Two cases, prenatal genetic testing for deafness and newborn genetic testing for diseases and talent, were firstly introduced. And then, the author analyzed the ethical issues in these cases, such as question about ge-netic testing technologies, freedom of genetic testing in clinical obstetrics, role of obstetricians in genetic testing, problems about informed consent, and harms to doctor-patient relationship, and so forth. Finally, it put forward some suggestions on commercial genetic testing in obstetric practice.

Objective To observe the results of melatonin combined with alprostadil in the treatment of patients with acute pancreatitis.Methods Seventy patients with acute pancreatitis were included in the study,14 patients died after conventional treatment were set to group Ⅰ ,28 patients cured after conventional treatment were set to group Ⅱ and 28 cases cured after melatonin combined with alprostadil and conventional treatment were set to group Ⅲ.White blood cell count,blood gas analysis,serum amylase,endotoxin and malondialdehyde (MDA) content was detected at 6 h,48 h and 4 d.Results White blood cell count,serum amylase,endotoxin,MDA content at 6 h,48 h and 4 d in group Ⅰ were higher than those in group Ⅱ ,Ⅲ (P＜0.05).Endotoxin levels reached a maximum in the 4 d [(273.5 ± 20.4) pg/L],and MDA content reached a maximum in the 4 d [(5.12 ± 0.87) μmol/L].White blood cell count,partial pressure of carbon dioxide in artery (PaCO2),serum amylase,endotoxin and MDA content at 48 h,4 d in group Ⅲ were lower than those in group Ⅰ,Ⅱ (P <0.05).Conclusions Melatonin combined with alprostadil not only shows antioxidant,anti-inflammatory,anti-apoptotic effect but also improves the pancreas,lung,small intestine microcirculation,protects the cell membrane and the lysosomal membrane,and prevents effectively the pancreatic digestive enzymes release; also it inhibits intestinal bacterial translocation,reduces the generation of gut-derived endotoxin and pro-inflammatory cytokine release.It can reduce effectively the systemic inflammatory response in acute pancreatitis.

This article selected several typical clinical cases, analyzed many factors affect the doctor-patient relationship of ethical issues and new technology of differentiating the ethical dilemma for clinical application, and put forward some suggestions for the reference of medical staff , hospital ethics committees and health policy makers.

In recent years , with dramatic increase of the number of clinical studies , researchers and ethical committees face with the new challenge of ethical issues about protection of subjects .Based on the experience of previous ethical review , this article summed up a few typical cases of clinical research , involving the practical ethi-cal issues, such as the goal of research , informed consent, and compensation for damage caused by research .And then it analyzed the ethical issues in these cases , and proposed some suggestions for the reference of clinical re-searchers , ethical committees and policy makers .

Objective To evaluate the efficacy of heat sensitive moxibustion plus herbal hot compress for primary dysmenorrhea. Methods Ninety patients with primary dysmenorrhea were randomly allocated to a treatment and a control group, with 45 patients in each group. The treatment group was treated with heat sensitive moxibustion plus herbal hot compress, and the control group received ibuprofen (slow-release capsule) for three menstrual cycles. Results At the end of the first menstrual cycle, the total instant effective rate in the treatment group was significantly higher than that in the control group (95.6%vs. 82.2%;χ2=4.050, P<0.05);at the end of the third menstrual cycle, healing rate (66.7% vs. 35.6%; χ2=8.720, P<0.05), total effective rate (97.8%vs. 80.0%;χ2=7.200, P<0.05) in the treatment group were significantly higher than those in the control group;at 6 months follow-up, the relapse rate in the treatment group were significantly lower than that in the control group (6.7% vs. 43.8%; χ2=4.050, P<0.05). Conclusion Heat sensitive moxibustion plus herbal hot compress is a effective approach for primary dysmenorrhea.

This paper analyzed medical dispute litigation from the view of game theory.The adoption of mediation strategy for both hospital and patient was the Pareto optimal of this model.The adoption of court decision for both hospital and patient was the Nash equilibrium and its overall benefit was the Pareto suboptimal of this model.The communication of patient's lawyer can prompt the reconciliation between hospital and patient.On the one hand,it let the hospital realize the responsibilities they should bear,on the other hand let patients be willing to make concessions on the basis of the original claims,and finally made the two sides reach a reconciliation agreement,thus to make conflict between hospital and patient end in litigation and the overall benefits maximize.

On the basis of the investigation of the status of doctor-patient relationship in ten cities of China,this article ethically analyzes and studies the situation of trust between doctors and patients,clarifies the lack of trust inevitable and the environmental factors of trust,and puts forward the corresponding proposal.

It is shown by the typical investigation on the status of doctor-patient relationship in ten cities of China that doctor-patient relationship is generally harmony and relative better,and it is affected by many important factors including governmental policy,hospital and staff,and patient aspects,so it is injustice for hospital and staff to be excessively criticized.This article mainly analyzes the factors of hospital and staff and advances the corresponding countermeasure.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.