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.

Objective:To analyze the influence of micro-course guided by mind mapping on the examination results, critical thinking ability and learning efficiency of interns in internal medicine department of traditional Chinese medicine.Methods:A total of 86 interns rotated in the internal medicine department of traditional Chinese medicine from July 2018 to November 2019 were randomized into two groups, namely the control group ( n=43) and the research group ( n=43). The control group received traditional teaching, and the research group adopted micro-course guided by mind mapping to carry out teaching activities. SPSS 21.0 was used to conduct t test and chi-square test to compare the evaluation results of assessment, critical thinking ability, learning efficiency and comprehensive ability. Results:The scores of theory and skill practice in the research group were higher than those in the control group ( P<0.05). After intervention, the evaluation results of critical thinking ability in the two groups were better than before intervention ( P<0.05), and the evaluation results of critical thinking ability in the research group were better than those in the control group ( P<0.05). The total effective rate of the research group was significantly higher than that of the control group ( P<0.05). The evaluation results of comprehensive ability in the research group were significantly higher than those in the control group ( P<0.05). Conclusion:The application of micro-course guided by mind mapping in practice teaching of internal medicine department of traditional Chinese medicine has a positive impact on the cultivation of interns' critical thinking ability and comprehensive ability, with excellent examination results and high learning efficiency.

Objective:To observe the influence of sevoflurane pretreatment in the lung function of the infants during heart operation by cardiopulmonary bypass (CPB), and to explore its lung protection and possible mechanism.Methods:Sixty infants with ventricular septal defect were enrolled at age less than 1 year old and randomly assigned to pretreatment group and control group (n=30).After the induction of general anesthesia and tracheal intubation,the patients in pretreatment group received continuous inhalation of 1.0 MAC sevoflurane until the beginning of CPB.Inhale sevoflurane was absent in control group.The duration of ventilator support of the infants in two groups was recorded.The Pplate,CL,OI,A-aDO2 ,RI,the number of leukocytes and neutrophils segregated in lung of the patients were compared between two groups at the four time points T0 (before aorta clamping),T1 (30 min after aorta declamping),T2,and T3 (2 h and 6 h after CPB).Results:Compared with control group,the duration of ventilator support of the infants in pretreatment group was obviously shortened (P <0.05).In each group,the CL and OI were significantly decreased (P < 0.05 or P < 0.01),while the Pplate, A-aDO2 ,RI,the number of leukocyte and neutrophils segregated in lung were significantly increased (P <0.05 or P <0.01)at T1,T2,T3 time points compared with T0 time point.The CL and OI in pretreatment group were significantly increased (P <0.05 or P <0.01);the Pplate,A-aDO2,RI,the number of leukocytes and neutrophils segregated in lung in pretreatment group were significantly decreased at T1,T2,and T3 (P <0.05 or P <0.01) compared with control group.Conclusion:Sevoflurane pretreatment might play a role in decreasing the leukocyte adhesion and protecting the lung function in the infants during opening heart operation by CPB.

Objective To assess the significance and the relationship of BODE index score and inflammation factors in stable chronic obstructive pulmonary disease(COPD).Methods Sixty COPD patients in their stable condition were evaluated for BODE index score and the level of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8) and C reactive protein (CRP) were determined.Results BODE index score in COPD patients was positively correlated with serum concentrations of TNF-α,IL-8 (r =0.455,P ＜ 0.01 ; r =0.303,P ＜0.05),but not with CRP (r =0.111,P =0.398).IL-8 and TNF-α were both significantly negatively correlated to body mass index(BMI),force exhale volume of the first second (FEV1) and 6 minute walking distance (6MWD) (r=-0.417,P ＜0.01;r=-0.538,P＜0.01;r =-0.419,P＜0.01 for IL-8;and r=-0.262,P＜0.05;r=-0.348,P＜0.01;r=-0.334,P＜0.01 for TNF-α).Conclusion The BODE index,as a simple multidimensional grading system for COPD,is closely related to system inflammation,which indicates that system inflammation may contribute to the systemic development of COPD.