Objective To identify and analyze the digital supervision issues of cross-province medical treatment in China,and propose countermeasures and suggestions.Methods Using literature research,expert interviews,and questionnaire surveys,from January 29,to February 132023,managers,staff from remote departments of medi-cal insurance bureau and scholar in the field of medical insurance in H province were selected.Principa l component analysis was used to extract questions,and based on the extraction results,a multiple logistic regression model to explore that have a significant impact on the digital supervision of cross-province direct settlement of medical treat-ment.Results The problems of digital supervision of direct settlement for medical treatment across provinces and re-gions in China can be divided into 7 categories,with a cumulative variance contribution rate of 63.17%.The connec-tion of digital regulatory systems,audit rules and early warning issues,as well as the lack of legal systems and defi-nitions have a significant impact on regulatory effectiveness(P＜0.05).Conclusion Incomplete construction of the digital supervision system between the place of insurance participation,and inadequate legal and institutional sateguards for the digital supervision of the direct settlement of cross-provincial cross-district medical consultations.Therefore,strengthening the basic construction of the digital supervision system for cross provincial and cross regional medical direct settlement,and improving the legal system for cross provincial and cross regional medical direct settle-ment digital supervision,have important guiding significance for the digital supervision of cross provincial and cross regional medical direct settlement in China.

Objective: To investigate the level of hypoxia inducible factor-1α (HIF-1α) on osteoblasts and angiogenesis-associated cytokines in bone marrow mesenchymal stem cells (BMSCs) from SD rats. Methods: BMSCs were isolated and cultured and identified by flow cytometry. Plasmid vectors containing upregulated and downregulated HIF-1α gene and a control vector were constructed. The plasmids were transfected into BMSCs by Lipofectamine®LTX transfection reagent, and the cells were divided into an overexpression experimental group, an overexpression control group, a low expression experimental group and a low expression control group. All components were stained with a lizarin red 3 d and 7 d after osteogenesis induction. The mRNA expression levels of the target gene HIF-1α, osteogenic differentiation-specific markers, including Runt-related transcription factor 2 (Runx2) and angiogenic markers, including platelet-derived growth factor-BB (PDGF-BB) and transforming growth factor-β (TGF-β), were detected by RT-PCR. Western blot was used to detect the protein expression of the target proteins HIF-1α, Runx2, and PDGF-BB. Results: The CD29- and CD45-positivity rates of BMSC surface markers identified by flow cytometry were 98.2% and 4.2%, respectively. RT-PCR results showed that the mRNA expression of HIF-1α, Runx2, TGF-β and PDGF-BB was observably increased (P < 0.001). The mRNA expression levels of HIF-1α, Runx2, TGF-β and PDGF-BB in BMSCs from the low expression experimental group were significantly reduced (P < 0.001). Western blot results showed that the expression levels of HIF-1α, Runx2 and PDGF-BB in BMSCs from the overexpression experimental group were all increased (P < 0.001). The expression levels of HIF-1α, Runx2 and PDGF-BB in BMSCs from the low expression experimental group were reduced (P < 0.001). Alizarin red staining results showed that the area of calcium nodules in the low expression experimental group was smaller than that in low expression control group, the area of red calcium nodules in the over expression experimental group was larger than that in over expression control group, and with the increase of osteogenic induction time, the calcification area of each group also increased. Conclusion Upregulation and downregulation of HIF-1α can regulate the osteogenic differentiation and the expression of angiogenesis related factors of BMSCs.

Three dimensionally printed composite porous bone tissue engineering scaffolds have become a research focus. Composite polyvinyl alcohol (PVA) has good biocompatibilityand degradability, but it cannot be prepared indepen⁃dently because it cannot resist highmechanical resistance. This material shows many advantages, such as good biocom⁃patibility, degradability and mechanical properties, when compounded with other materials with good mechanical proper⁃ties and good biocompatibility. Therefore, 3D printed composite PVA scaffold material can optimize the performance of PVA scaffolds. This article reviews 3D printing bone scaffold technology, polyvinyl alcohol (PVA), and composite PVA scaffolds for in vivo and in vitro bone formation.