Normative ethics is an important ethic theory that has been applied in contemporary medical ethics as principles and rules.Normative ethics can guide the doctors and the nurses to do a right behavior in medical practice effectively,but at the same time it has some limitation.Those limitation are mainly about a conflict from different moral norms and a demand for too perfect moral realm,which make the doctors and the nurses often meet a moral dilemma,and sometimes their working enthusiasm would be dampened.Virtues ethics is a different ethic theory that has some advantage such as consistence,stability and flexibility,so it can give us a more wide space of mind to perfect our medical moral theory.If we wish benevolence,justice and other virtues come true widely in medical practice,we should to rethink our professional moral education and to set a series of good rules and regulations.I believe our country's doctors and nurses would take shape a prevalent professional virtue when virtue ethics have been accepted as a important ethic theory.

Objective To analyze the water quality of the swimming pools in Yinchuan City from 2002 to 2005 and to know the sanitary states of the swimming pools, so as to prevent water-born infection effectually. Methods pH, turbidity, carbamide, free chlorine residual, coli group and total bacterial count in the water samples were determined. Results 664 water samples were tested, 252 water samples were qualified(the rate was 37.93%). From 2002 to 2005, the rates of up to standard were 29.08%, 22.83%, 40.48% and 50.00%, the difference was significant(?2=30.74, P

Objective To study the clinical effect, safety of stains collapse of traditional Chinese medicine (TCM) combined with tumor necrosis factor-alpha (TNF-α) antagonist-a recombinant human tumor necrosis factor receptor:Fc fusion protein (rhTNF:Fc) and sulfasalazine (SSZ) in treatment of active ankylosing spondylitis (AS). Methods A total of 98 patients of AS of Gansu Provincial Hospital were divided into two groups in random, the western medicine group (rhTNF:Fc and SSZ, n=46) and the combining group (stains collapse of TCM, rhTNF:Fc and SSZ, n=52). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Patient Global Assessment (PGA), Visual Analogue Scale (VAS) of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground,
thoracic activity, Schober test, and erythrocyte sedimentation rate (ESR), C reactive protein (CRP), adverse reactions before and after treatment were observed and the clinical effect was evaluated in two groups. Results A total of 86 patients achieved the study finally, 45 patients in the combining group and 41 patients in the western medicine group. The effective rate of ASAS20 was better in the combining group than that in the western medicine group(χ2=4.814,P=0.028), the Bath ankylosing spondylitis disease activity index (BASDAI) 50 showed no significant difference between the two group (χ2=0.100,P=0.752). The total effective rate in the combining group than that in the western medicine group(χ2=3.873,P=0.049). In comparison with the same group before treatment, the above indicators were improved after treatment (P<0.05). In comparison with the western medicine group after treatment, BASFI, PGA, VAS of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground and Schober test were getting better in the combining group (P<0.05), but BASDAI, thoracic activity, ESR, CRP were not improved in the combining group (P>0.05). The adverse reactions showed no significant difference (P>0.05). Conclusions Stains collapse of TCM combined with rhTNF:Fc was more effective than single method in treatment of AS, it can alleviated the symptoms, body signs and body function, decrease indexes of inflammation, which has dramatic effect and good safety in clinic.

Informed consent is an important medical ethical principle,which has been widely applied in clinical treatment and medical research.However,it is not fully applicable in epidemic prevention and control.The public characteristics of the technical means and governance measures of epidemic prevention and control have led to the lack of some elements of informed consent or changes in ethical standards.The principle of informed consent plays an important role in safeguarding individual rights and interests,therefore its practical value can't be ignored.One of the solutions is to redefine the connotation and practice path of informed consent,including emphasizing the combination of group-informed and individual-informed in the informed process,as well as grasping the boundaries of autonomy,and clarifying the way and scope of legal consent in the process of consent,so as to construct a paradigm of informed consent principles applicable to epidemic prevention and control work.

Medical practice not only requires medical staff to use technical means to alleviate patients'physical pain,but also to provide comprehensive care on the psychological,social,and spiritual levels.Therefore,medical staff need to have medical care capability.Medical care capability is the sum of psychological tendencies and behavioral characteristics required by medical staff to carry out care activities.It is also an important means to achieve medical goals and includes three elements:motivation,knowledge,and action methods.As a behavioral ability with altruistic characteristics,reasonable motivation is a prerequisite for implementing medical care.Meanwhile,it also requires the support of medical humanities and technical knowledge.The mode of action is the ultimate manifestation of medical care capability,including technical operations,effective communication,and the construction of social support systems.China's medical education has long neglected the cultivation of this professional ability.Therefore,systematic reforms need to be made,including emphasizing the practicality of medical professional virtues in educational concepts,reforming teaching content to improve caregiving ability,and enriching teaching methods and evaluation methods,thus effectively promoting the formation and improvement of medical care capability among medical students.

Objective:To explore the clinical characteristics and variant of CREBBP gene in a fetus with Rubinstein-Taybi syndrome (RSTS). Methods:A fetus with RSTS diagnosed at the Third Affiliated Hospital of Zhengzhou University in August 2022 was selected as the study subject. Clinical data, amniotic fluid sample of the fetus and peripheral blood samples of its parents were collected for whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing.Results:Foot malformation, cerebellar vermis agenesis, brain agenesis, polysyndactyly of the big toes and other phenotypes were found by prenatal ultrasound. WES revealed that the fetus has harbored a heterozygous c. 4684G>T (p.E1562*) variant in exon 28 of the CREBBP gene (NM_004380.3), which was de novo in origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic (PVS1+ PS2_Moderate+ PM2_Supporting). After genetic counseling, the couple had opted to terminate the pregnancy and refused autopsy for the fetus. Conclusion:The c. 4684G>T (p.E1562*) variant of the CREBBP gene probably underlay the RSTS in this fetus. The newly discovered variant has enriched the mutational spectrum of the CREBBP gene and illustrated that WES is an efficient tool for the prenatal diagnosis of RSTS.