This paper summarized the current ethical dilemmas of living will in our country including life ethical dilemmas, medical ethical dilemmas and family ethical dilemmas, and then proposed several suggestions for the promotion of living will in China:strengthening the theoretical research on related contents of living will, increasing the intensity of death education, carrying out related activities in the communities, strengthening the policy support and establishing hospital or regional pilots, to provide the feasible problems for the advancement of our country's living will.

Objective To explore the normal reference range of fetal gallbladder in 28 to 35 weeks of pregnancy under magnetic resonance imaging characteristics, observe and explore the growth and development of fetal gallbladder, and provide a new detection method for evaluating fetal growth and development for prenatal examination. Methods One hundred single pregnant women who had underwent fetal abdominal magnetic resonance imaging from June 2017 to May 2018 in Dalian Municipal Women and Children′s Medical Center were selected. The pregnant women were divided into 2 groups according to the gestational weeks: group A (pregnancy 28 to 31 weeks, 64 cases) and group B (pregnancy 32 to 35 weeks, 36 cases). The length, width and transverse diameter of fetal gallbladder were measured by magnetic resonance, and the gallbladder volume was calculated. Results In group A, magnetic resonance result showed that 1 case had no gallbladder and 1 case had double gallbladder, but the fetal gallbladders of these 2 cases were normal after birth. The display rate of fetal gallbladder in group A was 98.4% (63/64), and that in group B was 100.0% (36/36); the abnormal rate in group A was 3.1% (2/64), and that in group B was 0. The length, width, transverse diameter and volume of gallbladder in group B were significantly higher than those in group A: (16.5 ± 6.0) mm vs. (13.2 ± 4.2) mm, (6.5 ± 3.5) mm vs. (5.2 ± 1.1) mm, (6.8 ± 2.6) mm vs. (6.4 ± 3.4) mm and (373.3 ± 284.1) mm3 vs. (258.5 ± 232.4) mm3, and there were statistical differences (P＜0.05). Conclusions Fetal magnetic resonance during lategestation has the new means of prenatal evaluation of fetal growth and development, which has clinical application value.

Objective:To investigate the variation of reference ranges of hemodynamic parameters in normal pregnancy and their relation to maternal basic characteristics.Methods:A total of 598 healthy pregnant women who underwent regular prenatal examination at the Third Affiliated Hospital of Guangzhou Medical University from January to December 2023 were prospectively enrolled, and noninvasive hemodynamic monitors were used to detect changes in hemodynamic parameters of the pregnant women with the week of gestation, including cardiac output (CO), stroke volume (SV), thoracic fluid content (TFC), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR). Relationships between hemodynamic parameters and maternal basic characteristics, including age, height, and weight, were analyzed using restricted cubic spline.Results:(1) CO ( r=0.155, P<0.001), TFC ( r=0.338, P<0.001), MAP ( r=0.204, P<0.001), and HR ( r=0.352, P<0.001) were positively correlated with the week of gestation, and SV was negatively correlated with the week of gestation ( r=-0.158, P<0.001). There was no significant correlation between SVR and gestational age ( r=-0.051, P=0.258). (2) CO exhibited a positive correlation with maternal height and weight (all P<0.001). The taller and heavier of pregnant women, the higher their CO. A linear relationship was observed between maternal weight and SV, MAP and HR (all P<0.01). As maternal weight increased, SV, MAP and HR showed an upward trend. Furthermore, there was an inverse association between maternal age and SVR ( P<0.001). (3) There was a significant nonlinear association observed between TFC and body mass index during pregnancy ( P<0.05). Additionally, a nonlinear relationship was found between SVR and MAP in relation to maternal age (all P<0.05). Notably, when the age exceeded 31 years old, there was an evident upward trend observed in both SVR and MAP. Conclusions:The hemodynamic parameters of normal pregnant women are influenced by their height, body weight, and age. It is advisable to maintain a reasonable weight during pregnancy and give birth at an appropriate age.