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 investigate the implementation effect of the Diagnosis-Related Group(DRG)payment reform.Methods:Taking Panzhihua City in Sichuan Province,which implemented the DRG payment reform in 2018,as the treatment group,and the remaining 20 non-pilot prefecture-level administrative regions within the province as the control group,the panel data was constructed.The Synthetic Control Method(SCM)was employed to evaluate the effects of the DRG payment reform.Results:Four years after the implementation,the inpatient diagnosis and treatment costs in Panzhihua City were approximately 1200 yuan lower,and drug costs were about 500 yuan lower than the synthetic control group.Conclusion:The DRG payment reform has led to a significant reduction in both inpatient diagnosis and treatment costs and drug expenses,effectively mitigating the rapid growth of medical insurance fund expenditures.It is recommended to leverage artificial intelligence to optimize the precision of DRG grouping,utilize the technological outreach of national medical centers,and promote synergy between the DRG payment reform and public hospital performance reform,construct a medical service payment model that"controls costs,improves quality,and promotes efficiency",thereby enhancing the effectiveness of the DRG payment reform.

Objective To evaluate the value of multiple obesity indicators in predicting hypertension of the elderly population aged 65 years and above,to provide a scientific basis for the timely identification of hypertensive patients and high-risk groups,and to provide a strategic reference for the early intervention of hypertension in the elderly.Methods A total of 6873 elderly people who received health checkups at a community health service centre in Wuhan from March 2022 to December 2023 were selected as the study subjects.The Chinese visceral adipose index(CVAI),a body shape index(ABSI),conicity index(CI)and cardiometabolic index(CMI)were calcu-lated,the area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to analyze and compare the ability of the above obesity indicators for identifying the risk of hypertension in elderly people of different genders.Results There were signifi-cant differences in all obesity indexes between different gender(P＜0.05).The differences in AUC for identifying the risk of hypertension among ABSI,CI and CMI in males,and CVAI,ABSI and CI in females were statistically significant(P＜0.05),and the AUC were 0.524,0.575,0.611,0.635,0.530,0.565,respectively.The AUC of CMI in males and CVAI in females for identifying the risk of hypertension was larger than other indicators.Conclusion Obesity indicators for identifying the risk of hypertension differ between gen-ders;CMI and CVAI are the best indicators for predicting the risk of hypertension in elderly males and females,respectively;the commu-nity can apply and promote the corresponding obesity indicators for elderly hypertensive patients of different genders to improve the early intervention and prevention of hypertension.

Objective:To investigate the implementation effect of the Diagnosis-Related Group(DRG)payment reform.Methods:Taking Panzhihua City in Sichuan Province,which implemented the DRG payment reform in 2018,as the treatment group,and the remaining 20 non-pilot prefecture-level administrative regions within the province as the control group,the panel data was constructed.The Synthetic Control Method(SCM)was employed to evaluate the effects of the DRG payment reform.Results:Four years after the implementation,the inpatient diagnosis and treatment costs in Panzhihua City were approximately 1200 yuan lower,and drug costs were about 500 yuan lower than the synthetic control group.Conclusion:The DRG payment reform has led to a significant reduction in both inpatient diagnosis and treatment costs and drug expenses,effectively mitigating the rapid growth of medical insurance fund expenditures.It is recommended to leverage artificial intelligence to optimize the precision of DRG grouping,utilize the technological outreach of national medical centers,and promote synergy between the DRG payment reform and public hospital performance reform,construct a medical service payment model that"controls costs,improves quality,and promotes efficiency",thereby enhancing the effectiveness of the DRG payment reform.

Objective To evaluate the value of multiple obesity indicators in predicting hypertension of the elderly population aged 65 years and above,to provide a scientific basis for the timely identification of hypertensive patients and high-risk groups,and to provide a strategic reference for the early intervention of hypertension in the elderly.Methods A total of 6873 elderly people who received health checkups at a community health service centre in Wuhan from March 2022 to December 2023 were selected as the study subjects.The Chinese visceral adipose index(CVAI),a body shape index(ABSI),conicity index(CI)and cardiometabolic index(CMI)were calcu-lated,the area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to analyze and compare the ability of the above obesity indicators for identifying the risk of hypertension in elderly people of different genders.Results There were signifi-cant differences in all obesity indexes between different gender(P＜0.05).The differences in AUC for identifying the risk of hypertension among ABSI,CI and CMI in males,and CVAI,ABSI and CI in females were statistically significant(P＜0.05),and the AUC were 0.524,0.575,0.611,0.635,0.530,0.565,respectively.The AUC of CMI in males and CVAI in females for identifying the risk of hypertension was larger than other indicators.Conclusion Obesity indicators for identifying the risk of hypertension differ between gen-ders;CMI and CVAI are the best indicators for predicting the risk of hypertension in elderly males and females,respectively;the commu-nity can apply and promote the corresponding obesity indicators for elderly hypertensive patients of different genders to improve the early intervention and prevention of hypertension.

OBJECTIVE To investigate the potential of low-frequency, low-power ultrasound to enhance the transdermal absorption and efficacy of ketoprofen gel. METHODS Ketoprofen gel was used as a model drug to compare the in vitro transdermal permeation of ultrasound treated group and untreated group. Additionally, a rat model of collagen-induced inflammation provided a basis for evaluating pharmacodynamic differences. Pharmacokinetic studies further elucidated the effects of ultrasound on ketoprofen gel's penetration process. RESULTS Ultrasound treatment enhanced the cumulative transdermal permeation of ketoprofen gel by 3.5-fold over 24 hours compared to untreated. Significant pharmacokinetic improvements in AUC0-t from (4289.02±763.58)ng·h·mL−1 to (11301.10±3386.30)ng·h·mL−1 and a reduction in Tmax from (6.0±1.4)h to (3.0±2.0)h. Ultrasound notably improved the gel's anti-inflammatory effects in the rat model, effectively and rapidly reducing inflammation-induced swelling. CONCLUSION Low-frequency, low-power ultrasound can significantly improve the amount and rate of transdermal absorption of ketoprofen gel and enhance its pharmacological potency, from the aspects of skin permeation tests, pharmacodynamic evaluation, and pharmacokinetic studies, which is an effective penetration enhancer for transdermal administration of ketoprofen gel.

Objective:To analyze the current status and deficiencies of family bed service policies in China, for references for promoting the construction of China′s home health service system.Methods:Key words such as " family bed" and " home health services" were used to search for relevant policies(from January 1, 1984 to May 31, 2023)in Peking University Treasure Database, the State Council′s policy document repository, and official websites of health administrative departments at all levels. NVivo 11.0 software was utilized for a three-level coding process to establish a policy text analysis framework and to identify deficiencies in the construction of policies.Results:A total of 63 policy documents were included, comprising 53 provincial and municipal documents, which were mainly concentrated in economically developed provinces; After three-level coding, 72 third level nodes, 21 second level nodes, and 8 first level nodes(service objects, service providers, service methods, service content, service fees, subsidy policies, hospital bed configuration, and standardized management) were obtained. Among them, the responsibilities of service providers needed to be further clarified, the technical and innovative nature of service content was still insufficient, the charging standards and medical insurance reimbursement policies needed to be improved, the support for subsidy policies was limited, and the use of intelligent devices in bed configuration needed to be strengthened.Conclusions:China′s family bed service policy focused on eight dimensions, covering a comprehensive range of content, but there were still areas that need to be refined and improved. This study suggested that relevant departments should further clarify the responsibilities of service providers, deepen the construction of service connotations, moderately increase government support, promote the intelligent construction of services, and achieve multi-party collaboration to jointly promote the sustainable development of family bed services in China.

Objective:To investigate the short-term effects of articular injection of hyaluronic acid combined with glucocorticoid in patients with knee osteoarthritis.Methods:From October 2017 to June 2018, a total of 188 patients diagnosed with knee osteoarthritis received parallel articular injection. There were 60 cases with mild knee osteoarthritis, 72 with moderate and 56 with severe according to the WOMAC knee functional score. There patients were divided into group rank Ⅰ48 cases, Ⅱ 49 cases, Ⅲ 45 cases, Ⅳ 46 cases according to the knee joint X-ray Kellgren-Lawrence classification. The unified treatment regimen was 2.5 ml Sodium Hyaluronate (SHA) injection for the first time, SHA 2.5 ml and compound betamethasone injection (CBI) 1 ml for the second week, and 2.5 ml of SHA for the third week. WOMAC score and Lequesne index were used to evaluate joint function before the first injection and after SHA and SHA+CBI injection. The improvement rate of Lequesne index ≥30% or improvement rate of WOMAC score ≥25% was regarded as effective treatment.Results:Lequesne index and WOMAC score decreased gradually in the mild, moderate and severe groups after 3 weeks of injection. Among these patients, the improvement rates of Lequesne index after SHA injection and SHA+CBI injection were 36.44%±8.46% and 49.26%±13.75% in the mild group, 23.09%±12.61% and 30.66%±14.95% in the moderate group, and 10.50%±8.78% and 11.07%±6.52% in the severe group. The improvement rate of WOMAC score in the mild group after SHA injection and after SHA+CBI injection was greater than 25%. After SHA injection, the improvement rate of WOMAC score was 13.06%±10.21% in the moderate group, and 27.49%±13.61% after SHA+CBI injection. Those in severe group were all less than 25%. Kendall's staub correlation analysis results showed that there was a strong positive correlation between WOMAC function score and X-ray Kellgren-Lawrence classification ( r=0.744, P<0.001). The Lequesne index and WOMAC scores of the Kellgren-Lawrence X-ray classification decreased gradually after 3 weeks of injection. The improvement rate of Lequesne index period in group rank Ⅰ after SHA and SHA+CBI injection was 36.64%±10.05% and 52.00%±8.19%, respectively. That for group rank Ⅱ was 32.05%±8.09% and 41.95%±10.53%, group rank Ⅲ 16.93%±10.34% and 27.77%±10.25%, group rank Ⅳ 7.52%±5.53% and 7.60%±6.66%. The improvement rate of WOMAC score period in group rank Ⅰ after SHA and SHA+CBI injection was 29.48%±11.77% and 42.59%±13.55%, respectively. That for group rank Ⅱ was 26.72%±10.21% and 30.49%±16.90%, group rank Ⅲ 13.78%±5.96% and 23.05%±9.52%, group rank Ⅳ 4.77%±3.80% and 4.27%±4.23%. Conclusion:For mild or X-ray classification Ⅰ, Ⅱ knee osteoarthritis patients, articular injection SHA or SHA+CBI are effective. Further, SHA+CBI is better than single injection of SHA. SHA+CBI injection was effective for moderate knee osteoarthritis patients. For severe or X-ray classification Ⅲ, Ⅳ patients, SHA or SHA+CBI injection at interval are invalid.

Objective:To study the determination method of scutellarin in BREVISCAPINE INJECTION using HPLC.Methods:The waters ODS C 18 column (5?m,3.9?150mm) was used. The methanol water glacial acetic acid (40∶60∶1) was used as a mobile phase. The detection wavelength of scutellarin was set at 335nm and internal standard baicalin at 280nm. The resolution of scutellarin's and baicalin peaks was at least 5. Number of theoretical plates of column is no less than 1000 to scutellarin. Results:The recovery of additive sample is 99.8%. RSD is no more 2.0%.Conclusion: It is generally in agreement with external standard method.