1.Correlation between fluoride intake and serum alkaline phosphatase in pregnant women of different gestational periods in endemic fluorosis area
Xiaoyun HAN ; Lijuan LI ; Zhen YANG ; Xin LYU ; Jun LI ; Weiwei YANG ; Quan LI
Chinese Journal of Endemiology 2021;40(5):399-403
Objective:To explore the correlation between fluoride intake and serum alkaline phosphatase (ALP) in pregnant women of different gestational periods in endemic fluorosis area.Methods:Pregnant women in Rencheng District, Jinxiang County, Jiaxiang County of Jining City and Yuncheng County of Heze City were selected in April 2020. According to the gestational weeks, pregnant women were divided into early pregnancy group (0 - 12 weeks), middle pregnancy group (13 - 27 weeks) and late pregnancy group (> 27 weeks). The levels of urinary fluoride, ALP, osteocalcin (BGP), C-terminal peptide of β-Ⅰ collagen (β-CTX) and N-terminal propeptide of type Ⅰ collagen (PINP) of pregnant women in each group were measured, and the correlation between urinary fluoride and ALP, BGP, β-CTX, and PINP in pregnant women of different gestational periods was analyzed.Results:A total of 372 pregnant women were selected, including 97 cases in early pregnancy group, 169 cases in middle pregnancy group and 106 cases in late pregnancy group. There was no significant difference in urinary fluoride level between the three groups [(1.20 ± 0.25), (1.23 ± 0.19), (1.24 ± 0.30) mg/L, P > 0.05]. There was significant difference in serum ALP among the three groups ( P < 0.05), among them, the ALP level in early pregnancy was significantly lower than those of middle pregnancy group and late pregnancy group ( P < 0.05), and the ALP level in middle pregnancy was significantly lower than that of late pregnancy group ( P < 0.05). There was no significant differences in serum β-CTX among the three groups ( P > 0.05). There were significant differences in serum BGP and PINP levels among the three groups ( P < 0.05). The serum BGP and PINP levels in late pregnancy group were significantly higher than those of early pregnancy group and middle pregnancy group ( P < 0.05), and there were no significant differences in serum BGP and PINP levels between early pregnancy group and middle pregnancy group ( P < 0.05). There was a significant positive correlation between urinary fluoride and ALP in early pregnancy group ( r = 0.364, P < 0.05), but no significant correlation between urinary fluoride and BGP, β-CTX and PINP ( r = 0.164, 0.117, 0.136, P > 0.05). There was a significant positive correlation between urinary fluoride level and ALP in middle pregnancy group ( r = 0.417, P < 0.05), but no significant correlation between urinary fluoride level and BGP, β-CTX and PINP ( r = 0.127, 0.108, 0.129, P > 0.05). There was no significant correlation between urinary fluoride level and ALP, BGP, β-CTX and PINP in late pregnancy group ( r = 0.179, 0.158, 0.184, 0.149, P > 0.05). Conclusions:The urinary fluoride level of pregnant women in endemic fluorosis area is relatively stable in gestational period. The urinary fluoride level affects the ALP secretion of pregnant women in early and middle pregnancy. It is still necessary to strengthen the measures of improving water quality and defluoridation to reduce the impact of excessive fluoride intake on pregnancy complications in endemic fluorosis area.
2.Nursing care on the sedation of patients with non-invasive ventilation
Xiaohong LYU ; Liping YUAN ; Jun WANG ; Yundong WU ; Lili JIANG ; Quan ZHOU ; Weihua LU ; Zhen WANG
Chinese Journal of Practical Nursing 2015;(32):2419-2422
Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .
3.Preliminary study on dosimetry verification of VMAT on the basis of TG119 report
Meng LYU ; Jun ZHANG ; Lixin ZHOU ; Huanfan SU ; Tingting CAO ; Hong QUAN
Chinese Journal of Radiation Oncology 2019;28(3):209-213
Objective To preliminarily verify the feasibility of utilizing TG119 report to commission the volumetric modulated arc therapy (VMAT) plans.Methods Based on the test cases mentioned in TG119 report,7-/9-field intensity-modulated radiation therapy (IMRT) and dual-arc VMAT plans were devised by using two types of beam energy (6 MV and 10 MV) in the Eclipse TPS system according to the requirement of this report.All the plans were verified using 0.125cc semiflex thimble ionization chamber,MatriXX and Delta 4,respectively.The final results were statistically compared with the results measured by multiple institutions in the TG119 report.Results The resuhs of both IMRT and VMAT plans met the requirement of the TG119 report.The discrepancy of point dose in the high/low dose region of VMAT plans using different photon beams was ranged from-2.55% to 2.55%,and ± 1.85% for the IMRT plans.The percentage of γ passing points (±3%/3 mm) for the IMRT plans using 6 MV and 10 MV photon beams was 99.38% and 99.53%,99.32% and 99.46% for the VMAT plans.The γ passing rate of the compound field exceeded 98%.Conclusions The VMAT plans with 6 MV and 10 MV photon beams meet the requirement of the TG119 report.TG119 report provides certain guidance for establishing a benchmark for dosimetry verification of the VMAT plans.
4.Effects of different stimulatory factors on functions of CIK cells.
Jun-Quan LIU ; Yun ZHU ; Fu-Xing CHEN ; Yu ZHOU ; Hui-Chun JI ; Wan-Ying YANG ; Xiao-Ting LYU ; Song ZHANG ; Zheng-Zhong TAO ; Yi LI
Journal of Experimental Hematology 2013;21(4):1021-1026
This study was aimed to investigate the effects of different stimulatory factors on proliferation and function of cytokine induced killer (CIK) cells. Peripheral blood mononuclear cells (PBMNC) were separated by Ficoll-Hypacue gradient. According to supplement of different stimulatory factors (CD28 mAb, IL-15 and IL-21), the experiment was divided into five groups:control group (CIK), CB28+IL-15+IL-21 group, IL-15+IL-21 group, CD28+IL-15 group and CD28+IL-21 group. Effects of different stimulatory factors on the proliferation of CIK cells were assayed by an automated hematology analyzer. Changes of granzyme B,perforin and CD107a were detected by flow cytometry. IL-10, IL-12, INF-γ and TNF-α were quantified by ELISA. Cytotoxicities on lung cancer cell line A549, breast adenocarcinoma cell line MFC-7 and human melanoma cell line HME1 were examined by lactate dehydrogenase release method. The results showed that there were significant differences among different groups. The highest proliferation index on days 10 was observed in group CD28mAb, IL-15 and IL-21(255.3 ± 6.3), which was higher than control group, IL-21+IL-15 group and CD28 mAb+IL-21 group (166.6 ± 13.5, 199.4 ± 15.0 and 228.8 ± 16.6) (P < 0.05). The expression of perforin in CD28 mAb+IL-15 group was higher than the other groups. The expression of perforin,GranB and CD107a of costimulatory groups was higher than control group. The cytotoxicities of CD28 mAb+IL-15 group on A549, MFC-7 and HME1 cells (82.2%, 59.3% and 70.6%) were much higher than that of control group (60.9%, 49.6% and 48.4%) (P < 0.05). The highest IFN-γsecretion was found in CD28 mAb, IL-15 and IL-21 groups. It is concluded that there are significant difference of proliferative capacity, cytokine secretion and cytotoxicity after being activated by different stimulatory factors. Adding corresponding stimulatory factors into the culture system displays a great value for target cells culture.
Cell Line, Tumor
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Cell Proliferation
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drug effects
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Cytokine-Induced Killer Cells
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cytology
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drug effects
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Humans
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Interferon-gamma
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metabolism
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Interleukin-10
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metabolism
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Interleukin-12
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metabolism
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Interleukin-15
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pharmacology
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Interleukins
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pharmacology
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Tumor Necrosis Factor-alpha
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metabolism
5.Efficient Detection of Environmental Estrogens Bisphenol A and Estradiol By Sensing System Based on AuNP-AuNP-UCNP Triple Structure
Qiao-Feng LI ; Shu-Yue REN ; Yu WANG ; Jia-Lei BAI ; Yuan PENG ; Bao-An NING ; Quan-Jun LYU ; Zhi-Xian GAO
Chinese Journal of Analytical Chemistry 2018;46(4):486-492
A sensing system based on AuNP-AuNP-UCNP triple structure for efficient detection of dual targets was constructed. In the preparation of triple structure, the gold nanoparticles (AuNPs) and upconversion nanoparticles (NaYF4: Yb, Er, Gd, UCNPs) were synthesized and surface modified. Then the two nanoparticles and their aptamers were connected to form two kinds of optical fluorescent probes. A nucleic acid sequence that matches with two aptamers was designed, rendering the probes to get close based on the principle of complementary base pairing. On the basis of this, a sensing system with a triple structure was prepared,and its connecting effect was characterized by TEM. With this system, dual targets of bisphenol A and estradiol were efficiently and conveniently detected through quantitative determination by fluorescence and UV spectrophotometer. At reaction temperature of 30℃ and pH=7.8,this method exhibited good linear range for determination of bisphenol A and estradiol from 2 ng/mL to 200 ng/mL and from 10 ng/mL to 150 ng/mL, with limits of detection of 0.2 ng/mL and 0.5 ng/mL, respectively. This sensing system with the triple structure owned better specificity to structural and functional analogues, and showed good repeatability and stability. What's more,this sensing system was applied in actual water detection,with the recoveries between 86.1% and 107. 4%, and the relative standard deviation below 6. 8%. This method showed promising applications in other environmental estrogens in water samples.
6. Nasal continuous positive airway pressure ventilation in children with community-acquired pneumonia under five years of age: a prospective, multi-center clinical study
Jun LIU ; Quan WANG ; Suyun QIAN ; Wenmiao XU ; Lihong LI ; Limin NING ; Xiaoxu REN ; Fang LYU ; Yibing CHENG ; Liujiong GAO ; Chunfeng LIU ; Wei XU ; Liang PEI ; Guoping LU ; Weiming CHEN
Chinese Journal of Pediatrics 2017;55(5):329-333
Objective:
To analyze the clinical characteristics of community-acquired pneumonia (CAP) in children under five years of age and analyze the safety and efficiency of nasal continuous positive airway pressure (NCPAP) ventilation for CAP in this population.
Method:
This was a prospective multicenter study. Children who were admitted to these six centers with CAP and met the NCPAP ventilation indications, aged from 29 d to 5 years, were continuously included during November 2013 to October 2015. The baseline data were collected and NCPAP ventilation were then followed up by operation standards, and the vital signs and arterial blood gas change at special time points were observed and recorded. Any side effect associated with NCPAP were recorded. For categorical variables, comparisons were performed using Fisher test. Rank-sum test and
7. Effect of PIVKA-Ⅱ and AFP levels on the prognosis of patients with HBV infection-related hepatocellular carcinoma
Ming-jie YAO ; Hua-nan CHEN ; Xiang-jun QIAN ; Qiang XU ; Xiang-mei CHEN ; Quan-jun LYU ; Ling ZHANG ; Feng-min LU
Chinese Journal of Practical Internal Medicine 2019;39(07):640-643
OBJECTIVE: To evluated the prognostic potential of preoperative PIVKA-Ⅱ and AFP to the patients of HBV infection-related hepatocellular carcinoma(HCC) after radical resection. METHODS: Chronic HBV infection-related HCC patients who undergone resection in the Affiliated Cancer Hospital of Zhengzhou University from 2009 to 2013 with competed data of clinical information,laboratory results and follow-up records were enrolled our study. Finaly, a total of 107 subjects entered our research. PIVKA-Ⅱ was quantitatively measured by Chemiluminescence methods. Kaplan-Meier survival analysis and the Cox proportional hazards model were used to analyze the factors which can affect patient's post surgery survival. RESULTS: Kaplan-Meier survival curve analysis showed that the 1-,2-,3-year survival rate of the patients with high PIVKA-Ⅱ level were 56%, 28% and 16%, respectively, much poor than that of patients with low PIVKA-Ⅱ level, the 1-,2-,3-year survival rate for the latter were 73%, 54% and 46%, respectively(P = 0.002). The 1-,2-,3-year survival rates for patients with high AFP levels were 58%, 35% and 25%, respectively, and the the 1-,2-,3-year survival rates for patients with low AFP levels were 83%, 63% and 51%, respectively(P = 0.006). Multivariate factor results showed that high PIVKA-Ⅱ levels, high AFP levels, the presence of portal vein tumor thrombus and incomplete capsular were independent risk factors for prognosis,HR(95% CI) were 1.99(1.15-3.45), 2.03(110-3.76), 2.72(1.53-4.83) and 2.07(1.07-4.00), respectively. In addition, the prognosis would got worse with the superposition of four independent risk factors. CONCLUSION: Preoperative PIVKA-Ⅱ and AFP levels are associated with HCC patients' s poor post surgery prognosis.
8.Atypical Infantile-onset Pompe Disease with Hypertrophic Cardiomyopathy.
Jun-Jun QUAN ; Ling-Juan LIU ; Tie-Wei LYU ; Xu-Pei HUANG ; Jie TIAN
Chinese Medical Journal 2017;130(19):2393-2394
9.Diagnostic Value of G and GM Tests in Acute Leukemia Patients with Invasive Fungal Disease.
Ke-Yu QIAN ; Quan-Xing LYU ; Li-Jun DAI ; Hui-Rong CHANG ; De-Pei WU ; Ai-Ning SUN
Journal of Experimental Hematology 2019;27(5):1678-1681
OBJECTIVE:
To analyze the diagnostic value of (1, 3) -β-D-glucan and galactomannan (GM) tests in the patients with acute leukemia complicated by invasive fungal disease, and explore the application of serological detection (G/GM) and lung CT for early diagnosis of invasive fungal disease (IFD).
METHODS:
A total of 493 patients with acute leukemia complicated by high risk invasive fungal infection, also receival G and GM tests, in Department of hematology of our hospital from June 2016 to December 2016 were selected and were divided into IFD-confirmed group (62 cases) including confirmed and clinical diagnesed IFD, and IFD-unconfirmed group (431 cases) including suspected IFD and non-IFD according to the diagnostic criteria of IFD. The results of G and GM tests in patients of 2 groups were analyzed, then the diagnostic efficacy of G and GM done and combination evaluated. In addition, 26 patients whose lung CT negative at hospitalization, moreover, presentation of changes in lung by CT during hospitalization and serological G and GM test positive were selected, and the difference of time between serological that postive and presentation of changes in lung by CT were compared for the estimation of early diagnotic value.
RESULTS:
The positive rate of (1, 3) -β-D-glucan in IFD-confirmed group and IFD-unconfirmed group was 56.5% and 10.4%, respectively. Meanwhile, that of galactomannan test was 41.9% and 9.0%, respectively. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of (1, 3) -β-D-glucan was 56%, 90%, 44% and 92%, and that of galactomannan was 42%、91%、40% and 93%, respectively. Moreover, the combination of (1, 3) -β-D-glucan and galactomannan could raise the sensitivity to 69% and specificity to 98%. The positive results of serological detection (G/GM) come earlier about five days than CT changes.
CONCLUSION
Both (1, 3) -β-D-glucan and galactomannan test have high sensitivity and specificity, and the combination of them can improve the diagnostic efficacy, and make the clinical antifungal therapy more precisely. In the early clinical diagnosis of IFD, the positive results of serological detection coming earlier than lung CT.
Humans
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Invasive Fungal Infections
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diagnosis
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etiology
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Leukemia, Myeloid, Acute
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complications
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Mannans
10.Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: a report of 6 159 cases
Xuheng SUN ; Yijun WANG ; Wei ZHANG ; Yajun GENG ; Yongsheng LI ; Tai REN ; Maolan LI ; Xu'an WANG ; Xiangsong WU ; Wenguang WU ; Wei CHEN ; Tao CHEN ; Min HE ; Hui WANG ; Linhua YANG ; Lu ZOU ; Peng PU ; Mingjie YANG ; Zhaonan LIU ; Wenqi TAO ; Jiayi FENG ; Ziheng JIA ; Zhiyuan ZHENG ; Lijing ZHONG ; Yuanying QIAN ; Ping DONG ; Xuefeng WANG ; Jun GU ; Lianxin LIU ; Yeben QIAN ; Jianfeng GU ; Yong LIU ; Yunfu CUI ; Bei SUN ; Bing LI ; Chenghao SHAO ; Xiaoqing JIANG ; Qiang MA ; Jinfang ZHENG ; Changjun LIU ; Hong CAO ; Xiaoliang CHEN ; Qiyun LI ; Lin WANG ; Kunhua WANG ; Lei ZHANG ; Linhui ZHENG ; Chunfu ZHU ; Hongyu CAI ; Jingyu CAO ; Haihong ZHU ; Jun LIU ; Xueyi DANG ; Jiansheng LIU ; Xueli ZHANG ; Junming XU ; Zhewei FEI ; Xiaoping YANG ; Jiahua YANG ; Zaiyang ZHANG ; Xulin WANG ; Yi WANG ; Jihui HAO ; Qiyu ZHANG ; Huihan JIN ; Chang LIU ; Wei HAN ; Jun YAN ; Buqiang WU ; Chaoliu DAI ; Wencai LYU ; Zhiwei QUAN ; Shuyou PENG ; Wei GONG ; Yingbin LIU
Chinese Journal of Digestive Surgery 2022;21(1):114-128
Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.