The specialized teacher troop is the discipline construction,the development key,the teaching leading force and the personnel training quality guarantee. At present stage the quantity and quality of the specialized public health management teacher staff in our school have gradually become the bottleneck for the career development. Only by sharpening teachers' scientific research ability unceasingly, enhances teachers ' individual accomplishment and the teacher troop's overall quality,improving their work quality,can we adapt to the career devel-opment under the new situation.

Objective To apply six sigma management method to optimizing flow,enhancing treatment quality,prolonging service life and decreasing purchase cost of the non-coated surgical instrument.Methods The treatment flow of the noncoated surgical instrument was optimized through five steps of six sigma method including defining,measuring,analyzing,improving and controlling.The treatment results before and after flow optimization were compared,analyzed and evaluated.Results The rates for corrosion and rejection were both decreased significantly after flow optimization,while the quality was increased obviously (P＜0.05).Conclusion Six sigma management method involved in the treatment of the non-coated surgical instrument saves purchase cost,enhances the efficiency of disinfection supply room and facilitates effective supervision and monitoring.

Through the analysis of current situation of the setup of local professional institutions,the principles and characteristics,the author put forward countermeasures and suggestions to optimize the local medical professional institutions’ setup,to help local medical institutions’development and improve the quality of medicinal higher education.

Comprehensive treatment dominated by surgery is the mainstay in the treatment of hepatic cancer,and hepatectomy is still the most effective treatment method.Bile duct reconstruction after hepatectomy is still the difficult point for the treatment of hepatic cancer complicated by bile duct invasion.A 45-year-old patient with hepatic cancer and gallstone was admitted to the Affiliated Hospital of Guiyang Medical College,magnetic resonance cholangiopancreatography and enhanced computed tomography indicated that intrahepatic duct was dilated and tumor had invaded both left and right hepatic ducts.Cholecystectomy,mesohepatectomy,duct to duct anastomosis of left hepatic duct and common hepatic duct,duct to duct anastomosis of right hepatic duct and cystic duct were performed during the operation.The patient was cured 2 weeks after surgery.

Objective:To investigate whether the risk of intravesical recurrence increases in patients with upper urinary tract urothelial carcinoma (UUT-UC) and diabetes mellitus (DM) after radical nephroureterectomy (RNU) with bladder cuff excision. Methods:We ret-rospectively analyzed the clinicopathological data of 282 UUT-UC patients with no history of bladder neoplasm and who underwent RNU with bladder cuff excision in the Second Hospital of Tianjin Medical University from January 2005 to December 2013. The recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared between the non-diabetic (233 patients) and diabetic (49 patients) patients. The factors influencing intravesical recurrence in patients with UUT-UC after RNU were analyzed. These factors included age, DM, pathologic grade, and stage. Results:Among the 282 patients included in the study, 80 (28.4%) patients developed intravesical recurrence during the median fol ow up of 41 months, and the median time to recurrence was 11 months. Non-diabetic patients had a significantly longer duration of bladder neoplasm RFS than diabetic patients (P=0.013). Multivariate analysis using Cox's regression model indicated that DM (P=0.014), renal pelvis and ureter tumor (P=0.001), and postoperative chemotherapy (P=0.024) were independent influential factors for intravesical recurrence in patients with UUT-UC after RNU with bladder cuff excision. Conclusion:DM posed an increased risk for intravesical recurrence after RNU with bladder cuff excision in patients with UUT-UC. Therefore, these patients need to be closely monitored, and their blood glucose must be controlled.

Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.

Ginsenoside Rb3 (GRb3) is one of the main components in plasma of Panax quinquefolius Saponin of stem and leaf (PQS), which can be into human plasma. Previous studies have found PQS has estrogen-like vascular protective effects. In the present study, we investigated the estrogen-like protective effect of GRb3 on oxidative stress and dysfunction of endothelial cells induced by oxidized low-density lipoprotein. The activities of SOD, NOS and the contents of MDA in the cell lysate were examined by enzyme method or spectrophotometry. The NO and ET-1 concentrations in the cell culture supernatant were measured by ELISA method. The iNOS and eNOS mRNA expression were measured by real time RT-PCR, while the phosphorylation levels of Akt was measured by Western blotting. The results showed that GRb3 could enhance the activity of SOD, reduce the content of MDA, increase the level of NOS, NO, ET-1 and iNOS mRNA expression while decrease the eNOS mRNA expression and the phosphorylation level of Akt. These effects were blocked by estrogen receptor antagonist ICI182780. GRb3 can play a role in protecting vascular endothelial cells by estrogen receptors, the protective mechanism is similar to 17-β estrodiol.

Objective:To investigate the stress distribution in peri-implant bone with All-on-4 implant with various parameters by three-dimensional finite element method.Methods:An edentulous mandibular specimen was scanned by CT Mimcs.Geomagic,Uni-graphics,HyperMesh modeling software were used to establish All-on-4 implant finite element models with different inclination angles and corresponding cantilever lengths.1 50 N vertical static load was applied at the right end of the cantilever,peri-implant bone stress was analysed using Abaqus software.Results:When the distal implant inclined 0°with cantilever length of 1 9.5 mm,the peak stress in peri-implant cortical bone at the mesial and distal side was 25.526 MPa and 83.026 MPa respectively.When the distal implant in-clined 1 5°,30°and 45°with the cantilever length of 1 7.2 mm,1 3.3 mm and 9.8 mm,the stress in perio-implant cortical bone at distal side of the implant reduced by 1 2.4%,35.6% and 53.1 %,that at mesial side of the implant reduced by 1 3.6%,36.3% and 40.2%,respectively.Conclusion:From the perspective of the stress analysis,the design of All-on-4 distal implant with large incli-nation angle and short cantilever is superior to that with small inclination angle and long cantilever.

Objective:To observe the clinical efficacy of brain-benefiting and collateral-unblocking needling technique for chronic alcoholic gastritis complicated with depression. Methods:A total of 92 cases with chronic alcoholic gastritis complicated with depression were included in this trial. They were randomly allocated into an observation group (n=46) and a control group (n=46) by random number (envelope) method. Patients in the observation group received the brain-benefiting and collateral-unblocking needling technique. Scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 23), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7) and Luoque (BL 8). Body points included Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Gongsun (SP 4), Shenmen (HT 7), Daling (PC 7), Qimen (LR 14), Xinshu (BL 15) and Taichong (LR 3). The control group only received the same body acupuncture as the observation group. The treatment was conducted once a day, 30 min for each treatment, and 10 times made up a course of treatment. The efficacy was observed after 3 courses of treatment, and there was a 2-d interval between two courses. Results:After 3 courses of treatment, the clinical symptoms and gastroscopic features were significantly improved in the observation group than that in the control group. The clinical efficacy, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were significantly better than those in the control group (allP<0.05). Conclusion:The brain-benefiting and collateral-unblocking needling technique can significantly improve clinical symptoms in patients with chronic alcoholic gastritis complicated with depression and substantially alleviate their gastroscopic features, anxiety and depression.