Objective This paper mainly introduced the present situation of the local talents at Peking University Health Science Center,and proposed some corresponding suggestions for further development.Methods By using the methods of questionnaire investigation and literature review to acquaint the current situation of the local talents.Results The local talents face greater pressure of living stress,their material well-being needs to be improved,physical and psychological condition is poor,and the relationship with the returned overseas talents needs to be adjusted.Conclusions Several suggestions,such as mainly from the structural reform of local talents incentive mechanisms,the improvement of local talents distribution,the attention of the interests of local talents,the strength of self-construction and the coordinated development with overseas talents to promote the construction of the aspects of local talents.

Objective The measures and suggestions for the management of returned research talents in our country.Methods Through the study of the development of returned research talents in the last five years,Peking University Health Science Center.Results The country has provided a good working and living environment for the returned research talents,but the domestic treatment still has a gap with foreign countries.The differences between the domestic and foreign may cause psychological gap,not easy to adapt.Returned research talents have their own advantages in scientific research,teaching and other aspects,but the research output is relatively slow.Conclusions In terms of policy,academic environment and working environment should be improved.

Objective To analyze the pathogenic distribution and drug resistance of 7 534 clinical samples ,so as to provide a ba-sis for rational use of antimicrobial drugs in clinical .Methods The pathogens isolated from 7 534 clinical samples were counted and their drug resistance rates were analyzed by retrospective survey method .Results The positive rates of Gram positive coccus ,Gram negative bacillus and fungi were 14 .02% ,52 .98% ,and 7 .57% respectively .The drug resistance rates of pathogens were increas-ing .Conclusion Improving the accuracy of detection and standardizing the application of antibacterials would be helpful to reduce the generation of bacterial drug resistance .

Objectives To investigate the clinical significance of plasma adrenomedullin (ADM) concentrations in patients with asthma.Methods The plasma ADM concentrations in 23 asthmatic patients with an acute attack and 18 asthmatic patients in remission stage were measured by radioimmunoassay.Linear regression analysis was used to evaluate the correlations between two variables.Twenty healthy subjects served as a normal control group.Results The plasma ADM concentrations in asthmatic patients with an acute attack [(28.73?7.12)ng/L]were significantly higher than those of stable asthmatic patients [(13.85?4.48)ng/L,P0.05).Conclusion The results suggest that ADM is involved in the pathophysiological process of acute asthma attack and may play an important role in the inflammation of asthmatic airways.

Objective To determine the dangerous depths of acupuncture at Yamen(GV15) and Fengfu(GV16) in different age groups and different body types based on MRI measurements and to analyze their distribution chracteristic .Methods 98 patients of different age groups in the affiliated hospital of Hainan Medical College from June to December 2012 were selected and the each age group was divided into 3 types :asthenic type ,moderate type and endomorphy type according to the Rohrer index .All images took the median sagittal position .The dangerous depth was measured according to the clinical operation habit and actual feasibility .Re-sults The difference in the acupuncture depth of GV15 and GV16 among different asthenic type patients in different age groups had no statistical significance ;in the moderate type patients ,the difference in the acupuncture depth of GV15 and GV16 between the age group of 18- <45 years and 45-60 years had the statistical significance(P=0 .029 ,P=0 .018);in the endomorphy type pa-tients ,the difference in the acupuncture depth of GV15 and GV16 between the age group of 45-60 years and the other age groups had the statistical significance(P<0 .05) .Conclusion The dangerous depth of GV15 and GV16 had no correlation with age ,but is positively correlated with the Rohrer index ,i .e .,the dangerous depth of GV15 and GV16 is increased with the increase of Rohrer index .

Objective To investigate the effect of implementation of hand hygiene(HH)activities on HH compliance among health care workers(HCWs).Methods In May-December 2013,a series of HH intervention measures in a hospital were implemented,compliance to HH among all clinical and laboratory HCWs in April-December 2013 (before and after in-tervention)were surveyed and compared.Results After implementing HH activities,HH compliance rate of HCWs in-creased from 39.82% before intervention to 80.77% after intervention,HH compliance rates of doctors,nurses and clean-ing staff increased from 41.09%,41.30% and 34.33% before intervention to 83.87%,91.89%,and 59.54% after inter-vention respectively,the differences between before and after intervention were all statistically significant (all P <0.001). Except intensive care unit,HH compliance rates of HCWs in departments of surgery,internal medicine,and radiotherapy were all higher than pre-intervention(all P <0.001).Compliance to five indications for HH among HCWs after interven-tion were all higher than pre-intervention(all P <0.001 ),HH compliance rate before touching a patient increased from 23.88% to 73.37%,before clean/aseptic procedure increased from 58.65% to 94.23%.Conclusion Through the imple-mentation and supervision of HH activities,both the awareness and compliance of HH among HCWs have been significant-ly improved,good HH habit is gradually developed.

Objective To explore an effective method in reconstructing of burn scar contracture of the chin and neck in children. Methods The blood in the transverse cervical artery might flow reverse into the suprascapular artery and the posterior intercostals perforators through anastomic branches. An axial skin flap in the cervico-scapulo-dorsal area could be adequately supplied by this artery, and we had therefore used this flap to repair burn scar in the neck. Results 30 cases obtained satisfactory clinical results with this flap. The follow-up for two years in 18 patients showed that the neck of the patients moved about freely, and the develpment of the chin was not influenced, and the color of flaps was fine. Conclusion The blood supply of the flap is reliable and stable. So it is a very useful method in reconstructing the burn scar of the chin-neck in children.

Objectives To explore ventilation induced cytokine production and the role of oxidant stress in lung stretch. Methods Both in vitro and in vivo models of ventilator-induced lung injury (VILI) were used. Alveolar epithelial cells were stretched in vitro to mimic the lung injury in VILI. Rats were ventilated at large tidal volume to produce ventilator-induced lung injury in vivo. A total of 23 inflammatory cytokines were screened with micro gene array in stretched alveolar epithelial cells. Cytokines found to have up-regulated in cells were measured in serum and lung tissue of rats exposed to large tidal volume ventilation. For investigating the intracellular pathway of cytokine up-regulation in VILI, exogenous TNF-? or H_ 2O_ 2 was added to culture media of alveolar epithelial cells. Cytokines were then measured. To explore the role of oxidant stress in VILI, N-acetylcysteine (NAC), as an anti-oxidant, was used in vitro and in vivo. Results We found that transforming growth factor-?_1 (TGF-?_1 and transforming growth factor-?_2 (TGF-?_2) were up-regulated in stretched alveolar epithelial cells and also in serum of rats with large tidal volume ventilation. Tumor necrosis factor-? (TNF-?) had no effects on TGF-? production in alveolar epithelial cells. Exogenous H_ 2O_ 2, as an oxidant, increased TGF-? production in alveolar epithelial cells. NAC, an anti-oxidant, decreased stretch induced TGF-? production, along with a down-regulation of oxidant injury. NAC also blocked the up-regulation of TGF-? in in vivo model of VILI. Conclusion TGF-?_1 and TGF-?_2 were up-regulated in VILI. Oxidant injury mediated up-regulation of TGF-? in VILI. NAC, which attenuated oxidant injury and blocked TGF-? up-regulation in VILI, could be a future therapeutic strategy in VILI.

Objective: To observe the effect of acupuncture plus thunder-fire moxibustion on the expressions of matrix metalloproteinase-3 (MMP-3), tissue inhibitor of metalloproteinase-1 (TIMP-1) and transforming growth factor-β1 (TGF-β1) in cartilage of knee osteoarthritis (KOA) rats, and to explore the mechanism of acupuncture plus thunder-fire moxibustion in the treatment of KOA. Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a blank control group, a model group and an acupuncture-moxibustion group by random digits table, 10 rats in each group. Rats in the model group and the acupuncture-moxibustion group were injected with papain in the right posterior knee joint to prepare the models. The levels of MMP-3 and TIMP-1 in rat synovium of each group were measured by enzyme-linked immunosorbent assay (ELISA) after 2 weeks of treatment. The level of TGF-β1 was determined by Motic B5 Micro-camera system. Results:The levels of MMP-3 and TIMP-1 in the cartilage of the model group were significantly higher than those in the blank control group (allP<0.01); the levels of MMP-3 and TIMP-1 in the acupuncture-moxibustion group were lower than those in the model group, and the between-group differences were statistically significant (all P<0.05). The levels of MMP-3 and TIMP-1 in the acupuncture-moxibustion group were higher than those in the blank control group, and the differences were statistically significant (all P<0.05). The level of TGF-β1 in cartilage tissues of the model group was significantly lower than that in the blank control group (P<0.01); the level of TGF-β1 in the acupuncture-moxibustion group was higher than that in the model group (P<0.05), but it was lower than that in the blank control group, and the between-group difference was statistically significant (P<0.05). Conclusion: Acupuncture plus thunder-fire moxibustion can effectively recover the abnormal expressions of MMP-3 and TIMP-1 in KOA model rats and somewhat up-regulate TGF-β1, which may be one of its mechanisms of acupuncture plus thunder-fire for KOA.

Objective To observe the changes in serum vancomycin trough concentration,and explore its optimal dosage in critical patients.Methods A retrospective study was conducted.Data of 66 patients who used vancomycin during July 2010 to May 2012 in surgical intensive care unit (SICU) of the First Affiliated Hospital of Sun Yat-Sen University were collected and analyzed.According to the endogenous creatinine clearance rate (CCr),the patients were divided into two groups:CCr normal group (≥ 70 mL/min) and CCr lowered group (＜70 mL/min).The distribution of vancomycin serum trough concentration between two groups,relationship between vancomycin serum trough concentrations and CCr,and the influence of vancomycin serum trough concentrations on the prognosis was analyzed.The difference between actual dosage and the recommended dosage in guideline was compared between two groups.Results 119 times of vancomycin serum trough concentration in 66 patients were enrolled,and it was found that only 20.17％ (24/119) reached the target concentration (15-20 mg/L),45.38％ (54/119)＜ 15 mg/L and 34.45％ (41/1 19) ＞20 mg/L.Vancomycin serum trough concentration in CCr normal group (55 cases) was (13.11 ± 6.84) mg/L,among them 65.5％ (36/55) attained lower trough concentrations (＜ 15 mg/L).In the subgroup with 15-20 mg/L trough serum concentrations,vancomycin doses were significantly lower than that of recommendation (g/d:1.95 ± 0.61 vs.2.73 ± 0.32,F=1.739,P=0.001).Vancomycin serum trough concentration in CCr lowered group (64 cases) was (20.49 ± 8.12) mg/L,with 51.5％ (33/64) of them showed higher trough concentrations (＞20 rag/L).In the subgroup with 15-20 mg/L vancomycin trough serum concentration,vancomycin doses were higher than that of recommendation (g/d:1.08 ±0.49 vs.0.78 ±0.19,F=11.294,P=0.062).There was no significant difference in 28-day mortality between patients with targeting trough serum concentrations and those without [22.2％ (4/18) vs.18.8％ (9/48),x2=0.009,P=0.924].Serum creatinine [odds ratio (OR)=1.001,95％ confidence interval (95％CI):0.990-1.012,P=0.000],vancomycin doses (OR=0.600,95％CI:0.251-1.434,P=0.003),age (OR=0.985,95％CI:0.955-1.015,P=0.015) and body mass index (OR=1.013,95％CI:0.967-1.062,P=0.022) were found to be correlated to serum trough concentrations by multiple linear regression analysis.Conclusions The rate of vancomycin serum trough concentrations reaching the standard is low in critical patients,so constant monitoring is necessary.Creatinine,vancomycin dosage,age and body mass index show a relatively significant influence on the serum trough concentrations,and they should be taken into consideration in dosage to be given.