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ObjectiveTo investigate the effect of combination of proprioceptive neuromuscular facilitation (PNF) rope training and repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function of stroke patients with hemiplegia. MethodsFrom March, 2021 to February, 2022, 90 stroke inpatients with hemiplegia in the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangxi Medical University were divided into control group (n = 30), rope group (n = 30) and combination group (n = 30) randomly. All the groups received routine rehabilitation, while the control group received routine PNF training, the rope group received PNF rope training, and the combination group received PNF rope training and rTMS, for four weeks. They were assessed with Functional Test for the Hemiplegic Upper Extremity-Hong Kong version (FTHUE-HK), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment. ResultsThe scores of FTHUE-HK, FMA-UE and MBI increased in all the three groups after treatment (t > 2.167, P < 0.05), and they were more in the combination group than in the rope group (P < 0.05), and in the rope group than in the control group (P < 0.05). ConclusionThe combination of PNF rope training and rTMS is more effective on motor function of upper limbs of stroke patients with hemiplegia than PNF training alone.
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Objective:By analyzing the clinical data of patients with primary duodenal adenocarcinoma (PDA), the risk factors affecting the postoperative prognosis of PDA patients were discussed.Methods:The clinical data of 191 patients diagnosed with PDA in Peking University First Hospital from Jan 2009 to Dec 2022 were collected. The survival rate was calculated and the survival curve was plotted by Kaplan-Meier method. Univariate analysis was performed by Log-Rank test, and multivariate analysis was performed by COX proportional hazards regression model to obtain independent risk factors.Results:The median age of onset in patients with PDA is 65 years old, and the most common symptoms are abdominal pain and abdominal distension. Prognostic analysis showed that the survival rates at 1, 3 and 5 years were 73.8%, 44.6%, and 23.0%. The analysis of Cox risk proportional regression model showed that preoperative CA19-9 level, depth of tumor invasion, degree of differentiation, TNM stage, and surgical mode were independent risk factors for the prognosis of PDA (all P<0.01). Conclusion:The overall incidence of PDA is low, but the prognosis is rather poor. Multvariable factors are associated with its prognosis and surgery is still the mainstay for hope of cure.
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Objective:To evaluate CT and or MRI imaging in the diagnosis of lateral lymph node metastasis in patients of middle and low rectal cancer.Methods:In this study, 112 lateral lymph nodes were harvested in 79 patients with middle and low rectal cancer. The relationship between the preoperative imaging features of the lateral lymph nodes and the postoperative pathology was evaluated.Result:Thirty-eight cases (48%) were pathologically confirmed to have lateral lymph node metastasis. The diameter of metastasis-positive lateral lymph nodes was significantly larger than that of metastasis-negative lateral lymph nodes ( P<0.01). Multivariate analysis of clinical features and imaging features found that, tumors poorly differentiated, mucinous adenocarcinoma, signet ring cell carcinoma ( P=0.006), and the largest short diameter of the lateral lymph node ≥7 mm ( P=0.024), uneven density or signal ( P=0.022) were independent risk factors for lateral lymph node metastasis. Conclusion:Poor tumor differentiation, lateral lymph node maximum short diameter ≥7 mm, density or signal unevenness are independent risk factors for lateral lymph node metastasis in middle and low rectal carcinoma.
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Objective:To investigate the risk factors of low anterior resection syndrome (LARS)after low anterior resection of rectal cancer (Dixon).Methods:This retrospective study was conducted in Peking University First Hospital and Traditional Chinese Medicine Hospital of Shanxi Provice from Jan 2012 to Jun 2019. A cohort of 504 patients with rectal cancer was enrolled in the study. All the patients underwent anterior resection. The relationship between clinical-pathological data were analyzed retrospectively. Univariate analysis using χ 2 test. Logistic regression analysis was used to screen the influencing factors of LARS, and the Nomogram method was used to score each factors. Results:Univariate analysis showed that BMI≥28 kg/m 2(χ 2=9.450, P=0.002), the distance from the lower edge of the tumors to the anus <6 cm (χ 2=12.070, P=0.001), high ligation of the inferior mesenteric artery (IMA) (χ 2=8.279, P=0.004), preoperative neoadjuvant therapy (χ 2=11.230, P=0.001), postoperative anastomotic leakage (χ 2=11.840, P=0.001) were associated with severe LARS.Multivariate analysis showed that the distance from the lower edge of the tumors to the anus <6 cm ( OR=1.861, 95% CI: 1.289-2.688, P=0.001), BMI≥28 kg/m 2 ( OR=1.747, 95% CI: 1.022-2.987, P=0.041), high IMA ligation ( OR=1.688, 95% CI: 1.157-2.463, P=0.007), preoperative neoadjuvant therapy ( OR=2.719, 95% CI: 1.343-5.505, P=0.005) were independent risk factors for LARS. Nomogram model showed that the total factor ranged from 2 to 212, and the corresponding risk rate ranged from 30% to 80%. The patients with higher score have greater risk for severe LARS. The area under the predictive power curve of Nomogram model (AUC) was 0.749 (95% CI: 0.705-0.793, P<0.001). Conclusion:Lower tumor location, obesity, preoperative neoadjuvant therapy, high IMA ligation and postoperative anastomotic leakage increase the risk of severe LARS.
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OBJECTIVE@#To investigate the value of neoadjuvant chemoradiotherapy (nCRT) combined with total pelvic exenteration (TPE) in the treatment of primary T4b rectal cancer.@*METHODS@#A retrospective cohort study was conducted to analyze the clinicopathological data of 31 patients with primary T4b rectal cancer who underwent TPE from January 2008 to December 2015 at Peking University First Hospital.@*INCLUSION CRITERIA@#preoperative clinical stage (cTNM) was defined as cT4b primary rectal cancer with only front wall Invasion; the lower edge of tumor was within 10 cm from the anal margin; TPE was performed; R0 resection was confirmed by pathology. Patients with recurrent rectal cancer, distant metastasis, and undergoing TPE for non-rectal tumors were excluded. Patients were divided into nCRT group and non-nCRT group according to whether receiving nCRT before surgery. The nCRT group received long course radiotherapy (total dose 50 Gy in 25 daily fractions) with concomitant chemotherapy (Capecitabine), and the surgery was performed 6-8 weeks after the neoadjuvant chemoradiation, while the non-nCRT group received surgery directly. The intraoperative, postoperative and pathological conditions and local recurrence were compared between the two groups. The survival curves were drawn by Kaplan-Meier method and the survival of two groups were compared.@*RESULTS@#A total of 31 patients were enrolled, including 13 patients in the nCRT group and 18 patients in the non-nCRT group. The baseline data, such as age, duration of disease, preoperative basic disease, body mass index, smoking rate, and tumor distance from the anal margin, were not significantly different between the two groups (all P>0.05). In the nCRT group and non-nCRT group respectively, the ratio of anal preservation was 30.8%(4/13) and 38.9%(7/18) (P=0.468), the median intraoperative blood loss was 1 000 ml and 800 ml (P=0.644), the operation time was (531.7±137.2) minutes and (498.0±90.1) minutes (P=0.703), the median hospital stay was 18 days and 14 days (P=0.400), the morbidity of complications within 30 days after surgery was 23.1%(3/13) and 38.9%(7/18)(P=0.452), the incidence of postoperative abdominal abscess was 15.4%(2/13) and 0 (P=0.168), the proportion of secondary surgery was 7.7%(1/13) and 11.1%(2/18)(P=1.000), whose differences were not significantly different. The proportion of postoperative pathological pT4b in whole group was 58.1%(18/31), including 53.8%(7/13) in nCRT group and 61.1%(11/18) in non-nCRT group, which was not significantly different between the two groups (P=0.691). The number of harvested lymph node in nCRT group was 13.5±5.9, which was significantly less than 23.0±11.8 in non-nCRT group (P=0.013). There was no pathological complete remission (ypCR) case in nCRT group, and among 13 patients, tumor regression grade (TRG) of 2, 3, 4, and 5 was in 1 case (7.7%), 6 cases (46.2%), 5 cases(38.5%), and 1 case (7.7%), respectively. The median follow-up time was 33 (2 to 115) months, and the follow-up rate was 93.5%(29/31). One case was lost in both the nCRT group and non-nCRT group. The 3-year disease-free survival rate was 43.5% in pooled data, and was 43.6% and 43.3% in nCRT group and non-CRT group respectively without significant difference (P=0.833). The 3-year overall survival rate was 51.1% in pooled data, and was 45.7% and 54.7% in nCRT group and non-nCRT group respectively without significant difference (P=0.653).The local recurrence rate of nCRT and non-nCRT groups was 8.3%(1/12) and 5.9%(1/17) respectively, and the distant metastasis rate was 50.0%(6/12) and 41.2%(7/17) respectively, whose differences were not statistically significant as well (P=1.000 and P=0.865, respectively).@*CONCLUSION@#For primary T4b rectal cancer which can achieve R0 resection through total pelvic exenteration, neoadjuvant chemoradiotherapy has not been demonstrated any advantage in tumor regression, reducing local recurrence, or improving survival, and may increase postoperative complications.
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Humans , Adenocarcinoma , Pathology , Therapeutics , Antineoplastic Agents , Chemoradiotherapy , Combined Modality Therapy , Neoadjuvant Therapy , Neoplasm Staging , Pelvic Exenteration , Rectal Neoplasms , Pathology , Therapeutics , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To investigate the correlation between clinicopathological features and lymph node metastasis in early gastric cancer (EGC) and evaluate the influence of lymph node metastasis on the overall survival.Methods The clinicopathological data of 178 EGC patients undergoing radical gastrectomy with lymphadenectomy in Peking University First Hospital between Jan 2006 and Dec 2015 were retrospectively reviewed.The impact of lymph node metastasis on the overall survival was analyzed.Results Lymph node metastasis was detected in 19 (10.7％) of 178 patients.Univariate analysis showed a positive relationship between tumor size (x2 =4.804,P =0.028),depth of invasion (x2 =8.176,P =0.003),histological type (x2 =4.333,P =0.037),vascular tumor thrombus (x2 =9.992,P =0.002) and lymph node metastasis in EGC.Multivariate analysis revealed that depth of invasion (Wald =4.954,P =0.026)and intra-vascular tumor thrombus (Wald =3.966,P =0.046) were independent relative factors of lymph node metastasis in EGC patients.The 5-year survival rates of EGC patients with lymph node metastasis were 78.9％,much lower than that without lymph node metastasis (94.3％,x2 =8.310,P=0.004).Conclusions Lymph node metastasis in EGC is mainly correlated with depth of invasion and intra-vascular tumor thrombus.The prognosis of patients with lymph node metastasis is significantly poorer than those without lymph node metastasis.
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The clinical application of novel chemotherapeutic drugs including oral 5-FU and targeted drugs and preoperatively accurate imaging grading has brought challenges to the indication criteria developed by NCCN and ESMO for neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC). Extended hotspots have focused on the effectiveness of using capecitabine instead of fluorouracil infusion, the combination of multiple drugs and the feasibility of using neoadjuvant chemotherapy instead of neoadjuvant chemoradiotherapy for selective patients. Traditionally, the evaluation of the effect of neoadjuvant therapy has been based on the effect on the pathological complete remission (pCR) rate. However, current studies recommend the disease-free survival (DFS) as a more important outcome. Besides, seeking for effective biomarkers as predictive markers for neoadjuvant therapies or as prognostic markers remains a hotspot in the field of neoadjuvant chemoradiotherapy. The "watch and wait" approach refers to taking a close follow-up strategy instead of direct operation for patients achieving clinically complete remission (cCR) after neoadjuvant therapy. However, there is no unified evaluation criteria and time point for the evaluation of cCR following neoadjuvant therapy. Therefore, there remain a lot of controversies regarding the clinical application of neoadjuvant chemoradiotherapy in LARC. In this manuscript, research progress in the indication for neoadjuvant therapy, improvement in the neoadjuvant therapeutic schedule, advancement of the efficacy evaluation criteria of neoadjuvant therapy, the "watch and wait" approach and other hot topics is summarized to provide references for clinical practice.
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Humans , Antimetabolites, Antineoplastic , Therapeutic Uses , Capecitabine , Therapeutic Uses , Chemoradiotherapy , Fluorouracil , Therapeutic Uses , Neoadjuvant Therapy , Neoplasm Staging , Rectal Neoplasms , Therapeutics , Treatment OutcomeABSTRACT
Objective@#To investigate the risk factors and computed tomography (CT) diagnostic accuracy of anastomotic leakage after resection of rectal cancer (Dixon) .@*Methods@#This retrospective study was conducted in Peking University First Hospital from January 2013 to June 2015. A cohort of 452 patients with rectal cancer was enrolled in the study. All the patients underwent anterior resection. The relationship between clinical-pathological data (including sex, age, body mass index (BMI) , presence of diabetes, hypohemoglobin (Hb < 90 g/L) , hypoalbuminemia (Alb < 35 g/L) , the distance from the lower edge of the tumors to the anus, tumor diameter, tumor differentiation, tumor TNM stage, neoadjuvant therapy status, ligation of the left colonic artery (LCA) , preventive colostomy, and anastomotic leakage was analyzed retrospectively. Univariate analysis using χ2 test and multivariate analysis by using the Ordered Classification Arguments Logistic regression model.@*Results@#Of all the cases, 281 and 171 patients were men and women, respectively. The median age was 64 years (range, 18-88 years) . Forty-seven patients (10.4%) were diagnosed with anastomotic leakage, and the median diagnostic time of anastomotic leakage was 6.5 days (range, 3-31 days) . One patient with anastomotic leakage died because of respiratory failure within 1 month postoperatively; 11 patients underwent salvage colostomy performed 2-34 days (median, 7 days) after the first surgery. All the 11 patients underwent colostomy closure within 2 years. The other 35 patients recovered by antibiotic and peritoneal lavage treatment. The mean length of postoperative hospital stay in patients without anastomotic leakage was 8.4±2.4 days, which was significantly shorter than that in patients with anastomotic leakage (34.6±15.7 days) , and the difference was statistically significant (t = 24.127, P = 0.008) . The results of the univariate analysis showed that BMI≥28 kg/m2 (χ2 = 7.550, P = 0.000) , diabetes mellitus (χ2 = 5.055, P = 0.025) , Hb < 90 g/L preoperatively (χ2 = 5.718, P = 0.017) , Alb < 35 g/L preoperatively (χ2 = 8.096, P = 0.004) , distance of < 6 cm from the lower edge of the tumors to the anus (χ2 = 8.205, P = 0.004) and LCA ligation (χ2 = 16.540, P = 0.000) were risk factors for the occurrence of anastomotic leakage. Multivariate analysis showed that BMI≥28 kg/m2 (OR = 1.758, 95%CI: 1.265-2.454, P = 0.021) , distance of < 6 cm from the lower edge of the tumors to the anus (OR=1.530, 95%CI: 1.035-2.117, P = 0.037) , LCA ligation (OR = 1.551, 95%CI: 1.035-2.131, P = 0.042) were independent risk factors for anastomotic leakage. The CT diagnostic sensitivity of anastomotic leakage was 91.2% (31/34) . The false positive rate of CT for diagnosing anastomotic leakage was zero 7 days after the Dixon procedure.@*Conclusion@#Important factors, including BMI of patients, LCA ligation, and the distance from the lower edge of the tumors to the anus are related with anastomotic leakage. The individual treatments should be considered based on the patient′s clinical condition. CT was recommended 7 days postoperatively when anastomotic leakage was highly suspected.
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<p><b>OBJECTIVE</b>To investigate the clinicopathological features and prognosis of colorectal synchronous multiple primary cancer(SMPC).</p><p><b>METHODS</b>From January 2008 to June 2011, 51 patients diagnosed with colorectal SMPC underwent surgery at Department of General Surgery of Peking University First Hospital. Their clinicopathological features, diagnosis, treatment and prognosis were summarized and analyzed. SMPC was diagnosed according to the following criteria: each tumor must have a definite pathologic picture of malignancy; metastasis or recurrence from another colorectal cancer was excluded; tumors must be distinctly separated by at least 5 cm of all intact bowel wall from each other; SMPC has abnormal cells between tumor and normal mucosa and abnormal gland of transitional zone; each cancer is infiltrating carcinoma except the carcinoma in situ; all the cancers are detected at the same time or within 6 months. Multiple primary colorectal cancer originated from familial colonic polyposis or ulcerative colitis was excluded.</p><p><b>RESULTS</b>These 51 colorectal SMPC patients accounted for 3.5% of 1 452 colorectal cancer patients in the same period at our hospital, with 32 males and 19 females, and mean age of (63±13)(29 to 82) years. Of 51 cases, 46(90.2%) had 2 original carcinoma, 3(5.9%) had 3 original carcinoma and 2(3.9%) had 4 carcinoma; 23(45.1%) complicated with colon polyps, 4(7.8%) complicated with malignancy outside the colorectum. In TNM staging, 7(13.7%), 15(29.4%), 24(47.1%) and 5(9.8%) patients were stage I(, II(, III( and IIII( respectively. Among 51 patients undergoing surgery by different procedures, 16 were subtotal colon resection, 8 were extended right colon resection, 5 were extended left hemicolon resection, 8 were right hemicolon resection plus Dixon procedure, 10 were Dixon, and 4 were right hemicolon resection plus sigmoid colon resection. Adjuvant chemotherapy and support treatment were given according to the condition after operation. A total of 105 tumors were found, including 25(23.8%) tumors in sigmoid colon, 24(22.9%) in rectum, 22(21.0%) in ascending colon and 4 in organs outside the colorectum. Tubular adenocarcinoma (86/105, 81.9%) was the main pathological type in these colorectal SMPC patients. During the follow-up of median 43.5 months, 10 cases presented local recurrence and 6 cases had liver metastasis. Multivariable analysis showed that ≤65 years old (OR=22.757, 95%CI: 1.562-331.543, P=0.002),undifferentiated carcinoma or mucous adenocarcinoma (OR=27.174, 95%CI: 2.834-260.512, P=0.004), stage III(-IIII( (OR=29.626, 95%CI: 3.216-272.884, P=0.003) were independent risk factors of postoperative 5-year recurrence and metastasis, but the number of SMPC lesions and the surgical method were not associated with postoperative 5-year recurrence and metastasis (P=0.564, P=0.513). The 3-year and 5-year survival rates of colorectal SMPC patients were 76.5% and 64.7%.</p><p><b>CONCLUSION</b>Two-original carcinoma is the most common in colorectal SMPC patients, which mainly distributes in sigmoid colon and rectum. Postoperative monitoring should be strengthened for those patients with younger age, poor pathological types and advanced staging to prevent recurrence and metastasis.</p>
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<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics and prognosis of rectal neuroendocrine neoplasms (NENs).</p><p><b>METHODS</b>From January 2000 to May 2017, 84 patients were diagnosed as NENs by pathology and underwent surgical treatment in Peking University First Hospital. Their clinicopathological characteristics, surgial options and prognosis were analyzed retrospectively.</p><p><b>RESULT</b>Among these 84 cases, 67 cases were NET G1, 6 cases were NET G2, 10 cases were NEC G3 and 1 case was MANEC G3. The median size was 0.8 (0.2 to 18.0) cm. There were 60 cases of stage I(, 2 cases of stage II(, 12 cases of stage III(, 10 cases of stage IIII(. Forty-nine patients accepted examinations because of non-specific symptoms, including altered bowel habits(22/49), bloody stool (19/49) and abdominal pain(10/49); the other 35 cases including 2 patients with liver metastasis were diagnosed by endoscopy or CT during routine physical examination. Forty-four patients received endoscopic ultrasonography(EUS) with 100% of sensitivity and 90.9% of accuracy. Among 20 cases (23.8%) with lymph node metastasis (all ≥T2 stage), 12 cases were NET G1 and G2 (1 case of multiple NET G1) and 8 cases were NEC G3 and MANEC G3. The lymph node metastasis rate of stage T1 NET G1 and G2 was lower than that of stage T2 to T4 NET G1 and G2, also lower than that of NEC G3 and MANEC G3 (all P=0.000), however, stage T2 to T4 NET G1 and G2 showed the similar rate of lymph node metastasis with NEC G3 and MANCE G3(P>0.05). Synchronously distant metastasis was found in 10 (11.9%) patients at the first diagnosis, and ovarian metastasis was found in 1 case 9 years after curative resection of rectal NEN. Among 81 patients receiving operation, 57 patients underwent endoscopic mucosal resection (56 patients of stage T1 NET G1 and G2); 3 patients local excision without lymph node dissection; 13 patients curative resection; 1 patient curative resection with liver metastasis resection; 6 patients palliative surgery and 1 patient metastatic lesion resection only. Overall follw-up time was 1 month to 169 months, and the 3- and 5-year survival rates were 87.7% and 79.7% respectively. No recurrence or metastasis was observed in all the 62 patients with T1 G1 and G2, including 56 cases of ESD, 3 cases of local excision, 3 cases of curative resection, whose 3-year and 5-year survival rates were both 96%. The prognosis was closely associated with grade and stage of NENs (all P=0.000).</p><p><b>CONCLUSIONS</b>The early symptoms of rectal NENs are insidious and atypical, therefore some patients are diagnosed as stage II( or higher at their first consultation. ESD is safe and effective for NET G1 and G2. The prognosis depends on grade and stage of NENs.</p>
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Objective To study the applicability of Vienna Test System ( VTS) to psychological screening of flying cadets,and to establish a corresponding standard model for flying cadets .Methods VTS and pilot psychological selection system were used to evaluate the mental health of 134 cases of flying cadets , SPSS 13.0 was used to compare their consistency and relevance.Results The results of VTS included the raw score of overall mean duration [(46.68 ±21.06)s] on 2hand test, the correct reaction times (246.54 ±25.88) on DT test, the normal values of overall mean duration [(27.84 ±21.98)s] on 2 hand test,and the correct reaction times (60.57 ±18.61) on DT test and other indexes. Pearson coefficient was calculated as predictive validation .The composite score of VTS was significantly positively correla-ted with the first platform(r=0.46,P<0.0001), the second platform(r=0.27,P<0.05) and the psychological perform-ance of the pilot psychological selection system (r=0.31,P<0.05).Kappa-test showed that the two methods were highly consistent(Kappa=0.53).Conclusion The application of VTS to screening the mental health of flying cadets can yield and quick but accurate results , which are of high reliability and validity .It is undoubtedly of great significance for improving the level of aviation security ,objectivity of selection results and predictive validity .
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Objective To investigate factors affecting the metastasis of lymph nodes around the root of inferior mesenteric artery(IMA) in rectal cancer,and the significance of root lymph nodes dissection of IMA in radical surgery for rectal cancer.Methods Clinicopathological data of 105 rectal cancer patients undergoing root lymph node dissection of IMA during radical resection in Peking University First Hospital from January 2005 to December 2008 were analyzed retrospectively.Rectal cancer patients without root lymph node dissection of IMA during the same period served as control.Results were compared between these two groups for survival and local recurrence rates.Results The rate of lymph node metastasis around the origin of IMA was 9.5％ (10/105).The five-year survival rate in patients with IMA root nodal dissection was 71.3％,and that without was 70.6％ (P =0.995),while the local recurrence was respectively 1.9％ and 7.4％ (P ＜ 0.05).In multivariate analyses,IMA root nodal metastasis occurred more frequently in patients with pT3 and pT4 tumor(Wald =5.764,P ＜ 0.05) and poorly differentiated tumor(Wald =7.818,P ＜ 0.05).Conclusions Root lymph nodes dissection of IMA could not increase five-year survival rate,but it could reduce local recurrence rate in patients with rectal cancer.In radical surgery of rectal cancer,lymphadenectomy of IMA root should be performed in patients with T3 and T4 tumor with poorly differentiated tumor,so as to reduce local recurrence rate.
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Objective To detect the relationship between the pathological degrees of chronic cholecystitis and coincident diseases. Method The pathological degree was divided into mild,moderate and severe degree according to the pathological changes in 442 cases of chronic cholecystitis,and the proliferation of mucosa cell was detected by SP immunohistochemical staining in 105 cases. Results The coincident calculus, polyp, adenoma in the mild chronic cholecystitis were 65.0%,17.1% and 0.5%, respectively. The coincident calculus, polyp, adenoma and malignant neoplasms in the moderate chronic cholecystitis were 70.1%, 19.4%, 3.7% and 2.2%. The coincident calculus, polyp, adenoma and malignant neoplasms in the severe chronic cholecystitis were 88.0%, 26.4%, 24.2% and 9.9%. The positive expression rates of PCNA in mild, moderate and severe chronic cholecystitis were 12.3%, 17.5% and 38.7%, respectively. The results showed that the pathological degree of chronic cholecystitis was obviously related to the coincidence of calculus, polyp, adenoma, malignant neoplasms. Conclusions Severe chronic cholecystitis is a high-risk lesion of gallbladder carcinoma,it should be removed surgically.