and allele frequencies of rs6677188 between patients and controls were statistically significant (P＜O.01) ; The two SNPs rs11209032 and rs6677188 had strong linkage disequlibfium (D'=0.925, r2=0.561 ). Haplotype analysis had shown a higher proportion of GAC haplotype in patients and a higher proportion of GTC haplotype in controls. Conclusion These results suggest that IL-23R polymorphisms is associated with susceptibility to AS in Chinese Han population and IL-23R gene may be a susceptible gene of AS.

Objective To search for the genetic and molecular immunity basis of CXCR-1 associated pathogenesis in ankylosing spondylitis (AS) patients. Methods Sequencing analysis was used to detect mutation in the exonic, junctional and promoter sequences of CXCR-1 which might be related with ankylosing spondylitis; the hydrophobicity, conservation and evolutionary distance of the mutated amino acids were also analyzed. Results Six affected individuals in the family were detected with a novel mutation Arg192Gly. The glycine at 192 codon was highly conserved in different species. Arginine and glycine had quite distinct hydrophobicity and BLOSUM score. Conclusion The mutation CXCR-1 (Arg192Gly) detected in these patients might be involved in genetic and molecular immunity mechnisms of ankylosing spondylitis.

Objective To explore the application value of preoperative methylene blue staining in locating for the operation of intraspi-nal tumors. Methods The clinical data of patients with intraspinal tumors from September 2010 to September 2012 in our hospital were ret-rospectively analyzed. The patients were divided into tag group and control group according to whether stained by methylene blue or not. The operation time( min) ,intraoperative hemorrhage,the rate of total resection of tumor,spinal instability rate,tumor recurrence rate,and reopera-tion rate of two groups were compared. Results The operation time of tag group was significantly shorter than that of the control group. The amount of intraoperative bleeding was significantly less than that of in control group, the differences were statistically significant(P<0. 05). The total resection rate of tumor was significantly higher than that in control group,the differences were statistically significant(P<0. 05). The spinal instability rate,tumor recurrence rate and operation rate of patients within 1 year in two groups were not significant. Conclusion The methylene blue method is simple and convenient,and provides favorable conditions for the operation,which reduces the operation time and intraoperative hemorrhage,increases the rate of complete tumor resection. There was no difference in recurrence rate,operation rate and the stability of the spine within 1 year compared to traditional method.

Objective To validate the discriminatory capacity of the new ankylosing spondylitis disease activity scores (ASDAS) in Chinese ankylosing spondylitis (AS) patients, and assess its clinical value. Method One hundred and twenty-nine patients with AS was included in the study, in which 87 were par-ticipat clinical trials with Etanercept (n=87) and 42 were participants of clinical trails with. The disease activity and treatment effecticacy were assessed by ASDAS, BASDAI and patient global assessment. Discriminatory ability of all the measures was analyzed as standardized mean difference (SMD) and (-score. Pearson's correlation, two indepen -dent samples t test and simple linear regression model were used for statistical analysis. Result The four ASDAS scores correlated well with patient global assessment (r=0.56～0.74), ESR (r=0.50～0.80) and CRP (r=0.50～0.69) both at baseline and the changes form baseline to 6 weeks after treatment. The four ASDAS outperformed BASDAI, patient global assessment, ESR and CRP in differentiating patients with different levels of disease activity and patients with different levels of change. There was little difference in performance between the four ASDAS versions. Conclusion The four ASDAS are highly discriminatory in evaluating the disease activity and the efficacy of drugs in Chinese AS patients, showing a significant value in clinical practice.