Primary gallbladder cancer is a relatively common biliarv malignant tumor but with a high mortality rate.Most patients with this disease reach an advanced stage when late onset symptoms occtur, and the prognosis tends to be poor even after radical operation.Searching for new diagnostic approaches of primary gallbladder, standardizing treatment strategy, conducting multieenter clinical trials of new drug, developing preventive measures according to different situations are significant methodls to improve the treatment effect prognosis.In this article, we reviewed the research progress of high risk factors, diagnostics, and treatment strategies of primary gallbladder cancer.

Objective To investigate clinical significance of serum retinol -binding protein(RBP)in chron-ic hepatitis B(CHB)and liver cirrhosis after hepatitis B infection(LC).Methods 109 hospitalized patients were involved in this study.They were 51 patients with CHB,58 patients with LC.56 healthy individuals were selected as the the health controls(HC).RBP,ALT,AST,GGT,LDH,TBIL,PA and ALB were analyzed by automatic biochemical analyzer.Results Decreased serum RBP was observed in patients with CHB and LC(CHB vs.HC:t =8.06,P <0.01;LC vs.HC:t =10.26,P <0.01).In addition,the concentration of serum RBP in group of LC was lower than that in CHB(t =3.41,P <0.01).RBP was positively correlated with PA in patients with CHB and LC(CHB:r =0.856,P <0.01;LC:r =0.737,P <0.01),and RBP was positively correlated with ALB in patients with CHB and LC (CHB:r =0.571,P <0.01;LC:r =0.328,P <0.05).ROC analysis showed that area under the receiver operator characteristic curve(AUC)in CHB and LC were 0.874 and 0.942,respectively.Conclusion Serum RBP decreases significantly in patients with CHB and LC.Serum level of RBP is associated with severity of liver diseases and maybe a potential prognostic index for liver disease.

Objective To study the MRI findings of spinal hemangioblastomas.Methods The MRI findings of spinal hemangioblastomas proved pathologically in 29 cases (20 males,9 females) were retrospectively reviewed.Results The lesions were single in 12 cases (41.4%) and multiple in 17 cases(58.6%).Seven patients combined with intracranial hemangioblastomas.On unenhanced MRI,36 tumors were isointense on T 1WI and T 2WI,16 were mixed iso-hypointense on T 1WI and mixed iso-hyperintense on T 2WI,one was hypointense on T 1WI and hyperintense on T 2WI.Small hemangioblastomas tended to be isointense on T 1WI and T 2WI.After contrast injection,all tumors enhanced markedly and homogenously with clear borders.21 tumors in 17 patients had associated vascular flow voids on T 2WI.40 tumors in 27 patients were associated with syringes or cysts.Conclusion Hemangioblastomas of the spinal cord are often multiple and in company with intracranial hemangioblastomas.The marked contrast enhancements with clear borders and associated vascular flow voids are the most important signs on MRI.

Objective To summarize and analysis CT characteristics of traumatic adrenal hematomas.Methods There were 22 cases ofadrenal hematomas.The size, distribution and density of the adrenal hematomas on CT scanning, and the complications of other visceralinjury were analysed.Results 23 adrenal hematomas were found in 22 cases, of them,16 were in right,6 in left and 1 in bilateral. Conclusion CT has high value in diagnosis of the adrenal hematomas.

Objective To assess the value of CT in diagnosis of recurrent rectal carcinoma.Methods Forty seven patients who had undergone locally curative surgery were examined by CT.All patients received intravenous contrast medium and two oral doses and a intrarectal doses of 500 ml 3% Ultravist were given.The characters of benign and malignant lesions were analysed in order to evaluate the value of the classification on CT in the differentiation of benign masses from malignant ones.Results 26 local recurrences occurred in 47 cases,including 13 cases with an round preasacral mass,8 cases with an irregular rectal wall thickening,2 cases with a flat preasacral mass,3 cases with a preasacral mass with low attenuation.The degree of enhancement of local recurrent masses was higher than that of benign masses.Conclusion The features of recurrence of rectal carcinoma on CT is an round or irregular asymmetrical preasacral mass or an irregular rectal wall thickening.It is useful way in diagnosis of recurrence of rectal carcinoma.

Objective To study the MRI findings in a series of intracranial hemangiopericytomas, and to compare these findings with those of intracranial meningiomas. Methods The MRI appearances and clinical features in 27 cases of intracranial hemangiopericytomas and 236 cases of intracranial meningiomas were retrospectively reviewed. All cases were proved by operation and pathology. The data were evaluated by using ? 2 test, rank sum test, and Logistic Regression. Results Sex (? 2=6 981), shape of tumor (? 2=39 949), signal voids of vessel in tumor (? 2=12 366), necrosis or cystic degeneration in tumor (? 2=37 432), the type of dural attachment ( broad based or narrow based ) (? 2=16 956), T 1WI signal intensity (? 2=14 880), T 2WI signal intensity (? 2=37 068), enhanced degree of tumor (? 2=10 081), homogeneous degree of tumor after contrast enhancement (? 2=17 014), and duration time were significant different ( P

Objective To investigate the expression of chemokine ligand 2 (CCL2)in chronic uric acid nephropathy(CUAN)and its diagnostic values in kidney damage.Methods 29 patients with CUAN[male 23,female 6,age (44.4 ±8.8)years old ]and 35 health individuals[male 27,female 8,age (40.6 ±7.8 )years old ]were involved in this study.Serum and peripheral blood mononuclear cells were isolated from peripheral blood.CCL2 was assayed by ELISA,and CD +45 /CD +14 monocytes were analyzed by flow cytometry.Liver &kidney functions,lipids and glucose were detected by automatic biochemistry analyzer.Results Serum CCL2 in group of CUAN and health con-trols were 456.2(202.6 -594.9)pg/mL and 245.0(132.2 -544.5)pg/mL,respectively(F =4.915,P =0.030). Percentages of monocytes in each group were 7.4%(5.6% -8.7%)and 6.1%(4.7% -7.9%),(F =8.891,P =0.004).Pearson analysis found that levels of CCL2 positively correlated with percentages of monocytes,serum uric acid and creatinine in CUAN group(r values were 0.535,0.584 and 0.012;P values were 0.003,0.001 and 0.012, respectively),but there was no correlation with urea and retinol binding protein(r value were 0.145 and 0.746,P val-ues were 0.453 and 0.453).Conclusion Hyperuricaemia may directly contribute to elevate levels of CCL2 and facilitate monocytes release into inflammation part to induce kidney damage.

Objective To investigate the clinical characteristics of elderly patients with multiple myeloma and their prognostic factors.Methods 100 multiple myeloma patients with age≥ 60 years and 100 multiple myeloma patients with age <60 years who admitted in our hospital from December 2007 to December 2015 were collected as research subjects.100 patients with age ≥60 years were divided into elderly multiple myeloma group,100 cases with aged <60 years were divided into non -elderly multiple myeloma group.The clinical data and laboratory results of two groups were compared,the prognosis factors in elderly patients with multiple myeloma were analyzed.Results The incidence rate of ISS stage Ⅰ -Ⅱ in elderly multiple myeloma group (45.0%)was lower than non -elderly multiple myeloma group (60.0%),the incidence rate of stage Ⅲ was higher than non -elderly multiple myeloma group (χ2 =4.511,P <0.05).The infection incidence of elderly multiple myeloma group(30.0%)was higher than non -elderly multiple myeloma group(15.0%)(χ2 =10.452,P <0.05 ).The hemoglobin,serum albumin contents of elderly multiple myeloma group [(83.7 ±19.8)g/L,(27.89 ±6.87)g/L]were less than non -elderly multiple myeloma group[(92.1 ±22.5)g/L,(33.15 ±7.69)g/L](t =4.297,4.426,all P <0.05).The calcium content,the propor-tion of bone marrow plasma cells,serum creatinine and blood β-microspheres protein levels of elderly multiple mye-loma group [(2.51 ±0.41)mmol/L,(39.43 ±18.64)%,(182.24 ±125.47)μmol/L,(9.02 ±6.24)mg/L]were higher than non -elderly multiple myeloma group [(2.36 ±0.48)mmol/L,(37.45 ±19.86)%,(143.25 ± 116.43)μmol/L,(5.87 ±3.41)mg/L](t =5.945,4.196,4.375,4.264,all P <0.05).The median survival time of elderly multiple myeloma patients were significantly correlated with the patients'age,the proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin,and ISS staging (χ2 =4.125,3.254,8.542,5.748,9.244,all P <0.05).Conclusion The condition of elderly myeloma patients is more serious,age,proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin and ISS stage affect myeloma patients prognosis.

Objective To assess the value of contrast-enhanced computed tomography (CT) in the differentiation of benign solitary pulmonary nodules(SPN) from malignant ones.Methods Thirty-seven patients with solitary pulmonary nodules(≤3 cm phi)were examined by contrast-enhanced CT.Qualitative and quantitative characters of benign and malignant lesions were analysed after administration of Ultravist in order to evaluate the attenuation value of contrast-enhanced CT in the differentiation of benign SPN from malignant ones .Results A threshold value of 30 HU was selected on enhanced CT images to distinguish malignant( CT value≥30 HU)from benign( CT value