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 detect neurotransmitters function in the brain and the brain functional index of outpatients with methadone maintenance treatment,and understand the change features of brain function.Methods Collect brain electrical power signals were collected from 58 outpatients with methadone maintenance treatment (MMT) and 44 healthy adults,and the correlations between the power of the neurotransmitters and the brain functional status were analyzed.Results (1) In MMT group,all neurotransmitters were lower generally than those in the control group,and the differences of GABA ((17.73±3.54) μV2 vs.(121.48±44.64) iμV2,P＜0.01),Glu ((42.18±12.84) μV2 vs.(105.31 ± 34.95) μV2,P＜0.05) were significant.(2) The relative powers of GABA ((17.10±51.72) μV2 vs.(78.67± 10.93) μV2,P＜0.001) and Glu((30.48±21.61) μV2 vs.(69.23±42.26) μV2,P＜0.001) reduced significantly,while 5-HT((297.18±31.54) μ V2 vs.(280.18±31.54) μV2,P＜0.01),ACh ((235.08±37.72) μV2 vs.(217.23±40.60)μV2,P＜0.05),NE((164.11±33.05) μV2 vs (146.39±30.80) μV2,P ＜0.01),DA((98.87±22.48) μV2 vs.(91.49±21.04)μV2,P＜0.05) rised significantly in MMT group.(3)The global power was lower((1012.01± 195.09)μV2 Vs.(1775.94±458.99) μV2,P＜0.01),and the excitement-inhibition index(2.19± 1.46 vs.0.99±0.47,P＜0.001) and the relative entropy((89.45±9.71) ％ vs.(75.48±9.97) ％,P ＜0.01)were higher than those in the controls.(4) In MMT group,there were positive correlation between all neurotransmitters and global power,as well as that between Glu and excitement-inhibition index (r=0.264,P＜0.05),NE and Vasomotor index(r=0.269,P＜0.05),but negative correlation between relative entropy and 5-HT(r=-0.276,P＜0.05) as well as DA(r=-0.375,P＜0.01)significantly.Conclusion The brain function of outpatients with MMT are lower than the normal significantly,and there are clearly imbalance between the excitement and inhibition among the brain neurotransmitters.

Objective To evaluate the localization of adrenal functionless tumor by ultrasonographv(US).Methods One hundred and six patients with adrenal functionless tumor were examined by US and subsequentlv proved by surgery and pathology.Results In 106 cases,true positive was 103,true negative,false positive and false negative were 1 each.The sensitivity,specificity and accuracy was 99.0%,50.0%and 98.1%,respectively.The adrenal tunctionless tumor tended increasing year by year.Tumors detected at very first by US were 77.9%.Tumor size distribution was gradually increasing as following: adenoma,pheochromocytoma(PHEO), neurilemmoma,myelolipoma,gangliocytoma and adenocarcinoma,in which there is significant difference.The myelolipoma presented charactersitically hyperecho feature to be easily distinguished from other tumors.The echo featLlres in the rest tumors chaotic echo.Conclusions US is a reliable examination of the first chdce for localizing diagnosis of adrenal functionless tumor and also helpful in differentiating histopathologically.

In order to carry out subject librarian service and improve electronic literature service in hospital libraries, the utilization of electronic literature databases in 240 clinical nurses of class A and B hospitals in Jinan, Qingdao and Jining was investigated with questionnaire, which showed the new features of clinical nurses in awareness and utilization of electronic literature databases under the new turn of hospital class evaluation.

Objective:To evaluate the effect of segmental approach in the treatment of Angle class Ⅱ division 1 malocclusion.Methods:7 cases of classⅡ,division 1 maloclusion were treated.Upper first premolar and lower second premolars were extracted in all cases.Lower first molars were mesially moved by means of segmental arch. Cephalometric analysis was used to evaluate the effects of the treatment.Results:Facial profile improvement and lower anterior facial height maintenance were achieved.The occlusion plane angle,mandibular plane angle were well controlled with lower anterior teeth upright on the lower basal bone.All patients represented good mandible response.Conclusion:Segmental technique is a simple and effective approach in correcting class Ⅱ,division 1 maloclusion

Objective:To screen the best decocting technology by multi-index comprehensive score combined with response sur-face. Methods:The content of paeoniflroin and the ratio of dry extraction were used as the indicators, and response surface Central Composite with two factors and five levels was used in the experimental design. The effects of the ratio of solvent to solid, decocting du-ration and decocting times on the preparation process of tonic semifluid extract of ten ingredients were studied. Results:Design Expert 8. 0. 6b software was used for the data analysis. A quadratic mathematical model between the factors and the comprehensive score of paeoniflroin content and the ratio of dry extraction was established. Combined with the actual production, the best decocting conditions were as following:the ratio of solvent to solid was 10. 6 ml·g-1 , the decocting duration was 96 min, and decocted 3 times. Conclu-sion:The optimal decocting technology is scientific, reasonable and stable.

Objective To investigate the influence of impulsivity on the functions of the conflict monitoring and the conflict resolution process for heroin addicts.Methods 80 heroin addicts were drawn randomly using simple random sampling method and finished Opioid Addiction Severity Inventory ( OASI ) and Barratt Impulsivity Scale ( BIS-11) .High impulsivity group( 7 females of 22) and low impulsivity group (8 females of 21) were divided according to 27%of the total BIS-11score followed the grouping method in psychometrics.Then the event-related potentials (ERPs) technique with the classical color-word Stroop task was used to reveal the influence of impulsivity on the executive function for heroin addicts.Results ( 1) The scores of motor impulsivity(23.00±1.73) and no-plan impulsivity(27.77±3.22) were higher in high im-pulsivity group than those in low impulsivity group(19.31±2.80,23.38±3.59)(P<0.01);and there was posi-tive correlation between impulsivity and addiction severity( r=0.415, P<0.05).(2) The behavioral data showed significant Stroop interference effects in both groups(P<0.01).(3) ERPs data showed that there were significant incongruent-N450 and SP effects in the low impulsivity group,whereas incongruent N450 and SP effects disappeared in high impulsivity group ( Low impulsivity group incongruent vs congruent condition N450:(2.82±3.09)μV vs (4.51±2.77)μV, P<0.05; SP:(3.54±1.25)μV vs (2.84±1.03)μV, P<0.05;High impulsivity group incongruent vs congruent condition N450:(4.98±4.10)μV vs (3.39±3.31)μV, P<0.05;SP:(3.43±3.84)μV vs (4.66±4.53)μV, P<0.05).Conclusion The brain time-interval change of executive function such as the conflict monitoring and the conflict resolution process is influenced by the im-pulsivity levels of heroin addicts.

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 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 discuss the neuropsychological mechanism of executive control for methadone maintenance patients(MMP).Methods Using the event-related potentials (ERPs) technique to reveal the time course of information processes with high temporal resolution,and exam the function of attention monitoring and response inhibition in heroin-dependent MMP.Results (l) The behavioral results: there were significant withinsubjects Stroop interference effects for the MMP and control groups (reaction time:control group' s congruent condition(766.57±75.64) ms,incongruent condition(879.52±62.31) ms,MMP group' s congruent condition (821.89±64.44) ms,incongruent condition (906.29 ± 69.46) ms,P＜ 0.001 ; error rate: control group' s congruent condition (4.15± 2.92) ％,incongruent condition (8.70 ± 6.12) ％,P＜ 0.001,MMP group' s congruent condition (12.07 ±10.80) ％,incongruent condition (16.60±12.43)％,P＜0.01).(2)ERPs data showed that MMP demonstrated significantly smaller incongruent-N2/N450/SP amplitudes than controls,and all disappearing incongruent effects in N2,N450 and SP,comparing statistically significant incongruent effects for controls in N2,N450 and SP.In MMP group,the amplitudes of N2 and N450 incongruent condition (N2 (1.40± 2.91) μV、N450 (1.29 ± 0.55) μV) were bigger than congruent condition amplitudes(N2(0.77±3.61) μV 、N450(0.83± 1.07) μV,P＜0.05),but the amplitude of SP (0.37±3.58)μV was smaller than congruent condition(1.53±3.05) μV,P＜0.001 ;in control group,the amplitudes of N2 and N450 incongruent condition((-0.30±3.45) μV,N450(1.77± 1.55)tμV) were smaller than congruent condition (N2(1.10±3.64) μV,P＜0.001； N450(2.37±2.12) μV,P＜0.05),the amplitude of SP ((1.93±1.65) μV) was bigger than congruent condition((0.98±2.02)μV,P＜0.01).Conclusion There are impaired executive control functions during the conflict monitoring process and the conflict resolution process for MMP.These results provide the neural electrophysiological evidence to explain relapse behaviors in methadone maintenance patients.