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Background Since the comprehensive implementation of the contracted family doctor service in 2016, the willingness of residents to have their first contact in primary care has gradually increased, but the effectiveness evaluation of contracted residents' first contact in primary care needs to be further explored. Objective To understand the current status of contracted residents' first contact evaluation, explore its influencing factors and propose improvement strategies. Methods A multi-stage stratified random sampling method was used to select 54 community health service institutions/township health centers in three cities in Shandong Province, with a total of 4 000 contracted residents. The first contact dimension questionnaire of the Chinese version of the Primary Care Quality Assessment Scale (PCAT) was used to conduct the survey, comparing the first contact dimension scores of contracted residents with different characteristics and using multiple linear regression to analyse the factors affecting the first contact evaluation of contracted residents. Results A total of 3 859 valid questionnaires were collected, with the effective recovery rate of 96.48%. Among them, 2 086 (54.1%) were residents of township health centers and 1 773 (45.9%) were residents of community health centers; the total score of the first contact dimension in the three regions was 3.49, with the highest score being "Is your contracted institution open on Saturdays and Sundays?" (3.74) ; the item with the lowest score was "During non-business hours, if you were sick at night, would your contracted facility have a doctor or nurse available?" (3.05). The results of the multiple linear regression analysis showed that the contracted facility, personal monthly income, education level, marital status, occupation, physical health and diagnosis of chronic disease were the factors influencing the scores of the first contact dimension of contracted residents (P

Acute lung injury (ALI) is a severe respiratory disease with a high mortality rate. The integrity of the pulmonary endothelial barrier influences the development and prognosis of ALI. Therefore, it has become an important target for ALI treatment. Extracellular vesicles (EVs) are promising nanotherapeutic agents against ALI. Herein, endothelium‐derived engineered extracellular vesicles (eEVs) that deliver microRNA‐125b‐5p (miRNA‐125b) to lung tissues exerting a protective effect on endothelial barrier integrity are reported. eEVs that are modified with lung microvascular endothelial cell‐targeting peptides (LET) exhibit a prolonged retention time in lung tissues and targeted lung microvascular endothelial cells in vivo and in vitro. To improve the efficacy of the EVs, miRNA‐125b is loaded into EVs. Finally, LET‐EVs‐miRNA‐125b is constructed. The results show that compared to the EVs, miRNA‐125b, and EVs‐miRNA‐125b, LET‐EVs‐miRNA‐125b exhibit the most significant treatment efficacy in ALI. Moreover, LET‐EVs‐miRNA‐125b is found to have an important protective effect on endothelial barrier integrity by inhibiting cell apoptosis, promoting angiogenesis, and protecting intercellular junctions. Sequencing analysis reveals that LET‐EVs‐miRNA‐125b downregulates early growth response‐1 (EGR1) levels, which may be a potential mechanism of action. Taken together, these findings suggest that LET‐EVs‐miRNA‐125b can treat ALI by protecting the endothelial barrier integrity. [ABSTRACT FROM AUTHOR]