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.

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.

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.

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.

Purpose To evaluate the correlation between acute pulmonary embolism (APE) and right ventricular parameters by multi-slice spiral computed tomography pulmonary angiogmphy (MSCTPA),and assess the severity and mortality of patients with APE.Materials and Methods The clinical and MSCTPA image data of APE patients from January 2012 to November 2015 was analyzed retrospectively.All the patients were divided into three groups according to the pulmonary embolism type and clinical prognosis:66 cases in mixed embolism group (25 cases of death,41 cases of survival);36 cases in peripheral embolism group,2 cases in centralembolism group.The CT post-processing software was used to measure thoracic aorta and main pulmonary artery inner diameter ratio (PA/AO),right ventricular diameter to left ventricular diameter ratio (RVD/LVD);right ventricular area to left ventricular area ratio (RVA/LVA) on axial four-chamber (4-CH) sections and the largest of maximum minor axis diameters on axial sections (RV/LV-LD).The difference of CT related right ventricular parameters among the mixed embolism groups,peripheral embolism and normal groups was compared.Results Statistical difference was found in right ventricular parameters (RVD/LVD,RV-LD/LV-LD,RVA/LVA) in mixed embolism death patients compared with the patients in other three groups (P＜0.05).There was significant difference of right ventricular parameters RVD/LVD,RVA/LVA in mixed pulmonary embolism survival patients compared with patients in peripheral pulmonary embolism and normal groups (P＜0.05),but there was no significant difference between peripheral APE patients and the control group in all RV and PA/AO parameters (P＞0.05).According to the result of ROC curve in mixed type embolism death patients,RVA/LVA was the best indicator of predicting early death (AUC=0.881),with 100.0％ sensitivity and 73.2％ specificity.Conclusion The right ventricular parameters by multislice CT pulmonary angiography can assess APE patient's condition and forecast their early mortality;and the clinical diagnosis accuracy of RVA/LVA is higher.

Most content of pathophysiology is built by black-box method.Pathophysiology learning is a process from black-box to grey box and white-box.Therefore,black-box teaching method is a good way to train students efficiently and rapidly.It fits pathophysiology education wel1.During teaching of pathophysilogical theory and experimental classes,we should carefully design various black-boxes,and introduce students try to resolve the black-box problems,so as to interest students in pathophysiology and train them the capability to analyse and resolve problems.

BACKGROUND:The repair and reconstruction of laryngeal structure and function play a crucial role in partial laryngectomy,and the repairing materials and methods have been developed rapidly in recent years.OBJECTIVE:To explore the present application of tissue transplantation on the repair and functional reconstruction after partial laryngectomy,and provide evidences for the selection of repairing materials and reconstructive techniques for laryngeal function.RETRIEVAL STRATEGY:A computer-based search of PubMed database was undertaken to identify the articles of functional reconstruction after partial laryngectomy published from January 1997 to July 2007,with the keywords of "laryngectomy,laryngeal carcinoma/cancer,reconstruction" in English.Simultaneously,Chinese Journal Full-text Database was searched for the relevant articles published between January 2000 and July 2007 with the keywords of "partial laryngectomy,laryngeal carcinoma,repair/reconstruction" in Chinese.Totally 160 relevant articles was retrieved,of which 69 articles were English and 91 articles Chinese.Articles on repair or reconstruction after partial laryngectomy were selected.After the primary filtration,fulltexts of the English articles were checked,and articles on review and with repetitive content were excluded.The articles on clinical research,which were issued in authorized journals,were selected.At last,totally 31 articles were included for review.LITERATURE EVALUTION:Among 31 included articles,16 articles were English and 15 articles Chinese.DATA SYNTHESIS:Functional reconstruction is the key point in course of partial laryngectomy.Technique on repairing postoperative larynx have made a progress,and autologous tissues,such as myofascial flap,flap of strap muscles,myocutaneous flap of neck fascial lata and epiglottis,are extensively used for larynx,which have got good effect.The study of the application of tissue engineering and other variant materials after partial laryngectomy is going on.CONCLUSION:With rapid development of partial laryngectomy,all kinds of repairing materials and reconstruction techniques are used.Repairing postoperative larynx has no fixed mode.It is a very important topic to choose suitable repairing material and reconstruction technique according to different factors such as laryngeal carcinoma type,lesion degree and excision scope,so as to recover the vocalization,respiratory and deglutition function,and raise the patients' survival rate and life quality.

Objective To evaluate the clinical value of cervical conization in diagnosis and management of cervical carcinoma in situ.Methods The clinic-pathological data of the 65 patients with cervical carcinoma in situ from Jan 2004 to Feb 2007 were analyzed retrospectively.Results(1)Of the 65 patients,59 cases had received the colposcopical multiple biopsies before the cervical conization and there was a correlation in pathology between cervical conization and colposcopical multiple biopsies in 46 cases(78.0%),but there was not much correspondence between cervical conization and colposcopical multiple biopsy in 13 cases(22.0%).(2)30 patients were received hysterectomy or cervical conization again.Patients with positive margins were significantiy more likely to have residual disease than those with negative margins(P

Objective To explore the relationship between preoperative right ventricular ejection fraction(RVEF) and postoperative complications in the elderly patients with lung resection. Methods RVEF was assessed in 118 consecutive aged patients before pulmomary resection by echocardiography, 64 of whom received RVEF measurement again 3 weeks after operation. Results Preoperative RVEF in patients with postoperative complications was obviously lower than that in patients without ones. The frequency of postoperative complications in patients with different preoperative RVEF(

OBJECTIVE:To improve the quality of pharmaceutical service and to promote rational drug use in clinical practice.METHODS:According to in-patients'medical record and information of drug use,SOAP electronic pharmaceutical care database was established by using Microsoft Visual Foxpro6.0software.RESULTS:The established pharmaceutical care database had the advantages of huge information storage and rapid inquiry system and report output.CONCLUSION:This method is simple and convenient and can improve the efficiency of pharmaceutical work and serve patients better.