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.

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.

Diabetes patients in China is large in number, low level of health literacy, and their self management mainly relies on community doctor's health propaganda and education, as a result, it is very important to train community healthcare professionals to improve their communication skills with patients.Guided by the Social Cognitive Theory (SCT), the researchers developed a literacy-addressing training model specifically through: 1) low literacy healthcare education materials written in plain language, simple text, maximal white space, and behavior-oriented images or pictograms;2) a standardized health communication curriculum to promote simple communication with decreased jargon usage, teach teach back, and enhance shared goal-setting;3) use of standardized patients to enhance doctor-patient communication training;and 4) MOOC and a series of videos demonstrating doctor-patient communication scenarios.The novel training model can be used in continuing medical education through traditional on-site classes or by E-learning platform.It is expected to improve the communication skills of community doctors and patients, improve the satisfaction of both doctors and patients, and the effect of patients' self-management.

Building a new concept of combat forces is an important initiative in the 12th Five-Year Plan of National Defense Strategies.In the era of biotechnology,global powers have been competing for brain control by means of accelerated development in brain science and the military theory of Innovation to Subdue.Based on elaboration on the concepts and developments of military applications of brain science as well as on analysis of impacts on the mechanism of winning,this paper proposes the operation concepts of pre-settingand bio-orientation,the combat modes of mechanized warfareand idiodynamic warfare,and weapon evolution into intellectualizationand brain-control orientation.This paper presents a practical system design of military applications of brain science:presetting—key technology—weapons′power source-mechanism of winning.The constitution and winning mechanism of the three-stage mode of battle effectiveness are summarized as improving the operation capability—war of super soldiers,changing the main force of operations—war of mechanized legions,altering the principles of operations—war of spiritual consciousness. This paper also suggests the upgradation from damage theoryto control theory,the shift from informatizationtointellectualization,and strategic breakthroughs from independent developmentto collaborative innovation.

Objective To investigate the expression of regeneration gene protein-2(Reg-2) after the transection injury in rat spinal cord. Methods Forty five SD rats were randomly divided into two groups: in the injury group,the SCI was produced by complete transection of the cord at the 9(th) thoracic level,and the sham operation rats were taken as the normal control.The animals were perfused at 1h,1d,3d,7d,14d after the operation,and the spinal cord was taken out at different time points.The expressions of Reg-2 were tested by immunohistochemical analysis and Western blotting,the double staining of Reg-2 and different neural cells special markers(GFAP,Olig2,NPY,CGRP,GAP-43,et al)was done with immunofluorescence method. Results The expression of Reg-2 was found at 1h after the spinal cord injury,reached the peak on day 3 after the injury in the neurons of dorsal horn and day 7 in the neurons of ventral horn.The high expression persisted for 1 week,then decreased gradually.Conclusion Reg-2 may work as an important growth factor and participate in the regeneration and rehabilitation process after the spinal cord injury.

Objective To explore the nursing strategies for preoperative ventilator-dependent patients undergoing discontinuing mechanical ventilation after lung transplantation.Methods The clinical data and nursing experiences of 10 preoperative ventilator-dependent patients undergoing discontinuing mechanical ventilation after lung transplantation from September 2002 to December 2008 were retrospectively analyzed.Results The time of discontinuing mechanical ventilation ranged from 7 to 30 days and the average time was 16.5 days.Conclusion The key points to ensure the success of discontinuing mechanical ventilation were careful observation of ventilation modes,preparations before discontinuing,airway management,nutritional support and psychological nursing.

Objective To investigate the effect of BQ-123 on the ability of learning and memory and nerve cell autophagy in hippocam-pus in rats with subarachnoid hemorrhage (SAH). Methods 72 male Sprague-Dawley rats were randomly divided into sham group, SAH model group (SAH group) and BQ-123 group with 24 rats in each group. SAH model was established by injecting the autologous blood into cisterna magna twice. The sham group was not injected blood. BQ-123 group received intracerebroventricular injection with BQ-123 18μg 30 minutes before modeling. 6, 24, 72 and 144 hours after modeling, the passive avoidance latency (PAL) and active avoidance reaction rate (AARR) were tested with Shutter Box Test, the nerve cell morphological changes of hippocampus were observed with HE staining, and the expressions of Beclin-1 and LC3-II were detected with immunohistochemical staining. Results Compared with the sham group, the PAL pro-longed, the AARR decreased (P<0.05), the nerve cells in the hippocampus reduced (P<0.05), and the expressions of Beclin-1 and LC3-II in-creased (P<0.05) in SAH group. Compared with SAH group, PAL shortened (P<0.05), AARR increased (P<0.05), the nerve cells in the hip-pocampus increased (P<0.05), and the expressions of Beclin-1 and LC3-II increased (P<0.05) in BQ-123 group. Conclusion BQ-123 can promote the recovery of learning and memory ability, which may relate to the activation of nerve cell autophagy in the hippocampus.

Objective To explore the regulation of PI3K-mTOR signaling pathways on autophagy of hippocampus nerve cells after subarachnoid hemorrhage (SAH)in rats.Methods We randomly divided 72 male Sprague-Dawley rats into sham group,SAH model group and LY294002 group with 24 rats in each group.We established SAH model with the secondary injection of blood method while the sham group was not injected with blood.PI3K signaling pathways specific inhibitor LY294002 was injected with 500μmol per rat 30 minutes before modeling.After 6,24,72 and 144 h morphologic changes of hippocampus CA1 neural cells were observed by microscopy;the expression levels of PI3K,mTOR,Beclin-1 and LC3-Ⅱ were detected by immunohistochemical method.Results The density of survival neurons in the SAH group was significantly lower than that in the control group (P<0.05),PI3K-mTOR signaling pathways were activated obviously,and the expressions of Beclin 1 and LC3-Ⅱ were significantly higher than those in the control group (P<0.05 ).The number of survival neurons significantly decreased in the LY294002 group compared with the SAH group at each time point (P<0.05),PI3K-mTOR signaling pathways were suppressed.The expressions of Beclin-1 and LC3-Ⅱ were significantly lower than those in the SAH group (P<0.05).Conclusion PI3K-mTOR signaling pathways protect neurons by activating the autophagy of neurons after SAH.

Idiopathic macular hole after the internal limiting membrane (ILM) is removed during surgery, the intraoperative optical coherence tomography can be used to observe the presence of debris tissue (RF) protruding into the vitreous cavity at the edge of the hole. Current studies suggest that RF may be caused by epiretinal proliferation and vitreomacular traction, but it is still controversial, and the influence of postoperative anatomical and functional recovery is not clear. Common points can still be found, some of the studies suggest that RF is not conducive to postoperative anatomical and functional recovery during the operation, ILM fragments remain on RF tissues after ILM peeling and re-staining. However, in some studies suggest that RF is beneficial to postoperative anatomical and functional recovery, and ILM fragments on RF are removed. This suggests that whether ILM is removed on RF lead to a certain influence on the postoperative efficacy. There are few researches on RF at present, so it is necessary to understand RF from its essence and assist judgment through histological analysis.

Objective To evaluate the bonding condition of hydroxyapatite (HA)/zirconia ( ZrO2 ) composite and bone interface and the ability of HA/ZrO2 in repair of bone defects.Methods Bone defect models were established in the lumbar vertebral body of 24 Beagle dogs and were implanted with HA/ZrO2 gradient composite (Group A ),HA/ZrO2 unilayer composite (Group B ),pure ZrO2 (Group C) and pure HA (Group D) successively.Dogs were sacrificed and lumbar vertebral specimens were harvested 6,12,16 weeks postoperatively and before the sacrifice at postoperative 6 and 12 weeks,the dogs were intramuscularly administered of quadracycline for fluorescence labeling.The interface bonding and repair of bone defects were observed through X-ray films,histomorphology and biomechanical test.Results The X-ray films displayed that the Group A achieved more formation of osteotylus and better repair of bone defects with the extension of the implantation period,followed by the Groups B and D and that the Group C had relatively worse results.Histomorphology study showed that the fluorescence labeling was enhanced gradually from 6 to 12 weeks in the Group A,with its growth from the edge of the implanted material to the inner part and its tight adhesion to the material,indicating active osteogenesis and massive bone formation.While the fluorescence labeling of the Groups B,C and D centered in the edge of implanted materials without presence in the material inner part.The mineralization rate of the four materials at 6 and 12 weeks had significant differences ( P ＜ 0.05).Synostosis rates at 6,12 and 16 weeks were the highest in the Group A,with the rate of up to (90.26 ±3.82) ％ at 16 weeks (P ＜0.05 ).Biomechanical test showed the maximum shear strengths at 6,12,16 weeks in the Group A were (2.64±0.16) MPa,(2.95 ±0.19) MPa and (3.45 ±0.23) MPa respectively (P＜0.05).Conclusion HA/ZrO2gradient biocomposite bonds well with the bone and possesses good repair ability for bone defects and hence is an ideal novel material for bone defect reconstruction.