Objective:To identify key influencing factors and their structural relationships for continuity of care and care coordination in integrated healthcare systems,providing evidence for systemic improvement strategies.Methods:Taking the Yuhuan Health Consortium in Zhejiang Province as an example,this study integrated the Decision-Making Trial and Evaluation Laboratory(DEMATEL)and Adversarial Interpretive Structure Modeling(AISM).An expert questionnaire and literature review were used to construct a factor system,quantifying the influence degree,centrality,and hierarchical structure of 17 continuity and 14 coordination factors.Results:In the system of continuity of care,division-of-labor and linkage mechanisms(influence degree:2.516)and payment methods(causal degree:1.043)were identified as core drivers,forming a four-level interaction network.For care coordination,health planning(centrality:4.452)and health insurance policies(causal degree:1.131)emerged as root causes,establishing a three-tier hierarchical structure.Topological analysis revealed that continuity relies on the"institutional design-process articulation-patient perception"pathway,while coordination depends on the"policy traction-management synergy-technical support"linkage mechanism.Both systems shared disease characteristics(causal degree:1.650/1.384)as underlying drivers,yet service processes(centrality:4.680)and managerial awareness(centrality:4.754)served as unique hub nodes.Conclusion:Differentiated interventions are required:continuity improvement should prioritize payment reform and division-of-labor mechanisms,while coordination enhancement necessitates strengthened health planning and policy synergy.

Dental implantology has developed rapidly for over half a century,since pure titanium(99.7％)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95％.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.

Objective To develop a simple method for producing mice adipose stem cells with highly efficient adipogenic differentiation capability.Methods Subcutaneous adipose tissue was extracted from wild-type mice.By strictly controlling the digestion time of collagenase,we compared the number of adipose stem cells and their adipogenic differentiation ability obtained for different digestion times.Further,flow cytometry was used to clarify the differences in mesenchymal cells and vascular components at different digestion times.Results The adipose stem cells obtained after 40 minutes of digestion by collagenase exhibited over 90%adipogenic differentiation ability in vitro,while those obtained after 60 minutes of digestion only showed 20%adipogenic differentiation ability.The main reason for this discrepancy was the presence of a portion of vascular-related cells in the latter.Conclusion By controlling the digestion time of collagenase in adipose tissue,we have established an efficient method for preparing adipose stem cells with high adipogenic differentiation potential.The obtained adipose stem cells exhibit over 90%adipogenic differentiation ability in vitro.

Objective To develop a simple method for producing mice adipose stem cells with highly efficient adipogenic differentiation capability.Methods Subcutaneous adipose tissue was extracted from wild-type mice.By strictly controlling the digestion time of collagenase,we compared the number of adipose stem cells and their adipogenic differentiation ability obtained for different digestion times.Further,flow cytometry was used to clarify the differences in mesenchymal cells and vascular components at different digestion times.Results The adipose stem cells obtained after 40 minutes of digestion by collagenase exhibited over 90%adipogenic differentiation ability in vitro,while those obtained after 60 minutes of digestion only showed 20%adipogenic differentiation ability.The main reason for this discrepancy was the presence of a portion of vascular-related cells in the latter.Conclusion By controlling the digestion time of collagenase in adipose tissue,we have established an efficient method for preparing adipose stem cells with high adipogenic differentiation potential.The obtained adipose stem cells exhibit over 90%adipogenic differentiation ability in vitro.

Dental implantology has developed rapidly for over half a century,since pure titanium(99.7％)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95％.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.

Monkeypox is a viral zoonotic disease,and there is currently a lack of safe and effective vac-cines against the monkeypox virus.Therefore,screening and developing vaccine candidates is of signifi-cant practical importance.With the rapid advancement of molecular biology and plant genetic engineer-ing,plant bioreactors offer promising potential for producing vaccine proteins due to their advantages,in-cluding safety,cost-effectiveness,and scalability.In this study,we focused on the monkeypox protein B6R.The recombinant expression plasmid pFolia40108-B6R-Fer was successfully constructed using am-plification,enzyme digestion,and flexible linker tandem ferritin technology.A complete transient expres-sion system in Nicotiana benthamiana and a purification system for the recombinant monkeypox protein were established.The optimal expression time was determined to be 12-14 days,with a final purified pro-tein concentration of approximately 1 mg/mL and a yield of 0.85 mg/kg fresh weight.The purified B6R-Fer recombinant protein self-assembled into spherical virus-like particles(VLPs)with an average particle size of 24 nm.The B6R-Fer recombinant protein from this study shows promising potential for use in the development and screening of plant-derived monkeypox vaccine candidates.

Objective:To analyze the correlation of monocyte/high density lipoprotein ratio(MHR),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and bone density,bone metabolism markers in elderly essential hypertension with osteoporosis(OP)patients.Methods:This study was a retrospective study,198 elderly essential hypertension patients who were admitted in our hospital from January 2022 to June 2024 were selected.According to the patient's bone mass test results,patients were divided into normal bone mass group(n=79),osteopenia group(n=68)and OP group(n=51).MHR,NLR,PLR,bone density(left hip,left femoral neck and lumbar spine L1-L4)and bone metabolism markers were compared among three groups,the correlation of MHR,NLR,PLR and bone density,bone metabolism markers were analyzed by Pearson correlation.Results:MHR,NLR,PLR in normal bone mass group,osteopenia group and OP group increased in turn(P＜0.05).The left hip,left femoral neck and lumbar spine L1-L4 bone density in normal bone mass group,osteopenia group,OP group decreased in turn(P＜0.05).25-hydroxyvitamin D[25(OH)D]in normal bone mass group,osteopenia group and OP group decreased in turn,alkaline phosphatase(ALP)and parathyroid hormone(PTH)increased in turn(P＜0.05).MHR,NLR and PLR were negatively correlated with left hip bone density,left femoral neck bone density,lumbar spine L1-L4 bone density,25(OH)D and positively correlated with PTH and ALP(P＜0.05).Conclusion:The increase of MHR,NLR and PLR in elderly essential hypertension with OP patients can affect bone mineral density and bone metabolism.

Objective To analyze the imaging features of cerebral small vessel disease in patients with type 2 diabetes mellitus by multimodal MRI.Methods The clinical data of 160 patients with cerebral small vessel disease admitted to our hospital from January to December 2020 were retrospectively analyzed.According to whether they were complicated with type 2 diabetes mellitus,they were divided into the diabetic group and the non-diabetic group,with 80 cases in each group.Both groups underwent multimodal MRI scans.And the severity of lacunar infarction,the severity of subcortical and periventricular white matter lesions,white matter integral and cerebral microbleeds of patients in the two groups were compared.Results The severity of lacunar infarction(χ2=34.076,P=0.001),subcortical white matter lesions(χ2=25.000,P=0.001),periventricular white matter lesions(χ2=22.895,P=0.001)and white matter integral(t=12.370,P=0.001)of patients in the diabetic group were significantly higher than those in the non-diabetic group.No cerebral microbleeds were detected in either group of patients.Conclusion Patients with cerebral small vessel disease and type 2 diabetes mellitus show characteristic multimodal MRI changes.The increase in the number of lacunar infarction lesions and the aggravation of white matter lesions can be used as the characteristic imaging basis for the diagnosis of type 2 diabetes mellitus related cerebral small vessel disease.

Monkeypox is a viral zoonotic disease,and there is currently a lack of safe and effective vac-cines against the monkeypox virus.Therefore,screening and developing vaccine candidates is of signifi-cant practical importance.With the rapid advancement of molecular biology and plant genetic engineer-ing,plant bioreactors offer promising potential for producing vaccine proteins due to their advantages,in-cluding safety,cost-effectiveness,and scalability.In this study,we focused on the monkeypox protein B6R.The recombinant expression plasmid pFolia40108-B6R-Fer was successfully constructed using am-plification,enzyme digestion,and flexible linker tandem ferritin technology.A complete transient expres-sion system in Nicotiana benthamiana and a purification system for the recombinant monkeypox protein were established.The optimal expression time was determined to be 12-14 days,with a final purified pro-tein concentration of approximately 1 mg/mL and a yield of 0.85 mg/kg fresh weight.The purified B6R-Fer recombinant protein self-assembled into spherical virus-like particles(VLPs)with an average particle size of 24 nm.The B6R-Fer recombinant protein from this study shows promising potential for use in the development and screening of plant-derived monkeypox vaccine candidates.

Objective:To analyze the correlation of monocyte/high density lipoprotein ratio(MHR),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and bone density,bone metabolism markers in elderly essential hypertension with osteoporosis(OP)patients.Methods:This study was a retrospective study,198 elderly essential hypertension patients who were admitted in our hospital from January 2022 to June 2024 were selected.According to the patient's bone mass test results,patients were divided into normal bone mass group(n=79),osteopenia group(n=68)and OP group(n=51).MHR,NLR,PLR,bone density(left hip,left femoral neck and lumbar spine L1-L4)and bone metabolism markers were compared among three groups,the correlation of MHR,NLR,PLR and bone density,bone metabolism markers were analyzed by Pearson correlation.Results:MHR,NLR,PLR in normal bone mass group,osteopenia group and OP group increased in turn(P＜0.05).The left hip,left femoral neck and lumbar spine L1-L4 bone density in normal bone mass group,osteopenia group,OP group decreased in turn(P＜0.05).25-hydroxyvitamin D[25(OH)D]in normal bone mass group,osteopenia group and OP group decreased in turn,alkaline phosphatase(ALP)and parathyroid hormone(PTH)increased in turn(P＜0.05).MHR,NLR and PLR were negatively correlated with left hip bone density,left femoral neck bone density,lumbar spine L1-L4 bone density,25(OH)D and positively correlated with PTH and ALP(P＜0.05).Conclusion:The increase of MHR,NLR and PLR in elderly essential hypertension with OP patients can affect bone mineral density and bone metabolism.