Objective: To investigate the rationale for appropriate diagnostic methods and treatment protocols for unexpected gallbladder carcinoma(UGC). Methods: The clinical and pathological data of 45 patients with UGC admitted at Department of General Surgery, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine,from January 2008 to December 2017 were retrospectively collected and analyzed.There were 11 males(28.9%) and 34 females(71.1%),aged 68 years(range:27 to 68 years).And there were 20 cases who aged above 70 years. Twenty-four cases were diagnosed preoperatively as cholecystolithiasis plus chronic cholecystitis.Ten cases were diagnosed preoperatively as cholecystolithiasis plus actue cholecystitis.Six cases were diagnosed preoperatively as cholecystolithiasis plus choledocholith.Six cases were admitted because of gallbladder polyp and 1 case was admitted because of gallbladder adenomyomatosis. Results: Thirty-four patients with UGC received radical surgery.Among them,11 patients experienced postoperative complication and no posterative mortality occoured during hospital stay.Thirteen patients were diagnosed with T1b UGC, the harvested lymph node of Nx, N0, N1 and N2 was 2, 9, 1 and 1, respectively.In addition, 2 cases were identified to have local-regional tumor recurrence during our rescue radical surgery.The median overall survival time of the patients who did not receive radical surgery was 7 months(range:2-56 months).Nevertheless,the median overall survival time for patients diagnosed with T1, T2 and T3 tumors who received radical surgery, was 41 months(range: 19-82 months), 33.5 months(range: 31-36 months) and 17 months(range: 7-46 months), respectively. Conclusions For patients with UGC, rescue radical surgery can achieve a better survival time.Furhtermore, our experience proved that rescue radical surgery for UGC is safe and feasible.Therefore,rescue radical surgery should be performed in patients with diagnose with UGC especially those T1b patients.

OBJECTIVE To establish the fingerprints of Xanthoceras sorbifolia and determine the contents of flavonoids . METHODS HPLC was adopted . Using epigallocatechin as reference ，the fingerprints of 11 batches（No. S1-S11）of X. sorbifolia were drawn with Similarity Evaluation System of Chromatographic Fingerprints of TCM （2004A edition ）. The similarity evaluation was conducted ，the common peaks were also confirmed . Cluster analysis （CA）and principal component analysis （PCA）were also performed. Epigallocatechin was selected as internal reference ，and quantitative analysis of multi -components by single marker （QAMS）was used to determine the contents of gallocatechin ，catechin，epicatechin，dihydromyricetin，taxifolin and myricetin in 16 batches（No. S1-S16）of X. sorbifolia. The results were compared with the results of one point external standard method and standard curve method . RESULTS There were 15 common peaks in 11 batches of X. sorbifolia，and the similarity of them were 0.910-1.000. A total of 7 common peaks were identified ，i.e. galliccatechin（peak 1），epigallocatechin（peak 2），catechin（peak 3），epicatechin（peak 5），dihydromyricetin（peak 6），taxifolin（peak 14）and myricetin （peak 15）. The results of CA showed that S5-S7 and S 9 were clustered into one category ，S8 and S 11 were clustered into one category ，S10 were clustered into one category，S1-S4 were clustered into one category . The results of PCA showed that accumulative variance contribution rate of 3 principal components was 99.24%；S5-S7 were clustered into one category ，S8-S11 were clustered into one category ，S3 and S 4 were clustered into one category ，S1 and S 2 were clustered into one category . With the exception of myricetin and a partial batches （S12，S14-S16） of catechin ，the RSDs measured by the three methods for galliccatechin ，catechin （remaining batches ）， epicatechin，dihydromyricetin and taxifolin in 16 batches of X. sorbifolia were less than 4% （n＝3）. CONCLUSIONS The established HPLC fingerprint and the method for content determination can be used for the quality control of X. sorbifolia. QAMS method can be used for the content determination of galliccatechin，epicatechin，dihydromyricetin and taxifolin .