Objective To observe the value of intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI(DCE-MRI)combined with clinical indexes for predicting Ki-67 expression of prostate cancer(PCa).Methods Totally 294 PCa patients were retrospectively enrolled and randomly divided into training set(n=205)and test(n=89)set at a ratio of 7∶3,who were stratified into low-expression subgroup(Ki-67≤10%)and high-expression subgroup(Ki-67＞10%)based on pathological findings.ROIintratumoral and ROIperitumoral were delineated on DCE-MRI,and radiomics features were extracted from ROIintratumora,l ROIperitumoral and ROIintratumoral+peritumora,l respectively.Radiomic features significantly associated with Ki-67 expression status were selected to construct radiomics models.A multivariate logistic regression analysis was performed to develop a clinical predicting model,then a combined model was established combined with the optimal radiomics model.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)were calculate to evaluate the predictive efficacy of the models and compared between each two models.Decision curve analysis(DCA)was used to assess the clinical net benefit of each model.Results The AUC of modelintratumora,l modelperitumoral and modelintratumoral+peritumoral for predicting Ki-67 expression in training set was 0.905,0.867 and 0.930,and the last one was the best.In clinical model,total prostate-specific antigen(t-PSA)and T stage≥3 were both independent predictors of high Ki-67 expression of PCa(both P＜0.05).The AUC of combined model based on modelintratumoral+peritumoral and clinical model was 0.911 in test set,being not significantly different with that of modelintratumoral+peritumoral(AUC=0.906;Z=0.349,P=0.727)but higher than that of clinical model(AUC=0.684;Z=4.370,P＜0.05).DCA revealed that the combined model provided higher clinical net benefit than clinical model and modelintratumoral+peritumoral across risk thresholds of 0.10-0.70.Conclusion DCE-MRI intratumoral+peritumoral radiomics model could effectively predict Ki-67 expression status of PCa.Combining with clinical indexes could further enhance its clinical net benefit.

This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.

Objective To observe the value of intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI(DCE-MRI)combined with clinical indexes for predicting Ki-67 expression of prostate cancer(PCa).Methods Totally 294 PCa patients were retrospectively enrolled and randomly divided into training set(n=205)and test(n=89)set at a ratio of 7∶3,who were stratified into low-expression subgroup(Ki-67≤10%)and high-expression subgroup(Ki-67＞10%)based on pathological findings.ROIintratumoral and ROIperitumoral were delineated on DCE-MRI,and radiomics features were extracted from ROIintratumora,l ROIperitumoral and ROIintratumoral+peritumora,l respectively.Radiomic features significantly associated with Ki-67 expression status were selected to construct radiomics models.A multivariate logistic regression analysis was performed to develop a clinical predicting model,then a combined model was established combined with the optimal radiomics model.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)were calculate to evaluate the predictive efficacy of the models and compared between each two models.Decision curve analysis(DCA)was used to assess the clinical net benefit of each model.Results The AUC of modelintratumora,l modelperitumoral and modelintratumoral+peritumoral for predicting Ki-67 expression in training set was 0.905,0.867 and 0.930,and the last one was the best.In clinical model,total prostate-specific antigen(t-PSA)and T stage≥3 were both independent predictors of high Ki-67 expression of PCa(both P＜0.05).The AUC of combined model based on modelintratumoral+peritumoral and clinical model was 0.911 in test set,being not significantly different with that of modelintratumoral+peritumoral(AUC=0.906;Z=0.349,P=0.727)but higher than that of clinical model(AUC=0.684;Z=4.370,P＜0.05).DCA revealed that the combined model provided higher clinical net benefit than clinical model and modelintratumoral+peritumoral across risk thresholds of 0.10-0.70.Conclusion DCE-MRI intratumoral+peritumoral radiomics model could effectively predict Ki-67 expression status of PCa.Combining with clinical indexes could further enhance its clinical net benefit.

This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.

Objective:To investigate the effect and mechanism of esophageal squamous cell carcinoma exosomal miR-181b-5p to the polarization of M2 macrophages.Methods:Extracted and identified exosomes from esophageal squamous cell carcinoma,and detected the expression of miR-181b-5p in esophageal squamous cell carcinoma cells and their exosomes by qRT-PCR.M0 type macro-phages were divided into PBS group,HEEC exo group,Eca-109 exo group,miR-NC exo group,miR-181b-5p exo group,miR-NC group,miR-181b-5p mimic group,si-NC group,si-PTEN group,miR-181b-5p exo+PTEN group.qRT-PCR was used to detect the expressions of CD163,CD206,iNOS and TNF-α in each group.The targeting relationship between miR-181b-5p and PTEN were veri-fied by double luciferase reporter gene experiment.Results:miR-181b-5p was significantly overexpressed in esophageal squamous cell carcinoma cells TE-13,TE-12,TE-10,Eca-109,KYSE30 and their exosomes(P<0.001).Compared with miR-NC group,the expression of CD163 and CD206 in cells were significantly upregulated in the miR-181b-5p mimic group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).The results of double luciferase reporter genes showed that PTEN was the target gene of miR-181b-5p.Compared with si-NC group,the expressions of CD163 and CD206 in cells were significantly upregu-lated in the si-PTEN group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).Compared with PBS group,the expressions of CD163 and CD206 in cells were significantly upregulated in the Eca-109 exo group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).Compared with miR-NC exo group,the expressions of CD163 and CD206 in cells were significantly upregulated in the miR-181b-5p exo group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).Compared with miR-181b-5p exo group,the expressions of CD163 and CD206 in cells were significantly downregulated in the miR-181b-5p exo+PTEN group,as well as the expressions of iNOS and TNF-α were significantly upregulated(P<0.001).Conclusion:Exosomal miR-181b-5p inhibits PTEN expressions to promote M2 macrophage polarization.

Objective To explore the clinical efficacy of using rituximab and atoxiban in the treatment of cervical incompetence after emergency cervical cerclage surgery.Methods Sixty patients with cervical incompetence admitted from May 2020 to February 2022 were selected as the study subjects.Divide into control group A,control group B,and trial group C using random number table method,with 20 cases in each group.All three groups underwent emergency cervical cerclage surgery.After the surgical treatment,control group A received treatment with rituximab hydrochloride,control group B received treatment with atoxiban,and experimental group C received treatment with atoxiban on the basis of rituximab hydrochloride.Analyze and compare the inhibitory effects of uterine contractions,incidence of adverse reactions,and neonatal outcomes among three groups.Results The inhibition rate of uterine contractions in control group A and test group C was higher than that in control group B(P<0.05);The incidence of postoperative complications in experimental group C was lower than that in control group A and control group B,with a statistically significant difference(P<0.05);Compared with control group A and control group B,the incidence of fetal loss,neonatal asphyxia,and low birth weight infant outcomes in experimental group C was not statistically significant(P>0.05).Compared with control group A and control group B,experimental group C had a longer gestational week extension and a higher Apgar score for newborns,with statistically significant differences(P<0.05).Conclusion The combination treatment of rituximab and atoxiban after emergency cervical cerclage surgery for this disease has good effects,can better inhibit uterine contractions,appropriately prolong gestational age,improve neonatal outcomes and prognosis,and reduce adverse drug reactions in pregnant women.

Objective To analyze the reasons of gastrointestinal function recovery related to postoperative esophagogastric fistula and the roles of the Xiaochengqi decoction by enema and jejunal nutrition tube on gastrointestinal function recovery.Method Clinical data of 1 patient with esophagogastric anastomotic fistula after gastric stromal tumors(GST)resection on March 16,2022 was retrospectively analyzed,to observe the influence of Traditional Chinese Medicine in postoperative recovery.Results The patient,a 77-year-old male,underwent laparoscopic proximal gastrectomy and esophagogastrostomy on March 16,2022 due to cardia tumor.Seven days after surgery,there was some turbid matter in the abdominal drain tube,severe pain on upper abdomindal occurred after digestive tract radiography,it was indicated that anastomotic fistula was existed.After intragastric administration and nasal feeding of Xiaochengqi decoction,anus ventilates and defecates much mushy stool on the 15th day after postoperative esophagogastric fistula.On the 21st day after fistula,Buzhongyiqi and Xiaochengqi decoction was applied by nasointestinal feeding tube.On the 47th day,the patient got out of bed and stood,the stools were out by enema.On the 58th day after surgery,the digestive tract radiography indicated there was not any contrast media overflow near the fistula and contrast media could get through the duodenum smoothly.Anastomotic stricture.After tube extraction,a liquid diet is fed,formed stool is defecated without abdominal distension and pain.On the 63rd day after surgery,the patient is discharged from hospital.Conclusions It is advantageous for the recovery of gastrointestinal function by enema and jejunal nutrition tube feeding of Xiaochengqi decoction.It shortens the anal exhaust time,fastens the recovery of gastrointestinal function,improves health status,promotes healing,and shortens the length of stay.

【Objective】 To establish a co-expression lncRNA-mRNA ceRNA network and explore the potential molecular mechanism of lncRNA in dengue fever. 【Methods】 DENV-2-infected and normal pHUVEC were sequenced and screened for differentially expressed lncRNA and mRNA by gene microarray technology. Differentially expressed mRNA was analyzed by protein-protein interaction (PPI), and significantly related co-expressed lncRNA-mRNA was screened by Pearson’s correlation coefficient. The microRNA (miRNA) that bound to co-expressed lncRNA-mRNA was predicted by the database. The ceRNA network of co-expressed lncRNA-mRNA was constructed by Cytoscape software. Finally differentially expressed mRNAs and co-expressed lncRNA-mRNA were analyzed by GO and KEGG enrichment, and co-expressed lncRNA-mRNA was verified by RT-qPCR. 【Results】 At 48 h and 72 h after infection, 105 and 51 differentially expressed mRNAs were obtained, respectively, while 59 and 29 differentially expressed lncRNAs were obtained, respectively. Furthermore, at the two time intervals, there were 10 differential mRNAs and 5 differential lncRNAs, respectively. PPI analysis of differential mRNAs showed that isocratic values of interleukin 6 (IL6), interferon-induced protein with tetratricopeptide repeats 2 (IFIT2), and 2’-5’-oligoadenylate synthetase 2 (OAS2) were relatively high. The pairing results of lncRNA-mRNA co-expression analysis with the highest correlation coefficients at 48 h and 72 h after infection were XLOC_001966-SMTNL1 and XLOC_001966-ESR2, respectively. According to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, the functions of differentially expressed mRNA and co-expressed lncRNA-mRNA were mainly involved in virus epidemic prevention response, immune response, and signal transduction, as well as the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) signaling pathway, type I interferon, and cytokine receptor interaction. RT-qPCR revealed that lncRNA XLOC-I2-8991 was upregulated in the co-expressed lncRNA-mRNA, whereas all the other lncRNA and mRNA were downregulated. 【Conclusion】 This study initially revealed the potential lncRNA-mRNA co-expression network during dengue virus infection, and found that co-expressed lncRNA-mRNA was mainly enriched in the immune regulation and signal transduction pathways during virus infection. The findings will help further exploration into the infection mechanism of DENV-2.

Objective:To investigate the relationship between histone deacetylase (HDAC) gene polymorphism and type 2 diabetes mellitus (T2DM) in Bai and Han populations in Dali of Yunnan province.Methods:A total of 148 patients with T2DM of Bai and Han nationalities who received treatment in Dali Bai Autonomous Prefecture People's Hospital from May 2019 to March 2021 were included in the T2DM group. An additional 100 healthy controls of Bai and Han nationalities who concurrently received physical examination in the same hospital from May 2019 to December 2020 were included in the normal control group. The susceptibility genes of T2DM were detected using the Taqman MGB probe method. The susceptibility gene loci were amplified using polymerase chain reaction. The whole sequence of susceptibility gene was sequenced.Results:There were no significant differences in the distribution frequencies of rs2530223 genotype, rs11741808 genotype, rs2547547 genotype, and rs1741981 genotype between Bai and Han populations (all P > 0.05). There was a significant difference in blood lipid level between four loci ( t = -1.06, -0.19, 0.39, -2.12, -2.04, 0.16, 1.47, < 0.01, -0.16, -3.17, -2.93, 0.69, -2.58, -2.33, all P < 0.05). There was a significant difference in homeostasis model assessment of insulin resistance between different states (all P < 0.05). The frequency distributions of each genotype and each allele did not differ significantly between healthy control people of Bai nationality and T2DM patients of Bai nationality and between healthy control people of Han nationality and T2DM patients of Han nationality (all P > 0.05). Logistic regression analysis showed that the polymorphism was not an independent risk factor for T2DM. Conclusion:The relationships between HDAC gene polymorphism and T2DM, obesity and dyslipidemia differ between Bai and Han populations.

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.