Objective To investigate the influence of laparoscopic cholecystectomy (LC)versus open cholecystectomy (OC)on postopera-tive systemic infection and immune response in patients with acute cholecystitis complicated by choleperitonitis.Methods A prospective randomized controlled trial was performed for 45 patients who had a definite diagnosis of acute calculous cholecystitis complicated by cho-leperitonitis in Shanghai Liqun Hospital from January 2014 to June 2016.According to surgical procedures,the patients were randomized in-to LC group (23 patients)and OC group (22 patients).The length of hospital stay,postoperative complications,and deaths were evaluated in both groups.Blood samples were collected from all patients before surgery and at 1,3,and 6 days after surgery to compare the changes in neutrophil count,serum levels of C -reactive protein (CRP)and interleukin -6 (IL -6),and erythrocyte sedimentation rate (ESR),as well as the incidence of endotoxemia.The t -test was used for comparison of continuous data between groups,and the chi -square test was used for comparison of categorical data between groups.Results The LC group had a significantly shorter length of hospital stay than the OC group (5.4 ±2.7 d vs 10.2 ±3.5 d,t = -5.46,P <0.001).One patient (4.3%)in the LC group and 6 (27.3%)in the OC group ex-perienced peritoneal abscess after surgery,and there was a significant difference in the incidence rate of complications between the two groups (χ2 =4.77,P =0.03).In all patients,the mortality rate was 17.8% (8 /45),with 1 (4.3%)in the LC group and 7 (31.8%)in the OC group,and there was a significant difference between the two groups (χ2 =5.16,P =0.02).Of all patients in the OC group,4 died of peritoneal abscess,1 died of pulmonary embolism,and 1 died of myocardial infarction;of all patients in the LC group,1 died of my-ocardial infarction.There were no significant differences in inflammatory markers before surgery between the two groups.At 1,3,and 6 days after surgery,the LC group had significantly lower neutrophil count,serum levels of CRP and IL -6,and ESR (except at 1 day after surger-y)than the OC group (all P <0.05).Furthermore,the OC group had a significantly higher concentration of endotoxin than the LC group (P <0.05),but the level of endotoxin returned to normal at 2 days after surgery in both groups.Conclusion Compared with OC,LC can reduce the probability of endotoxemia,help with the establishment of immunological defense,and reduce the risk of postoperative infection.

Clinical data management,a critical part of clinical trials,plays a decisive role in assuring the accuracy and reliability of the trail results.This article discusses the quality standards of clinical data,introduces the important rules and principles for standardized clinical data management,and reviews the development and current status of clinical data management home and abroad.It is proposed that we should learn the advanced clinical data management modes from international partners and introduce standardized clinical management software from abroad,so as to improve the clinical data management in China.

Objective To transform the equipment with traditional RS232 interface into that with CAN connection interface.Methods On the CAN main line,node is the station for information receiving and transmission in the network.The intelligent node can establish the work way ID,the address and the baud rate through the programming.It is mainly composed by the singlechip and the programmable CAN correspondence controller.Results The hardware and software were designed.SJA1000 initialization,transmission and receiving subroutines are including in the software design.Conclusion CAN is a kind of excellent field bus with high reliability,low cost and has been applied in many fields.It has already formed the international standard and been viewed as one of the most widely used field buses in future.Lots of traditional equipment with RS232 interface are facing the problem of CAN interface transformation.

Objective: To study the group consultation in preventing psychological disorders causing by retirement. Methods: Implement group consultation to 23 elderly staff members from a government organization. Both the self-designed health knowledge and SCL-90 questionnaires were used before and after he/she participated the group consultation. Comparisons were conducted of the results getting from 18 old people who had never had the consultation. Results: There was significant difference in two groups. Experiments show that group consultation can impressively held to improve the psychological and behavior disroders. Conclusion: Group consultation is an effective way to prevent psychological problems causing by retirement.

Objective: To study an epidemiological methodology for domestic violence. Methods:A program was drawn,the epidemiological instruments were developed, investigators were trained, not only according to the principles of epidemiology but also being suited to Chinese condition. Then,We win over the support of government bodies, arouse the messes to action, and all clues from investigation were confirmed by interview with persons concerned.Spot check randomly was used for control of quality.Results:The reliability of the epidemiological instruments was 97%, the sensitivity was 95%, the specificity was 100%. The prevalence of domestic violence in life-time and past year was 16.2% and 11.6% respectively.Conclusion:This was a practical methodology in epidemiological survey for domestic violence in China.

OBJECTIVE:To determine camphor in compound menthol nose drop by RP-HPLC.METHODS:Waters No-va-pak C 18 was taken as the chromatographic column,the mobile phase was composed of chloroform-methanol-water(14∶52∶30)with a flow speed at1.0ml/min and detection wavelength at289nm,the column temperature was35℃.RESULTS:The linear range for camphor was0.8～5.6?g/ml(r=0.9998)and the average recovery rate was99.4%(RSD=0.7%).CONCLUSION:The method is specific,convenient and accurate,which can be used for the quality control of the preparation.

Objective To analysis the victim's help-seeking behavior of domestic violence. Methods Using a multi-stage sampling strategy,306 victims of domestic violence were randomly selected and face-to-face interviewed. A self-designed help-seeking questionnaire of domestic violence was administered. Results 33.7%victims felt nowhere to seek help. The three leading helpers they seek were the other family member (34.6%),neighbor and friend( 17.0% ) and community office ( 12.5% ) ,and the community office had highest prevalence of effect (71. 1% ). The prevalence of seeking help from other family member and Women's Federation were highest in urban victims (P＜0.01) ,and seeking help from community office was highest in rural victims (P＜0.01). The three leading helpers were other family member (27.3%) ,community office ( 15.8% ) and neighbor and friend ( 10.9% ) by male victims, and other family member ( 38.0% ), neighbor and friend ( 20.0% ) and community office ( 10.8% ) by female victims. The prevalence of seeking help from neighbor and friend was higher in female than in male ( 20.0% vs 10.9%, x2 = 3. 980, P＜ 0.05 ). Adult victims seek help from other family member were less than children and the elderly (31.6% vs 42.0% and 46.9%, x2 =5.993, P＜0.05),and the elderly seek help from community office were more than adults and children (28.1% vs 12. 1% and 4.0%, x2 =9.930, P＜0.01 ). The victims with higher level of education were with higher prevalence of feeling nowhere to seek help (47.8%). Seeking help from other family member and community office were most in victims with lower level of education( 38.5% and 24.0% ,respectively) and were least in victims with higher level of education ( 17.4% and 0,respectively, P ＜ 0.05, P ＜ 0. 01 ). Conclusion Help-seeking behaviors of victims of domestic violence are varied by geographic settings,age,gender and education levels.

Objective To review the experience on screening,diagnosis and treatment for neonatal congenital hypothyroidism (CH)in Xuancheng City,Anhui Province.MethodsFrom Jan 2008 to Dec 2014,peripheral blood samples from the heel were collected among 83787 neonates and the blood samples were sent to the screening center to test the level of thyroid stimulating hormone (TSH).Neonates with abnormal level of TSH were admitted to our hospital for further TSH and free tetraiodothyronine (FT4 )tests. Neonates with CH diagnosis were given standard treatments of levothyroxine and their thyroid function, physical and intelligence development were evaluated on a routine basis.Results Among the 106 neonates with abnormal TSH level ,68 were diagnosed CH.The prevalence of CH in Xuancheng City was 0.8 ‰.All 68 patients with CH received levothyroxine treatment and 6 cases were lost during follow-up.44 patients received physical examination and their bone ages were normal. 53 patients received intelligence assessment.Only 1 of them was diagnosed of mental retardation, and 3 with suspicious mental retardation.Conclusion Neonatal screening is necessary for the early diagnosis and treatment of CH. Neonates with CH can have normal physical and mental development if they receive standard treatment as early as possible and followed up regularly.

Objective To compare the effects on neurobiological factors of attributional retraining group therapy (ARGT) or selective serotonin reuptake inhibitors (SSRI) for major depressive disorder (MDD),anxiety disorder (AD) and obsessive-compulsive disorder (OCD).Methods Outpatients with MDD,AD and OCD were divided into ARGT group (n =63) and SSRI group (n =66) according to the sequence of entering the study.MDD,AD and OCD patients were respectively measured with Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after 8 weeks treatment.All subjects were detected of plasma serotonin,norepinephrine,cortisol and adrenocorticotropic hormone by radioimmunoassay before and after treatment.Results After treatment,HAMD scores of MDD patients were reduced significantly in both ARGT group (t =18.411,P =0.000) and SSRI group (t =20.092,P =0.000) ; HAMA scores of GAD patients were reduced significantly in both ARGT group (t =13.989,P=0.000) and SSRI group (t=15.815,P=0.000) ;Y-BOCS scores of OCD patients were reduced significantly in both ARGT group (t =5.465,P =0.000)and SSRI group (t =4.792,P =0.000).In ARGT group,MDD (t =3.145,P =0.006),AD (t =2.785,P =0.012) and OCD patients (t =2.877,P =0.011) decreased plasma cortisol concentrations significantly.In SSRI group,MDD (t =-2.923,P =0.010) and OCD patients (t =-2.301,P =0.035) improved plasma serotonin significantly and MDD patients (t =-2.333,P =0.033) improved plasma norepinephrine significantly.Conclusion ARGT can modulate plasma cortisol level.SSRI can up-modulate plasma serotonin level.The two therapies take effect by different biological ways.

As the final link of quality evaluation of postgraduates'cultivation,academic oral defense system should be strictly organized to promote the training quality. Many problems such as formality of pre-defense,high proportion of personal relations and difficulty invitation for defensive experts exist in the current academic oral defense system. Aiming at the problems,the author puts forward corresponding countermeasures for the actual improvement including establishment of defensive experts bank,double-blind evaluation system of papers ,twice arrangements of pre-defense and unified organization of defensive experts on hospital level.