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.

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 .

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.

Various reasons are responsible for the current tension and conflicts in physician-patient relationship,in which media factors contribute a lot.It is of great significance for promoting the construction of a harmonious society and soothing physician-patient conflicts to conduct research on media factors affecting current physician-patient relationship and seek for relevant countermeasures.

y of care,in an effort to build a better doctor-patient relationship.

【Objective】 To study the incidence, possible etiology, diagnosis and prognosis of endometrial carcinoma with multiple primary carcinom a. 【Method】 45 cases of EC with other primary tumors were eligible for the ret rospective study. 【Results】 Of 1389 cases with EC, the rate of EC accompanied wit h other primary carcinoma was 3.2% (45/1389); the interval between two tumors d iagnosed was ranged from 8 months to 19 years. The percentage of interval more t han 5 years accounted for 62% (16/26). Among these 45 patients, the percentage o f EC complicated by other reproductive tract tumor was 53%(24/45), of them, 19 were synchronous carcinoma. The rate of EC with breast cancer and colo-rectal carcinoma were 169%(7/45), and 11%(5/45) respectively. Clinical staging for pati ents with EC plus multiple primary malignancy were 30 with stage Ⅰ, 9 stage Ⅱ, 3 stage Ⅲ and 2 stage Ⅳ. All patients with first primary tumors were treated by radical treatment. While 8 cases were also treated by radiation and 6 cases t reated by chemotherapy. In this group, all multiple primary tumors were treated by radical therapy. The overall 5-year survival rate was 63%. 【Conclusions】 ①The possibility of second primary tumor, such as female reproductive tract tu mor , breast cancer, and colo-rectal carcinoma should be considered in the patients with EC. ②The etiology of EC with multiple primary tumor may be relevant to th e same embryonic histogenesis, estrogen receptor, radiotherapy and chemotherapy.

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.