Objective To explore the relapse prevention effect of community independent skills in patients with schizophrenia.Methods 100 patients with schizophrenia from May 2014 to February 2015 were analyzed and divided into the observation group and the control group by using the computer random grouping.The standardization of community rehabilitation training was taken in the control group patients,whike independent skill training was taken in the observation group patients.The clinical curative effect of the study for a year were evaluated through SAPS, BPRS,SDSS,SANS and ITAQ for all the object.Results There was no statistical significance of ITAQ,SDSS,SAPS and SANS score difference in all the research objects before the rehabilitation treatment has (P >0.05 ).ITAQ, SDSS,SAPS and SANS score of the observation group were better than that of the control group after 8 weeks, 26 weeks and after 1 year,the difference was statistically significant(P <0.05).Recurrence rates of the observation group and control group were 16% and 40% respectively,and hospital admission rates were 10% and 32% respec-tively,the difference was statistically significant(P <0.05).The adherence were significant between the two groups (χ2 =6.92,P <0.05).Medication adherence to drug management ability were better in the observation group than the control group(χ2 =41.558,P <0.05).Conclusion The community independent skill training have an remarka-ble effect on the rehabilitation of patients with schizophrenia,and can improve the residual symptoms of schizophrenia after rehabilitation.It can help people with schizophrenia to maintain a good long-term positive effect,which is worth further clinical research and extension.

Lysosomes are acidic catabolic organelles,containing over 50 acid hydrolases and many lysosomal specific membrane proteins.Lysosomes are responsible for the disposal and recycling of worn out and damaged cellular macromolecules and organelles as well as the digestion of extracellular and foreign materials delivered to them by endocytosis,autophagy and phagocytosis.Increased expression and function of various lysosomal hydrolases are common in human tumors,and they often correlate with a higher risk of rccurrence and poor prognosis.Inhibition of lysosomal exocytosis can inhibit tumor invasion and metastasis.It does not affect the activity of acid hydrolytic enzymes,but causes the instability of lysosomal membrane and increases the sensitivity of tumor cells to drugs.

Antibody drug is a new kind of new anticancer drug with distinct superiorities in tumor thera-py developed in recent years.Antibody drugs can effectively kill the tumor cells with goodselectivity,and have good efficacy,lower toxicity and a specificity of distribution in vivo.They can specifically bind to tumor-associated target moleculars.Besides,the antibody drugs can effectively kill the tumor cells with drug-resistane.

In recent years,the techniques of radical cystectomy and urinary diversion are continually improving,the surgical safety and efficacy are continually increasing.From open to laparoscopic to robotic,surgical techniques are progressing,but it is not yet possible to replace each other.With the development of equipment,laparoscopic radical cystectomy (LRC) and robotic-assisted laparoscopic radical cystectomy (RARC) can further improve the perioperative efficacy,the basic principles of open surgery can be copied,their perioperative oncologic outcomes are not inferior to open surgery.RALRC seems to have more advantages in pelvic lymph node dissection,long-term oncologic outcomes of the three techniques are simnilar,and open surgery seems to have more advantages in advanced tumors.Intracorporeal construction of the urinary diversion is still the mainstream,extracorporeal is likely to be the future direction.Laparoscopy is still the most suitable minimally invasive technique of radical cystectomy according to our national conditions.

The aim of this review is to detect the difference in outcome of cardiac resynchronization therapy (CRT) between ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM).By reviewing some clinical trials of large scale,we found that restore of heart structure and function in NICM was more significant than ICM.However,there were no significant differences in clinical outcome of improving cardiac function and quality of life,decreasing heart failure re-hospitalization and mortality.

With the rapid development of internet and multimedia technology,the training of visual literacy has gained much more attention.In the teaching of Biochemistry,when confronting numerous visual tools in various ways for biological molecules research and rapid development of subject,teachers and students are required to have higher level of visual literacy.However,it is slighting and retarded to develop visual literacy education in China.Therefore,it is very important to emphasize the improvement of visual literacy in the teaching of Biochemistry,which can improve the ability in teaching design and learning method in this era of graphical interpretation.

Bladder cancer remains a highly immunogenic and refractory malignant tumor today.Cancer immunotherapy is coming of age;it has prompted a paradigm shift in oncology treatment,in which therapeutic agents are used to target immune cells rather than cancer cells.Immunotherapy blocking immune checkpoints have been recently been applied to many aggressive cancers and changed interventions of urological cancers including advanced bladder cancer.The inhibition of PD-1/PD-L1 interactions can restore antitumor T-cell activity and enhance the cellular immune attack on antigens.The overall goals of this review are to introduce current cancer immunotherapy and immune checkpoint inhibitors,and to determine whether bladder cancer patients could benefit from this new cancer therapy through analyzing data in clinical trials.Furthermore,this review will also discuss the diagnosis and management of immune-related adverse events (irAEs),which deserve particular attention due to impact on the outcome of patients receiving these therapies.

Objective To investigate the effect of herbs for nourishing kidney and strengthening governor vessel on postoperative intervertebral fusion rate in elderly patients with degenerative lumbar spinal stenosis ( DLSS) . Methods A retrospective analysis was carried out for the clinical data of 72 elderly DLSS patients treated with modified transforaminal lumbar interbody fusion (TLIF) during the period from October, 2012 to October, 2013. The patients were divided into two groups, 39 in Chinese medicine group and 33 in control group. Operative efficacy was evaluated with Japanese Orthopaedic Association ( JOA) scores for assessment of cervical myelopathy, postoperative function improvement was evaluated by Oswestry disability index (ODI) scores, and lumbar interbody fusion was evaluated by the modified Brantigan scores. Results (1) During the follow-up period, patients of the two groups had no complications such as screw breaking or loosening, cage displacement, or endplate collapse. (2) Before opera tion and 3 days after operation, the differences of JOA scores were insignificant between the two groups (P>0.05) . (3) Significant difference of intragroup ODI scores were shown 12 months after operation vs 6 months after operation, and between 6 months after operation and pre-operation in the two groups (P<0.01) . ODI scores of Chinese medicine group 6 and 12 months after operation were lower than those of the control group, the difference being significant ( P<0.05 or P<0.01) . ( 4) The results of modified Brantigan scoring showed that the interbody fusion rate 6 months after operation was 71.79% in Chinese medicine group, higher than 48.48% in the control group ( P<0.05) . Twelve months months after operation, the interbody fusion rate was 87.18% in Chinese medicine group, higher than 66.67% in the control group (P<0.05) . Conclusion Herbs for nourishing kidney and strengthening governor vessel may improve the lumbar interbody fusion rate and the quality of life of the elderly DLSS patients treated by modified TLIF.

Objective:To retrospectively evaluate the prognostic risk factors of patients with gallbladder carcinoma and the effect of normal prognostic nutrition index (PNI) on the survival. Methods:We retrospectively analyzed 63 patients with gallbladder carcino-ma treated in our hospital between January 2008 and December 2012. The independent prognostic factors of the patients were calculat-ed by the Cox proportional hazards model. The benefit of normal PNI status on the prognosis was further explored in the patients using survival analysis. Results:Lymph node metastasis, PNI≤50, squamous carcinoma, liver invasion and choledoch invasion were the risk factors of overall survival (OS) in the univariate analysis, while only lymph node metastasis (HR=4.495, 95%CI 2.380~8.488, P<0.001) and PNI(HR=0.195, 95%CI 0.098~0.389, P<0.001) were the dependent influential factors of the prognosis and OS in the multi-variate analysis. The effect of PNI on OS was even more statistically significant different in the younger patients (≤65y) than in the el-der (>65y) (younger group:P=0.011;elder group:P=0.078). Conclusion:The gallbladder carcinoma patients with normal PNI status (>50) have better OS compared to the patients with PNI≤50, with statistical differences between the two. And it is more significant in the patients of the younger group (≤65y), comparing with the elder group. PNI could be taken as a potential prognostic evaluation factor for the gallbladder carcinoma patients and can provide a more comprehensive evaluation of patients' conditions to clinician.