Venous system diseases mainly include varicose veins and venous malformations of lower limbs and the genital system. Most of them are chronic diseases that cause serious clinical symptoms to patients and affect their health and quality of life. Sclerotherapy has become the first-line therapy for venous system diseases. However, there are problems such as incomplete fibrosis and vascular recanalization after sclerotherapy, and improper operation will cause serious adverse consequences. Therefore, exploring a safe and effective sclerotherapy strategy is essential for developing clinically successful sclerotherapy. To solve the above problems, we proposed a new sclerotherapy strategy with a dual mechanism of "vascular damage and plasmin (PLA) system inhibition." We intended to construct a novel cationic surfactant (AEO_x-TA) by reacting tranexamic acid (TA), a parent structure, with fatty alcohol polyoxyethylene ether (AEO_x) by ester bonds. AEO_x-TA could damage vascular endothelium and initiate a coagulation cascade effect to induce thrombus. Furthermore, AEO_x-TA could be degraded by esterase and release the parent drug, TA, which could inhibit the PLA system to inhibit the degradation of thrombus and extracellular matrix and promote the process of vascular fibrosis. In addition, such surfactant-based sclerosants have foam-forming properties, and they can be blended with polyvinyl alcohol (PVA) to prepare a highly stable foam formulation (AEO_x-TA/P), which can achieve a precise drug delivery and prolonged drug retention time, thereby improving drug efficacy and reducing the risk of ectopic embolism. Overall, the novel cationic surfactant AEO_x-TA provides a new avenue to resolve the bottleneck: surfactant sclerosants' efficiency is relatively low in the current sclerotherapy.

Against the backdrop of deep integration between digital technology and healthcare,internet hospitals are tran-sitioning from"channel supplementation"to"service reconstruction."Based on conventional internet hospital service processes,this paper proposes construction suggestions and optimization strategies for four key nodes:the development of intelligent triage systems,the improvement of appointment systems,the integration of online and offline services,and the expansion of post-consul-tation services.By focusing on patient experience,medical services can become more humanized and personalized,thereby en-hancing patient efficiency and satisfaction with internet-based healthcare services and promoting the overall development of the medical service industry.

Against the backdrop of the digital transformation in healthcare,the high detection rate of pulmonary nodules has created an urgent need for precise diagnosis,treatment,and whole-course management.This article elaborates in detail on the whole-course management model for pulmonary nodules constructed based on Internet hospitals,covering core elements such as the implementation process and the application of innovative technologies.It also conducts an in-depth analysis of its effec-tiveness,advantages,challenges,and future development directions in clinical practice.The aim is to provide innovative ideas and practical evidence for improving the management level of pulmonary nodules and the prognosis of patients,and to promote the deep empowerment of Internet medical technology in the field of pulmonary nodule disease management.

In the current medical system in China,there is uneven distribution of resources and shortcomings in primary medical services.In this context,the construction of urban medical groups has become an important focus of medical reform.This article analyzes the development status and existing problems of urban medical groups,and proposes measures such as innovating internal management structure,improving incentive and constraint mechanisms,accelerating the construction of information sha-ring platform,and strengthening policy support to help urban medical groups break through development bottlenecks and promote the medical service system to a higher level.

Against the backdrop of deep integration between digital technology and healthcare,internet hospitals are tran-sitioning from"channel supplementation"to"service reconstruction."Based on conventional internet hospital service processes,this paper proposes construction suggestions and optimization strategies for four key nodes:the development of intelligent triage systems,the improvement of appointment systems,the integration of online and offline services,and the expansion of post-consul-tation services.By focusing on patient experience,medical services can become more humanized and personalized,thereby en-hancing patient efficiency and satisfaction with internet-based healthcare services and promoting the overall development of the medical service industry.

Against the backdrop of the digital transformation in healthcare,the high detection rate of pulmonary nodules has created an urgent need for precise diagnosis,treatment,and whole-course management.This article elaborates in detail on the whole-course management model for pulmonary nodules constructed based on Internet hospitals,covering core elements such as the implementation process and the application of innovative technologies.It also conducts an in-depth analysis of its effec-tiveness,advantages,challenges,and future development directions in clinical practice.The aim is to provide innovative ideas and practical evidence for improving the management level of pulmonary nodules and the prognosis of patients,and to promote the deep empowerment of Internet medical technology in the field of pulmonary nodule disease management.

In the current medical system in China,there is uneven distribution of resources and shortcomings in primary medical services.In this context,the construction of urban medical groups has become an important focus of medical reform.This article analyzes the development status and existing problems of urban medical groups,and proposes measures such as innovating internal management structure,improving incentive and constraint mechanisms,accelerating the construction of information sha-ring platform,and strengthening policy support to help urban medical groups break through development bottlenecks and promote the medical service system to a higher level.

Objective To compare the efficacy of contrast-enhanced ultrasound (CEUS) and enhanced CT (CECT) in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.Methods The clinical data of 68 cases of space-occupying lesions of gallbladder confirmed by surgery and biopsy were retrospectively analyzed.The diagnostic accuracy,sensitivity and specificity of CEUS and CECT were analyzed and compared.Results In a total of 68 cases of space-occupying lesions of gallbladder,31 cases were benign lesions and 37 were malignant lesions (gallbladder cancer).For the benign lesions cases,CEUS and CECT were mainly hyper-enhanced in the early stage of enhancement,which were 90.3％ and 83.9％,respectively.In the late stage of enhancement,they were mostly low-enhanced,which were 93.5％ and 87.1％,respectively.For the gallbladder cancer cases,CEUS and CECT were predominantly hyper-enhanced in the early stage of enhancement,which were 94.6％ and 89.2％,respectively,and were all low-enhanced in the late stage of enhancement.In the differential diagnosis for benign and malignant space-occupying gallbladder lesions by CEUS,the differences in peak time,extinction time,peak intensity and average transit time were statistically significant (all P＜0.01).The inhomogeneous enhancement rates were 41.9％ and 48.4％ respectively for CEUS and CECT in the benign lesions cases,and 94.6％ and 91.9％ in the gallbladder cancer cases.Besides,the incomplete gallbladder wall rates are 89.2％ and 91.9％ in the gallbladder cancer cases.However,these differences were all not statistically significant (all P＞0.05).In the diagnosis of benign and malignant lesions cases,the diagnostic accuracy of CEUS and CECT were 92.6％ and 89.7％,the sensitivity was 93.5％ and 90.3％,and the specificity was 89.2％ and 83.8％,respectively,but the differences were not statistically significant (all P＞0.05).Conclusion CEUS and CECT have comparable efficacy in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.CEUS has advantages over CECT and is worthy of extensive clinical application and promotion.

Objective In this study,we explored the role of combination of autophagy inhibition and anti-VEGF in proliferation,migration and tube formation of mouse retinal vascular endothelial cells(RVECs). Methods Well cultured mouse RVECs were randomly divided into four groups:autophagy inhibition group(add-ing autophagy inhibitor 3-MA),anti-VEGF group(adding anti-VEGF-A neutralized antibody),autophagy inhibi-tion+anti-VEGF group(adding the two reagents)and the control group.All cells were then cultured in the hypoxic condition. The cell proliferation,migration and tube formation were detected by EdU,transwell and matrigel as-say,respectively. Results The cell proliferation rate,number of migrated cells and number of tube formation of the other three groups decreased when compared with the control group.These data above in autophagy inhibition+anti-VEGF group were all significantly less than 3-MA group and anti-VEGF group. Conclusion Combination of autophagy inhibition and anti-VEGF may be more effective than simple anti-VEGF in inhibition of retinal neovascu-larization.

Promotion of outstanding people to head nurses is key to hospital nursing management.In view of the current shortcomings in the analysis of appraisal data and the interpretation of appraisal results,the analysis of means(ANOM)method is introduced to the process of hospital human resource management.The proposed method aims to solve the problem when the score differences between interviewers are great and the score differences between candidates are small.An example for head nurses' promotion appraisal in a hospital is offered to demonstrate that statistical tools can provide the decision support for hospital personnel selection.Finally,the application differences between ANOM and analysis of variance(ANOVA) in human resources appraisal are compared.