New insights in nano-copper chromite catalyzing ultrafine AP:Evaluation of dispersity and mixing uniformity

Improving the application of nanomaterials has always been a research hotspot in the field of energetic materials(EMs)due to their obvious catalytic effect on the EMs,especially the uniformly dispersed nanomaterials.However,few studies have reported the dispersion of nanomaterials.In this study,the dispersity and mixing uniformity of nano-CuCr_(2)O_(4)was evaluated based on the difference of solid UV light absorption between the nano-catalytic materials and EMs.The nano-CuCr_(2)O_(4)/ultrafine AP composites with different dispersity of nano-CuCr_(2)O_(4)were prepared by manual grinding and mechanical grinding with different grinding strength and griding time.And then,the absorbance of different samples at 212 nm was obtained by solid UV testing due to the high repeatability of the absorbance at 210-214 nm for three parallel experiments,and the dispersity of different samples was calculated through the established difference equation.Furthermore,the samples were characterized by XRD,IR,SEM,EDS,DSC and TG-MS,which confirmed that different mixing methods did not change the structure of the samples(XRD and IR),and the mixing uniformity improved with the increase of grinding strength and grinding time(SEM and EDS).The scientificity and feasibility of the difference equation were further verified by DSC.The dispersity of nano-CuCr_(2)O_(4)exhibits a positive intrinsic relationship with its catalytic performance,and the uniformly dispersed nano-CuCr_(2)O_(4)significantly reduces the thermal decomposition temperature of ultrafine AP from 367.7 to 338.8℃.The TG-MS patterns show that the dispersed nano-CuCr_(2)O_(4)advanced the thermal decomposition process of ultrafine AP by about 700 s,especially in the high temperature decomposition stage,and the more concentrated energy release characteristic is beneficial to further enhance the energy performance of AP-based propellants.The above conclusions show that the evaluation method of dispersity based on solid UV curves could provide new ideas for the dispersity characterization of nano-catalytic materials in EMs,which is expected to be widely used in the field of EMs.

TDERS,an exosome RNA-derived signature predicts prognosis and immunotherapeutic response in clear cell renal cell cancer:a multicohort study

Background:Tumor-derived exosomes are involved in tumor progression and immune invasion and might func-tion as promising noninvasive approaches for clinical management.However,there are few reports on exosom-based markers for predicting the progression and adjuvant therapy response rate among patients with clear cell renal cell carcinoma(ccRCC).Methods:The signatures differentially expressed in exosomes from tumor and normal tissues from ccRCC pa-tients were correspondingly deregulated in ccRCC tissues.We adopted a two-step strategy,including Lasso and bootstrapping,to construct a novel risk stratification system termed the TDERS(Tumor-Derived Exosome-Related Risk Score).During the testing and validation phases,we leveraged multiple external datasets containing over 2000 RCC cases from eight cohorts and one inhouse cohort to evaluate the accuracy of the TDERS.In addition,enrichment analysis,immune infiltration signatures,mutation landscape and therapy sensitivity between the high and low TDERS groups were compared.Finally,the impact of TDERS on the tumor microenvironment(TME)was also analysed in our single-cell datasets.Results:TDERS consisted of 12 mRNAs deregulated in both exosomes and tissues from patients with ccRCC.TDERS achieved satisfactory performance in both prognosis and immune checkpoint inhibitor(ICI)response across all ccRCC cohorts and other pathological types,since the average area under the curve(AUC)to predict 5-year overall survival(OS)was larger than 0.8 across the four cohorts.Patients in the TDERS high group were resistant to ICIs,while mercaptopurine might function as a promising agent for those patients.Patients with a high TDERS were characterized by coagulation and hypoxia,which induced hampered tumor antigen presentation and relative resistance to ICIs.In addition,single cells from 12 advanced samples validated this phenomenon since the interaction between dendritic cells and macrophages was limited.Finally,PLOD2,which is highly expressed in fibro-and epi-tissue,could be a potential therapeutic target for ccRCC patients since inhibiting PLOD2 altered the malignant phenotype of ccRCC in vitro.Conclusion:As a novel,non-invasive,and repeatable monitoring tool,the TDERS could work as a robust risk stratification system for patients with ccRCC and precisely inform treatment decisions about ICI therapy.

DCS, a novel classifier system based on disulfidptosis reveals tumor microenvironment heterogeneity and guides frontline therapy for clear cell renal carcinoma

Background: Emerging evidence suggests that cell deaths are involved in tumorigenesis and progression, which may be treated as a novel direction of cancers. Recently, a novel type of programmed cell death, disulfidptosis, was discovered. However, the detailed biological and clinical impact of disulfidptosis and related regulators remains largely unknown. Methods: In this work, we first enrolled pancancer datasets and performed multi-omics analysis, including gene expression, DNA methylation, copy number variation and single nucleic variation profiles. Then we deciphered the biological implication of disulfidptosis in clear cell renal cell carcinoma (ccRCC) by machine learning. Finally, a novel agent targeting at disulfidptosis in ccRCC was identified and verified. Results: We found that disulfidptosis regulators were dysregulated among cancers, which could be explained by aberrant DNA methylation and genomic mutation events. Disulfidptosis scores were depressed among cancers and negatively correlated with epithelial mesenchymal transition. Disulfidptosis regulators could satisfactorily stratify risk subgroups in ccRCC, and a novel subtype, DCS3, owning with disulfidptosis depression, insensitivity to immune therapy and aberrant genome instability were identified and verified. Moreover, treating DCS3 with NU1025 could significantly inhibit ccRCC malignancy. Conclusion: This work provided a better understanding of disulfidptosis in cancers and new insights into individual management based on disulfidptosis.

Quantitative proteomic and phosphoproteomic analyses of the hippocampus reveal the involvement of NMDAR1 signaling in repetitive mild traumatic brain injury

The cumulative damage caused by repetitive mild traumatic brain injury can cause long-term neurodegeneration leading to cognitive impairment.This cognitive impairment is thought to result specifically from damage to the hippocampus.In this study,we detected cognitive impairment in mice 6 weeks after repetitive mild traumatic brain injury using the novel object recognition test and the Morris water maze test.Immunofluorescence staining showed that p-tau expression was increased in the hippocampus after repetitive mild traumatic brain injury.Golgi staining showed a significant decrease in the total density of neuronal dendritic spines in the hippocampus,as well as in the density of mature dendritic spines.To investigate the specific molecular mechanisms underlying cognitive impairment due to hippocampal damage,we performed proteomic and phosphoproteomic analyses of the hippocampus with and without repetitive mild traumatic brain injury.The differentially expressed proteins were mainly enriched in inflammation,immunity,and coagulation,suggesting that non-neuronal cells are involved in the pathological changes that occur in the hippocampus in the chronic stage after repetitive mild traumatic brain injury.In contrast,differentially expressed phosphorylated proteins were mainly enriched in pathways related to neuronal function and structure,which is more consistent with neurodegeneration.We identified N-methyl-D-aspartate receptor 1 as a hub molecule involved in the response to repetitive mild traumatic brain injury,and western blotting showed that,while N-methyl-D-aspartate receptor 1 expression was not altered in the hippocampus after repetitive mild traumatic brain injury,its phosphorylation level was significantly increased,which is consistent with the omics results.Administration of GRP78608,an N-methyl-D-aspartate receptor 1 antagonist,to the hippocampus markedly improved repetitive mild traumatic brain injury-induced cognitive impairment.In conclusion,our findings suggest that N-methyl-D-aspartate receptor 1 signaling in the hippocampus is involved in cognitive impairment in the chronic stage after repetitive mild traumatic brain injury and may be a potential target for intervention and treatment.

党建品牌建设的路径与策略研究——以中海油监督中心地质开发党支部为例

本文以中海油监督中心地质开发党支部为例,深入分析党建品牌的理论基础与重要性,地质开发党支部的现状与问题,以及构建党建品牌的路径与策略。在党建品牌的理论基础中,探讨了党建品牌的概念、特点和构建要素,明确其重要作用。在地质开发党支部的现状与问题分析中,剖析了支部组织结构、党建活动开展现状以及存在的问题与挑战。在构建党建品牌的路径与策略中,深入研究了党建品牌定位与目标的明确,创新党建工作模式,以及加强组织建设与人才培养。通过结合现实情况,提出了具体的解决方案,如引入现代科技手段、发挥党员示范引领作用等。本文旨在为地质开发党支部的党建品牌建设提供深度理解和详细指导,以推动党建工作深入开展,增强党组织凝聚力与吸引力,服务地方经济社会发展。

一种新的多输入多输出柔顺机构拓扑优化方法

针对多输入多输出柔顺机构的输出位移最大化拓扑优化问题,提出了一种新的拓扑优化求解方法。首先,引入柔顺度的小量变化约束函数来处理柔顺机构拓扑优化的病态载荷问题和类铰链问题。基于传统界限公式法思路,通过一个界限变量将多个输出位移最大化目标等效转化为多个约束条件,构建了一种新的多输入多输出柔顺机构拓扑优化的界限公式模型。然后,结合变体积约束限技术、密度过滤技术、Heaviside映射技术、固体各向同性材料插值方法及光滑对偶求解算法,提出了一种新的多输入多输出柔顺机构拓扑优化方法。算例计算结果表明:相对于现有方法,本研究提出的方法获得的最终拓扑不仅清晰,不含类铰链,且具有更大的输出位移。

Another Important Parameter’s Research on Estimating Self-Similarity

It is convincingly demonstrated by numerous studies that the self-similarity of modern multimedia network traffic is presented by Hurst parameter (H). The specific performance is that the similar degree is higher along with the increase of H when H is between 0.5 and 1. However, it is doubtable that whether the complicated process of self-similarity can be described comprehensively by the parameter H only. Therefore, another important parameter cf has been proposed based on the discrete wavelet decomposition in this paper. The significance of the parameters is provided and the performance of the self-similarity process is described better.

中美电竞玩家动机与自尊对比研究

本文采用问卷调查法,以中国和美国的电子竞技类游戏玩家为研究对象,试图探讨电子竞技类游戏在不同游戏形式、不同玩家性别和国别之间的游戏动机与自尊之间的区别。研究结果显示:电脑游戏玩家的自尊低于手机和主机的游戏玩家;男性和女性玩家在游戏自尊上没有差异;手机游戏玩家拥有最低的动机分数;中美游戏玩家的无动机因素和外部调节因素有着显著差异,而另外的内在动机因素、整合调节因素、认同调节和摄入调节没有发现差异。

Surface characteristics,corrosion behavior,and antibacterial property of Ag-implanted NiTi alloy

NiTi shape memory alloy was modified by Ag ion implantation with different incident doses to improve its antibacterial property. The atomic force microscopy, auger electron spectroscopy, and X-ray photoelectron spectroscopy show that the surface of NiTi alloy is covered by TiO2 nano-film with embedded pure Ag with a peak concentration of 5.0 at% at the incident dose of 1.5 x10^17 ions.cm-a, and Ni concentration is reduced in the super- ficial surface layer. The surface roughness reaches the maximum value nearly twice higher than the control sample at the incident dose of 1.5x10^17 ions.cm-2. The potentiodynamic anodic polarization curves show that the Ag-implanted NiTi samples possess higher self-corrosion potential （Ecorr） and lower self-corrosion current density （icor0 but lower breakdown potential （Ebr）. Therefore, the corrosion resistance of the Ag-NiTi is comparable to, if not better than, the untreated NiTi. The antibacterial tests reveal that there is a distinct reduction of the germ numbers on the Ag-NiTi, which is due to the direct contact between Ag and germ, and enhanced by the leaching Ag ions.

Tissue-engineered rhesus monkey nerve grafts for the repair of long ulnar nerve defects:similar outcomes to autologous nerve grafts

Acellular nerve allografts can help preserve normal nerve structure and extracellular matrix composition. These allografts have low immunogenicity and are more readily available than autologous nerves for the repair of long-segment peripheral nerve defects. In this study, we repaired a 40-mm ulnar nerve defect in rhesus monkeys with tissue-engineered peripheral nerve, and compared the outcome with that of autograft. The graft was prepared using a chemical extract from adult rhesus monkeys and seeded with allogeneic Schwann cells. Pathomo- rphology, electromyogram and immunohistochemistry findings revealed the absence of palmar erosion or ulcers, and that the morphology and elasticity of the hypothenar eminence were normal 5 months postoperatively. There were no significant differences in the mean peak compound muscle action potential, the mean nerve conduction velocity, or the number of neurofilaments between the experimental and control groups. However, outcome was significantly better in the experimental group than in the blank group. These findings suggest that chemically extracted allogeneic nerve seeded with autologous Schwann cells can repair 40-mm ulnar nerve defects in the rhesus monkey. The outcomes are similar to those obtained with autologous nerve graft.

Positive carbon isotope excursions:global correlation and genesis in the Middle-Upper Ordovician in the northern Tarim Basin,Northwest China

Stable carbon isotope ratio （δ13Ccarb） analysis has been widely applied to the study of the inter-conti- nental or global marine carbonate correlation. Large-scale Cambrian-Ordovician carbonate platforms were developed in the Tarim Basin. But research on fluctuation character- istics and global correlation of δ13Ccarb is still weak. Based on conodont biostratigraphy and whole-rock δ13Ccarb data in the Tahe oil-gas field of the northern Tarim Basin, the global correlation and genesis of positive carbon isotope excursions in the Darriwilian--Early Katian was exam- ined. Three positive excursions were identified in the Tahe oil-gas field including the middle Darriwilian carbon iso- tope excursion （MDICE）, the Guttenberg carbon isotope excursion （GICE）, and a positive excursion within the Pygodus anserinus conodont zone which is named the Early Sandbian carbon isotope excursion （ESICE） in this paper. Furthermore, these positive excursions had no direct relation with sea level fluctuations. MDICE and GICE could be globally correlated. The Middle-Upper Ordovi- cian Saergan Formation source rocks of the Kalpin outcrops were in accordance with the geological time of MDICE and ESICE. GICE had close relationship with the source rock of the Lianglitag Formation in the basin.Massive organic carbon burial was an important factor controlling the genesis of these positive excursions.

3D numerical simulation of heterogeneous in situ stress field in low-permeability reservoirs

Analysis of the in situ stress orientation and magnitude in the No.4 Structure of Nanpu Sag was performed on the basis of data obtained from borehole breakout and acoustic emission measurements.On the basis of mechanical experiments,logging interpretation,and seismic data,a 3 D geological model and heterogeneous rock mechanics field of the reservoir were constructed.Finite element simulation techniques were then used for the detailed prediction of the 3 D stress field.The results indicated that the maximum horizontal stress orientation in the study area was generally NEE-SWW trending,with significant changes in the in situ stress orientation within and between fault blocks.Along surfaces and profiles,stress magnitudes were discrete and the in situ stress belonged to theⅠa-type.Observed inter-strata differences were characterized as five different types of in situ stress profile.Faults were the most important factor causing large distributional differences in the stress field of reservoirs within the complex fault blocks.The next important influence on the stress field was the reservoir’s rock mechanics parameters,which impacted on the magnitudes of in situ stress magnitudes.This technique provided a theoretical basis for more efficient exploration and development of low-permeability reservoirs within complex fault blocks.

Three-dimensional visualization of the functional fascicular groups of a long-segment peripheral nerve

The three-dimensional（3D） visualization of the functional bundles in the peripheral nerve provides direct and detailed intraneural spatial information. It is useful for selecting suitable surgical methods to repair nerve defects and in optimizing the construction of tissue-engineered nerve grafts. However, there remain major technical hurdles in obtaining, registering and interpreting 2D images, as well as in establishing 3D models. Moreover, the 3D models are plagued by poor accuracy and lack of detail and cannot completely reflect the stereoscopic microstructure inside the nerve. To explore and help resolve these key technical problems of 3D reconstruction, in the present study, we designed a novel method based on re-imaging techniques and computer image layer processing technology. A 20-cm ulnar nerve segment from the upper arm of a fresh adult cadaver was used for acetylcholinesterase（ACh E） staining. Then, 2D panoramic images were obtained before and after ACh E staining under the stereomicroscope. Using layer processing techniques in Photoshop, a space transformation method was used to fulfill automatic registration. The contours were outlined, and the 3D rendering of functional fascicular groups in the long-segment ulnar nerve was performed with Amira 4.1 software. The re-imaging technique based on layer processing in Photoshop produced an image that was detailed and accurate. The merging of images was accurate, and the whole procedure was simple and fast. The least square support vector machine was accurate, with an error rate of only 8.25%. The 3D reconstruction directly revealed changes in the fusion of different nerve functional fascicular groups. In conclusion. The technique is fast with satisfactory visual reconstruction.

Long-term effect of vasectomy on spermatogenesis in ,en： a morphometric study

Spermatogenic damage may occur after vasectomy, and the damage is pressure mediated, occurring when the occluded reproductive tract is unable to accommodate additional sperm produced by the testis. This study aimed to determine the long-term effect of vasectomy on spermatogenesis in humans and clarify how the balance between sperm production in the testis and sperm storage in or removal from the tract might be maintained. During inguinal hernia repair, an open biopsy was performed to obtain testicular tissue blocks from 51 Chinese men （aged ≥ 50 years）, of whom 25 （control group） had not undergone vasectomy and 26 （vasectomized group） had undergone bilateral vasectomy 22-42 years before. Methacrylate resin-embedded testicular sections were made, and morphometric studies were performed using light microscopy. In addition, sizes of the testis and epididymis were estimated with ultrasonography. The testicular tissue blocks obtained from one control and seven vasectomized men consisted almost completely of connective tissue. In the other 43 men, significant differences were not found between the two groups in the testicular or epididymal size, qualitative histology or quantitative parameters including the mean diameter or volume fraction of the seminiferous tubules. In conclusion, sperm production and sperm storage/removal reached a static equilibrium after vasectomy, likely due to spermatogenic degeneration or less sperm production as a result of aging or due to vasectomy-induced testicular （interstitial） fibrosis. Thus, complications that might occur in association with overproduction of sperm and distension of the tract would disappear or be relieved with time.

Evaluation of H2 Influence on the Evolution Mechanism of NOx Storage and Reduction over Pt–Ba–Ce/c-Al2O3 Catalysts

In this investigation, Pt–Ba–Ce/c-Al2O3 catalysts were prepared by incipient wetness impregnation and experiments were performed to evaluate the influence of H2 on the evolution mechanism of nitrogen oxides (NOx) storage and reduction (NSR). The physical and chemical properties of the Pt–Ba–Ce/c- Al2O3 catalysts were studied using a combination of characterization techniques, which showed that PtOx, CeO2, and BaCO3, whose peaks were observed in X-ray diffraction (XRD) spectra, dispersed well on the c-Al2O3, as shown by transmission electron microscope (TEM), and that the difference between Ce3+ and Ce4+, as detected by X-ray photoelectron spectroscopy (XPS), facilitated the migration of active oxygen over the catalyst. In the process of a complete NSR experiment, the NOx storage capability was greatly enhanced in the temperature range of 250–350℃, and reached a maximum value of 315.3μmol·gcat^-1 at 350℃, which was ascribed to the increase in NO2 yield. In a lean and rich cycling experiment, the results showed that NOx storage efficiency and conversion were increased when the time of H2 exposure (i.e., 30, 45, and 60 s) was extended. The maximum NOx conversion of the catalyst reached 83.5% when the duration of the lean and rich phases was 240 and 60 s, respectively. The results revealed that increasing the content of H2 by an appropriate amount was favorable to the NSR mechanism due to increased decomposition of nitrate or nitrite, and the refreshing of trapping sites for the next cycle of NSR.

Surface modification of Ti-49.8at%Ni alloy by Ti ion implantation: phase transformation, corrosion, and cell behavior

The Ti-49.8at%Ni alloy was modified by Ti ion implantation to improve its corrosion resistance and biocompatibility. The chemical composition and morphologies of the Ti Ni alloy surface were determined using atomic force microscopy(AFM), auger electron spectroscopy(AES), and X-ray photoelectron spectroscopy(XPS). The results revealed that Ti ion implantation caused the reduction of Ni concentration and the formation of a Ti O2 nano-film on the Ti Ni alloy. The phase transformation temperatures of the Ti–Ti Ni alloy remained almost invariable after Ti ion implantation. Electrochemical tests indicated that the corrosion resistance of Ti Ni increased after Ti ion implantation. Moreover, the Ni ion release rate in 0.9% Na Cl solution for the Ti Ni alloy remarkably decreased due to the barrier effect of the Ti O2 nano-film. The cell proliferation behavior on Ti-implanted Ti Ni was better than that on the untreated Ti Ni after cell culture for 1 d and 3 d.

Immunomodulatory effect of schisandrae oil in mouse model of autoimmune hepatitis induced by concanavalin A

Objective:To study the immunomodulatory effect of schisandra oil (SCO) in mouse model of autoimmune hepatitis induced by concanavalin A (ConA). Methods: C57BL/6 mice were divided into control group, model group and SCO group. Mice in SCO group were given SCO at 5 mg/kg by intragastric administration every day for 7 days, followed by intravenous injection of ConA at 10 mg/kg. 10 hours after ConA injection, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured by the kits, the expression of inflammatory cytokines like interferon-γ(IFN-γ), interleukin-4 (IL-4), interleukin-17 (IL-17), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and interleukin-6 (IL-6) in liver was detected by real-time quantitative PCR, and the T cell activation and IFN-γ expression in spleen and MLN were examined by flow cytometry. Results: Compared with control group, each indicator in model group were significantly higher. In SCO preventive treatment group, the levels of serum ALT, AST and LDH were significantly reduced (all P < 0.001), the expression levels of inflammatory cytokines in liver were downregulated, the T cell activation in spleen and MLN was inhibited (P = 0.006 and P = 0.008), the percentages of IFN-γ+ CD8+ and IFN-γ+ CD4+ T cells were decreased, and the frequencies of Th2 and Th17 cells in spleen and MLN were also decreased at the same time. Conclusion: SCO has a protective effect on immune liver injury by inhibiting the activation of T cells and reducing the expression of inflammatory cytokines, which reflects that SCO plays a role in the immunomodulation of autoimmune hepatitis, indicating that SCO is of great significance for the maintenance of autoimmune homeostasis.

Improvement of plasma uniformity and mechanical properties of Cr films deposited on the inner surface of a tube by an auxiliary anode near the tube tail

In order to improve the length of plasma in a whole tube and mechanical properties of Cr films deposited on the inner surface of the tube, a high-power impulse magnetron sputtering coating method with a planar cathode target and auxiliary anode was proposed. The auxiliary anode was placed near the tube tail to attract plasma into the inner part of the tube. Cr films were deposited on the inner wall of a 20# carbon steel tube with a diameter of 40 mm and length of 120 mm. The influence of auxiliary anode voltage on the discharge characteristics of the Cr target, and the structure and mechanical properties of Cr films deposited on the inner surface of the tube were explored. With higher auxiliary anode voltage, an increase in substrate current was observed, especially in the tube tail. The thickness uniformity, compactness, hardness and H/E ratios of the Cr films deposited on the inner surface of the tube increased with the increase in auxiliary anode voltage. The Cr films deposited with auxiliary anode voltage of 60 V exhibited the highest hardness of 9.6 GPa and the lowest friction coefficient of 0.68.

Research on Remaining Useful Life Prediction Method of Rolling Bearing Based on Health Indicator Extraction and Trajectory Enhanced Particle Filter

Aiming at the difficulty of mining fault prognosis starting points and constructing prognostic models for remaining useful life(RUL)prediction of rolling bearings,a RUL prediction method is proposed based on health indicator(HI)extraction and trajectory-enhanced particle filter(TE-PF).By extracting a HI that can accurately track the trending of bearing degradation and combining it with the early fault enhancement technology,early abnormal sample nodes can be mined to provide more samples with fault information for the construction and training of subsequent prediction models.Aiming at the problem that traditional degradation rate models based on PF are vulnerable to HI mutations,a TE-PF prediction method is proposed based on comprehensive utilization of historical degradation information to timely modify prediction model parameters.Results from a rolling bearing prognostic study show that prediction starting points can be accurately detected and a reasonable prediction model can be conveniently constructed by the RUL prediction method based on HI amplitude abnormal detection and TE-PF.Furthermore,aiming at the RUL prediction problem under the condition of HI mutation,RUL prediction with probability and statistics characteristics under a confidence interval can be obtained based on the method proposed.

Successful multimodality treatment of metastatic gallbladder cancer:A case report and review of literature

BACKGROUND Gallbladder cancer is the most common malignant tumor in the biliary system,and it is characterized by high aggressiveness and an extremely poor prognosis.Current treatment for advanced gallbladder cancer remains unsatisfactory.Here,we report a patient with advanced gallbladder cancer who was cured by multidisciplinary treatment.CASE SUMMARY A 73-year-old male presented to our hospital with right abdominal pain for 3 d and was diagnosed with stage IVB gallbladder cancer with multiple liver metastases,peritoneum metastasis,diaphragm metastasis and lymph node metastases.The patient initially received chemotherapy,targeted therapy,125I seed implantation and immunotherapy,as there were no specific indications for radical surgery.During these palliative therapies,the level of tumor markers gradually decreased but remained higher than the normal level,lymph node metastases gradually disappeared,and liver metastasis was gradually limited to the left liver.Finally,the patient received radical surgery with left hepatectomy,radical lymphadenectomy and partial diaphragmatic resection.To date,the patient has survived for more than six years posttreatment,the levels of tumor markers are normal,and imaging examinations show no signs of tumor recurrence.CONCLUSION Currently,the prognosis of advanced gallbladder cancer remains unsatisfactory.A single treatment method is not sufficient for patients with advanced gallbladder cancer.Multidisciplinary individualized treatment is essential and should be utilized for advanced gallbladder cancer patients to further improve prognosis.