Along with the application and development of the assisted reproductive technology in vitro fertilization and embryo transfer,the emergence of frozen embryos in the law,medicine,and ethics area are gradually increased.Two-child policy makes more older couples choose assisted reproductive technology,which will cause more disputes about frozen embryos.There is no unified conclusion of the legal status of human embryos,and there exists three main views of embryos namely property,person and intermediate state.Defined the legal status of frozen embryos as ethical substance,this paper analyzed the main position and possible legal and ethical issues involved in the disposal of frozen embryos through three typical cases.

Objective To investigate the prevalence of genes conferring aminoglycoside resistance in multidrug-resistant strains of Acinetobacter baumannii (MDR-ABA).Methods Multidrug-resistant A.baumannii strains were isolated during the period from August to November 2012 from patients in the affiliated hospital of Jiangsu University and the First Hospital of Zhen-jiang.Kirby-Bauer diffusion method was used to determine the susceptibility of these strains to antimicrobial agents.PCR was performed to detect the aminoglycoside resistance genes.Results The 36 MDR-ABA strains showed high resistance rates to most antimicrobial agents except cefoperazone-sulbactam.The prevalence of the genes conferring aminoglycoside resistance, aac (3)-I,aac (6’)-Ib,aph (3’)-I and armA,was 72.2% (26/36),72.2% (26/36),80.6% (29/36)and 80.6% (29/36), respectively.Conclusions The MDR-ABA strains in this study are highly resistant to antimicrobial agents,which is closely as-sociated with the genes conferring aminoglycoside resistance.

Objective:To evaluate the image quality of dual-source computed tomography pulmonary angiography (DE-CTPA) with low-dose contrast agent using the advanced modeled iterative reconstruction (ADMIRE) method with 70 kVp and non-linear blending in overweight patients.Methods:Seventy patients (normal BMI, 35; overweight, 35) with suspected pulmonary embolization who underwent DE-CTPA between October 2018 and March 2019 were included in this study. The imaging protocol included assessments at 70 kV/sn150 kV with 30 ml of contrast agent, and images were obtained at 70 kVp and 150 kVp with and without linear blending. The CT value, SD value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of pulmonary arteries were compared and analyzed among groups 1 (70 kVp, normal BMI), 2 (non-linear blending, normal BMI), 3 (70 kVp, overweight), and group 4 (non-linear blending, overweight). The radiation dose parameters included CT volume dose index (CTDI vol), dose length product (DLP), and effective dose ( E). Results:The CT values for the pulmonary artery did not show significant differences among the four groups ( P>0.05). The SD value of the segmental artery in group 1 was higher than that in group 4 ( t=2.69, P<0.05). The SNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.44, 5.40, P<0.05), while the corresponding value of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.52, 1.52, P<0.05). The CNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.45, 5.01, P<0.05) and that of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.50, 1.50, P<0.05). The E values for normal BMI and overweight patients were(1.60±0.54)mSv and(1.88±0.45)mSv, respectively. Conclusions:For overweight patients, the CTPA protocol using ADMIRE with a 70 kV/sn150 kV scanning mode could yield diagnostic image quality with significantly lower radiation and contrast material doses.

Objective:To analyze the clinical characteristics and risk factors of impaired liver and renal function in hospitalized patients with gout.Methods:A total of 494 hospitalized patients with confirmed gout were selected and divided into four groups according to liver and renal function, control(Con), impaired liver function (ILF), impaired renal function (IRF), and both function impaired (ILRF) group. Multivariate logistic regression was used to analyze the risk factors related with impaired liver and renal function.Results:Compared to Con group, ILF group were younger with shorter gout duration, higher body mass index, waist circumference, homeostasis model assessment for insulin resistance (HOMA-IR), serum uric acid, low density lipoprotein-cholesterol (LDL-C), total cholesterol, triglycerides, C reactive protein, higher prevalence of dyslipidemia, obesity, fatty liver, and monosodium urate crystal (MSU) deposition (all P<0.05). IRF group were older and with higher serum uric acid, serum creatinine, C reactive protein, and hypertension, MSU deposition prevalence, with lower prevalence of fatty liver (all P<0.05). Compared to ILF group, IRF group were older, with longer gout duration, lower level of body mass index, waist circumference, HOMA-IR, LDL-C, total cholesterol, triglycerides, lower prevalence of obesity, fatty liver, and higher prevalence of hypertension and type 2 diabetes (all P<0.05). The univariate logistic regression analysis showed that age( OR=0.941, 95% CI 0.906-0.977, P<0.001), serum uric acid ( OR=1.002, 95% CI 1.000-1.005, P=0.043), HOMA-IR ( OR=1.147, 95% CI 1.024-1.285, P=0.018), and MSU deposition ( OR=1.959, 95% CI 1.154-3.326, P=0.013) were the independent risk factors of impaired liver function, while the independent risk factors of impaired renal function were age ( OR=1.104, 95% CI 1.048-1.162, P<0.001), serum uric acid ( OR=1.007, 95% CI 1.004-1.010, P<0.001), and MSU deposition ( OR=2.393, 95% CI 1.191-4.805, P=0.014). Conclusions:Serum uric acid and MSU deposition are the common independent risk factors for impaired liver and renal function in patients with gout. Younger patients with insulin resistance are susceptible to impaired liver function, older patients with hypertension and diabetes are susceptible to impaired renal function.

Objective: To explore the effect of different midwifery methods on the pelvic floor function of parturients and nursing experience. Methods: From January 2018 to December 2018, 200 cases of vaginal delivery in Enze Obstetrics and Gynecology Hospital of Taizhou Hospital were selected as study objects.According to the random number table method, they were divided into non-invasive midwifery group and traditional midwifery group, with 100 cases in each group.The non-invasive midwifery group adopted non-invasive midwifery, while the traditional midwifery group adopted traditional midwifery.The pelvic floor muscle strength, pelvic floor muscle dysfunction and postpartum hemorrhage were observed in the two groups. Results: There was no statistically significant difference in pelvic floor muscle strength between the two groups in grade 0, grade Ⅰ, grade Ⅱ, grade Ⅲ and grade Ⅳ(all P>0.05). The pelvic floor muscle strength of the observation group in grade Ⅴ (45.00%) was higher than that of the control group (31.00%), the difference was statistically significant (χ²=4.160, P<0.05). The incidence of sexual dysfunction (15.00%) and stress urinary incontinence (28.00%) in the observation group were significantly lower than those in the control group (41.00%, 54.00%) (χ²=16.766, 13.973, all P<0.05). The amount of bleeding 2 hours after delivery in the observation group [(245.93±19.89)mL] was less than that in the control group [(297.42±24.21)mL] (t=16.433, P<0.05). Conclusion Non-invasive midwifery has little effect on the pelvic floor function of parturients, and the incidence rate of sexual dysfunction and stress urinary incontinence is low, and the amount of bleeding is small, which is worthy of clinical reference.