This paper studied the usage and impact of the theory in hospital development.Based on such,special manifestations behind the marginal diminishing effect are taken into consideration to grasp particular demands and requirements of health,and to look for a positive role and a progressive increase of the marginal utility.Furthermore,the explorations in hospitals,such as technical innovations,structure optimizations and management breakthroughs,as well as the experimental and practical construction of micro-economic administrative mechanism in clinical departments were discussed in the text.It has been demonstrated in practice that the practice has a significant effect on the prevention of marginal diminishing utility and an essential reference on hospital transformational development.

Objective To evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.

AIM　The content of baicalin in Scutellalria baicalensis Georgi. in the different parts was determined by RP-HPLC. METHODS　The mobile phase was a mixed liquid with MeOH-Water-H3PO4(60∶40∶0.2). Standard curve showed a linearity within the range of 0.36～0.84 μg/ml(r=0.9995), the average recovery was 99.28%, and RSD=1.4%(n=5). RESULTS　The results showed that the content of baicalin is highest in the bark (cortex) part of Scutellalria baicalensis Georgi.

Objective: To explore the effect of health education and supportive therapy on neuroses. Methods: Fifty six subjects were assigned into two groups according to the sequence of hospitalization. Both groups received the same drug treatment, average dosage: in experiment group fluoxetine 20～30mg/d (9 cases), Amitriptyline 75～150mg/d(8 case), Alprazolam 1.6～ 2.8mg/d(13 cases), received the health education and supportive therapy for 38 to 60 days in addition to drug treatment. In control group, fluoxetine 20～30mg/d(11 case), Amitriptyline 75～200mg/d(5 cases), Alprazolam 1.2～2.8mg/d(10 cases) were used. The Symptom Checklist 90 was used for assessment before and after treatment and cure rate was evaluated by clinical standard at discharge in both groups. Results: Cure rate was higher in the experimental group (94%) than control group (71%, P<0.05). The total score of the Symptom Checklist 90 and main factors were lower in the experimental group than the control group (P<0.01). Conclussion: Early health education and supportive therapy can improve the treatment outcome of patients with neuroses.

Objective To explore carotid atherosclerosis and its relative factors of maintenance peritoneal dialysis patients. Methods The general clinical conditions,hematobiochemical parameters and color ultrasound parameters of 27 maintenance peritoneal dialysis patients and 24 controll patients were collecled. General clinical conditions included body weight, height and BMI. Hematobiochemical paremeters included Hb, Alb, LP (a), TC, TG, HDL-C,LDL-C, CRP, plasma fibrinogen, C3, Apo-A 1, Apo-B, LP (a). Color ultrasound parameters included plaque incidence rate,thickness of vascularendothelium(IMT). Results Compared with the controll group,maintenance peritoneal dialysis patients: plaque incidence rate, thickness of vascularendothelium (IMT) increased significantly, Age, TC, TG,LDL-C,LP (a), dialysis time increased significantly in plaque-positive group(all p ＜ 0. 05), while Hb, Alb andPAB decreased significantly (all P ＜ 0.0 5) , CRP increased significantly (P ＜ 0.0 1) . Conclusions In maintenance peritoneal dialysis group,CRP,LP(a) had positive relationship with C-IMT. CRP had negative relationship with ALb. CRP had not relationship with age and dialysis time. There were relationships among malnutrition,inflammation and atherosclerosis in maintenance peritoneal dialysis patients. Interdiction of the relationship may played a very important role in ameliorating the prognosis of the maintenance peritoneal patients.

Objective To evaluate the safety of conscious venous anesthesia with fentanyl and propofol in elderly patients over 70 during gastrointestinal endoscopy. Methods Clinical data of 826 elderly patients over 70, who underwent gastrointestinal endoscopy with venous anesthesia, were retrospectively analyzed. The patients were divided into 2 groups according to their ages, with 618 patients aging from 70 to 80 in group A, in which 342 received endoscopy and 276 underwent colonoscopy, and 208 patients older than 80 in group B, in which 112 underwent endoscopy and 96 had colonoscopy. Another cohort of 600 patients younger than 70, who underwent venous anesthetic endoscopy during the same time period, was randomly selected as the control group, in which 400 patients received endoscopy and 200 had colonoscopy. Blood pressure, heart rate, peripheral oxygen saturation (SpO2) and adverse reaction were monitored in each patient during the procedure and compared among different groups. Results No procedure-related perforation or sedation-related mortality was observed, and no procedure was terminated clue to sedation complication. The average dosages of propofol used in procedure of endoscopy in groups A, B and control were 54.22±21.36 mg, 40.22±12.46 mg, and 86.44±34.26 mg, respectively. The average dosages of propofol in colonoscopy were 82.56±40.64 mg, 45.36±15.44 mg and 102.23±46.32 mg, respectively. With same procedure, there was no significant difference in heart rate and blood pressure among different groups, nor was there any difference in these variables before and after the procedure in each group (P>0.05). Sedation exerted more influence on SpO<,2> in elderly patients. A total of 18 cases in groups A and B experienced SpO<,2> <90%, which was mainly due to aspiration of saliva and relieved by oxygen inhalation. Conclusion Under appropriate monitor, it is safe and feasible to give conscious sedation to elderly patients over 70 during gastroimestinal endoscopy.

To support the ongoing health reform in China,Chongqing municipal government made the decision in 2008 "Building Healthy Chongqing" ,and pinpointed for the first time regional development as a key goal.In line with this situation,the hospital proposed such hypothesis changes as from "disease hypothesis to "health hypothesis",from "illness oriented" to "capability oriented",and from "shaping development" to "adaptive development",as well as from one-sided efforts of medical staff to minimize casualty to joint efforts with patients to safeguard life and health.Focusing on these four strategic shifts,the hospital works in developing its "technical attraction,service capacity,innovation capacity,and emergency assurance capability,and management soft power",aiming at building a sustainable hospital in its development.

Syncope is a common pediatric emergency event,which can be caused by various metabolic disorders different from other illness. The major metabolic anomalies include hypoglycemia, hyperventilation,electrolytes imbalance,hypoxemia and others, in which hypoglycemia is caused by hyperinsulinemia,pituitary and adrenal disease, diabetes, ketotic hypoglycemia, inherited metabolic disorders of sugar, organic acids and amino-acids,etc. This article introduced the common metabolic anomalies and their causes,diagnosis and therapy.

Objective To study the effect of Ghrelin on food choice of rats.Methods Twenty-four Wistar rats were randomly divided into control group,0.1 nM Ghrenlin group and 1.0 nM Ghrenlin group,and 8 rats in each group.0.2 μl arificial cerebrospinal fluid were injected into the lateral ventricle in control group,and the same volume 0.1nM and 1.0 nM Ghrelin were done in 0.1 nM Ghrenlin group and 1.0 nM Ghrenlin group respectively.The changes of food intake,feeding interval,and torlerance of different flavors of food intake were observed.The SCH23390,an antagonist of dopamine D1 receptor,was used to explore the mechanisms of Ghrelin.Results The rats' food consumption increased significantly and the intake intervals reduced dose dependently after injecting Ghrelin into the lateral ventricles (P＜0.05 ～ 0.01).Compared with normal liquid food,the rats' intake of food added with quinine was reduced((16.73±5.21)ml vs (23.47±9.46)ml,P＜0.01),and injecting Ghrelin into the lateral ventricles could not reverse this effect ((13.74±3.29) ml vs (16.73±5.21)ml,P＞0.05).Mter injecting Ghrelin,the rats' intake of liquid food added with sugar increased in a dose dependent manner(P＜0.05 ～ 0.01),and higher than the food intake of fasted rats ((59.24 ± 17.32) ml vs (38.13 ± 10.98) ml,P＜ 0.05).The food intake reduced obviously after injecting SCH23390 ((22.69±6.54) ml vs (28.21±7.35)ml,P＜0.05).But the rats' food intake was significantly lower after injecting SCH23390 ± Ghrehn than the rats only injected of Ghrehn ((3Z44±10.62)ml vs (65.81±13.47)ml,P＜0.05).Conclusion Ghrelin can affect the food choice of rats,and dopamine may be involved in the regulation of this process.

Metabolic markers were released in the process of bone resorption and formation during bone remodelling. These markers have been extensively studied in trials of osteoporosis and other metabolic bone disorders during the past de?cades. Bone metabolic markers can replenish bone mineral density in the management of osteoporosis, but their use in clini?cal practice is challenged by their variability. Recently, there are many great progress in research of bone metabolic markers application in non metabolic bone disorders.