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.

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.

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.

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 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.

Objective To investigate the therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic bile duct exploration lithotomy (LBDEL) in treatment of intra/extra-hepatic duct stones. Methods There were 110 patients whose intrahepatic stones located in Ⅰ , Ⅱ hepatic duct and 378 patients whose stones only located in the common bile duct. These patients respectively underwent LBDE combined with choledochoscope laser lithotripsy or ERCP combined with endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) to remove the stones. Common bile ducts were performed primary suture or T tube placement in the LBDEL cases. The evaluation was carried out for perioperative complications and postoperative recovery of the surgical methods. Results The residual stone rate was 31.82% in 110 cases. The rate was higher in ERCP group (51.06%) than that in LBDEL group (17.46%) (P < 0.05). Postoperative recovery was better in LBDEL group than that in ERCP group. The residual stone rate was 8.20% in 378 cases. The rate was lower in ERCP group (3.68%) than that in LBDEL group(11.63%) (P < 0.05). Between the two groups, there had no statistical significance in postoperative recovery. The incidences of bile leakage and pulmonary infection were higher in LBDEL group than in ERCP group. The incidences of abdominal cavity infection, acute pancreatitis, digestive tract perforation and gastrointestinal bleeding were higher in ERCP group than that in LBDEL group. 2 of the 378 patients occurred death were happened digestive tract perforation which were induced during ERCP procedure. Conclusion LBDEL and ERCP demonstrated the same therapeutic effects in the treatment of common bile duct stones. However, ERCP has no large advantages in the treatment of hepatolithiasis, and shows higher complication rates. LBDEL has a significant curative effect for intra-and extrahepatic bile duct calculi and can maintain the integrity of Oddi sphincter. This technology is easy to spread to the basic-level hospital to benefit the majority of patients.

Objective To identify the RNA interference action of recombined pSUPER-NRF2 vectors for the expression of NRF2 gene in colon cancer cells.Methods Two sequences targeting at the ORF of NRF2 were cloned into RNA polymerase III based expression vector pSUPER.These recombinants were transfected into Caco-2 cells.Fluorescence microscopy and flow cytometry were performed after transfection with pEGFP-N1 plasmids to observe the lipfectin transfection efficiency.The stable cells were selected in medium(48 h) after co-transfected pEGFP-N1 with G418. The expression of NRF2 was assayed by RT-PCR and Western blot.Results The construction of the recombinant expression vector pSUPER-NRF2-A1、B1 and its control vector pSUPER-NRF2-A2、B2 were successfully confirmed by the results of enzyme digestion,electrophoresis and sequencing. The transfection efficiency was 45.6%,74.3%,53.0% and 46.5% respectively in 24,48,72 and(96 h).We compared the ability of these vectors to inhibit NRF2 in a transient and stable expression experiment.Importantly,pSUPER-NRF2-B1 was able to knockdown NRF2 expression.pSUPER-NRF2-A1 only had a moderate activity,whereas pSUPER-NRF2-A2、(B2 were) inactive in this assay.Conclusion The constructed pSUPER-NRF2-A1、B1 showed an interfering effecton the expression of NRF2 and product the stable cells with low NRF2 expression.Therefore,the pSUPER vector constitutes a new and powerful system to analyze NRF2 gene function in colon cancer.

Objective To assess the diagnostic value of confoeal laser endomicroscopy(CLE) in histological gastritis.Methods A total of 149 patients underwent CLE.Standard locations and focal lesions were examined by confocal imaging, and specimens were taken by targeted biopsy.The relationship between confocal images and histological findings were studied systemically.Results The sensitivity,specificity and accuracy of CLE in diagnosis of atrophy were 83.6%,99.6%and 97.5%,respectively;and those in moderate to severe neutrophil infiltration were 81.9%,99.3%,and 95.8%,respectively.The mean kappa values for inter-and intra-observer agreement on the classification of confocal images in groups were 0.749 and 0.811 respectively.Conclusion The validity and reproducibility of CLE in diagnosis of histologic gastritis are promising,which might warrant its further application in clinical practice.