Objectives:To establish the Chinese Healthy Lifestyle Index(CHLI),which can be applied to comprehensively assess healthy level of lifestyle among Chinese population.Methods:Potential indicators were screened through literature review.Enrolled indicators were determined by the Delphi expert consultation method and the weight of the indicator was assessed by the analytic hierarchy process(AHP).Finally,the CHLI was obtained though weighted sum.Results:In both rounds of correspondence,the positive coefficients were 92.9% and 93.8%,and the expert authority coefficients were 0.846±0.027 and 0.861±0.030,respectively.The coordination coefficients Kendall's W of the importance scores on primary/secondary indicators were 0.482/0.451 and 0.535/0.557 for the first and second round of consultation,respectively(all P<0.001),indicating a good coordination between expert opinions.The final index system of CHLI includes 5 primary indicators and 28 secondary indicators.Regarding the weights of primary indicators,the highest weight was assigned to diet(0.239),followed by psychological health(0.220),physical activity(0.198),nicotine exposure(0.175)and sleep health(0.167).The combined weights of the secondary indicators ranged from 0.009 to 0.198.The consistency ratios of the AHP judgment matrices were all less than 0.1,indicating the results were credible.Conclusions:The CHLI can be used to comprehensively evaluate the healthy level of lifestyle among Chinese population.

The"Report on Cardiovascular Health and Diseases in China"is compiled by the National Center for Cardiovascular Diseases under the guidance of the National Health Commission.Since its inception in 2005,the report has spanned two decades.It has consistently adhered to the principles of professionalism,cutting-edge insights,representativeness,and authority.By continuously collecting,analyzing,and disseminating data on changes in cardiovascular health-related factors and disease trends,the report serves as a critical reference for policymakers in formulating public health strategies,identifying priority intervention areas,evaluating the effectiveness of prevention and control measures,and optimizing resource allocation.Cardiovascular diseases(CVD)remain the leading cause of death among urban and rural residents in China,accounting for 48.98%of rural deaths and 47.35%of urban deaths in 2021,and 2 out of every 5 deaths were CVD-related.The Healthy China 2030 initiative includes a dedicated"Cardiovascular and Cerebrovascular Disease Prevention and Control Action"among its 15 key campaigns,setting a clear target:reducing CVD mortality to 190.7 per 100 000 or lower by 2030.To achieve this goal,more refined action plans and high-quality multidimensional data are needed to track the CVD prevention progress.This includes not only monitoring and reporting CVD incidence,prevalence,mortality,disease burden,and healthcare quality but also actively promoting and tracking improvements in cardiovascular health indicators,such as tobacco consumption,diet,physical activity,sleep,body mass index(BMI),blood pressure,cholesterol,blood glucose,and environmental factors.

The National Report on the Services,Quality and Safety in Medical Care System-Cardiovascular Disease Specialty Volume 2024(hereinafter referred to as the report)was organized and compiled by the National Center for Cardiovascular Quality Improvement.Based on representative national medical quality monitoring and survey data,it comprehensively analyzes and presents the current status and changing trends of medical services and quality safety in the cardiovascular disease specialty in China,and proposes future key work directions and improvement suggestions for weak links and common problems.The main content of the report is divided into two parts.The first part covers the overall situation of medical services for cardiovascular disease,mainly analyzing the overall medical service volume,patient characteristics,and the implementation of key diagnostic and treatment technologies.The second part covers the analysis of key quality control indicators for cardiovascular disease subspecialties,which analyzes the medical service volume,patient characteristics,process quality control indicators,and outcome quality control indicators for 12 specialties including coronary heart disease,heart failure,hypertension,atrial fibrillation,pulmonary hypertension,cardiomyopathy,cardiac surgery,major vascular surgery,structural heart disease intervention,arrhythmia intervention,extracorporeal circulation and extracorporeal life support,and cardiovascular imaging.The analysis focuses on key points of medical quality control and makes in-depth comparisons of regional differences in medical quality and the homogeneity of medical quality among hospitals within regions.The report provides evidence-based support for health administrative departments at all levels to formulate corresponding policies and offers important data support for enhancing the scientific and refined management of medical quality and safety of cardiovascular disease in China.

The Third Plenary Session of the 20th Central Committee of the Communist Party of China clearly stated that it is necessary to"implement the health-first strategy and improve the public health system",which is the foundation for promoting the development of China's health services and also points out the development direction of China's health services in the future.Lifestyle medicine is an inevitable choice following the development mode of modern medicine and the change of disease spectrum,and lifestyle intervention is the most effective and economical means of disease prevention.At present,the development of lifestyle medicine in China faces significant challenges,majoring in the following four respects:lack of mechanism researches and evidence-based researches,difficulty to get paid for provided services,shortage of professionals,and lack of effective promotion and popularization measures.In view of this,we propose five major initiatives to promote the popularization of healthy lifestyle:It is recommended to vigorously promote the national healthy lifestyle campaign;It is recommended to set up lifestyle medicine departments in all public hospitals with the potential capacity;It is recommended that all medical schools and medical colleges in China should establish lifestyle medicine majors;It is suggested to cooperate with social forces to promote the development of lifestyle medicine industry;It is recommended to hold the national healthy lifestyle medicine conference.

The National Report on the Services,Quality and Safety in Medical Care System-Cardiovascular Disease Specialty Volume 2024(hereinafter referred to as the report)was organized and compiled by the National Center for Cardiovascular Quality Improvement.Based on representative national medical quality monitoring and survey data,it comprehensively analyzes and presents the current status and changing trends of medical services and quality safety in the cardiovascular disease specialty in China,and proposes future key work directions and improvement suggestions for weak links and common problems.The main content of the report is divided into two parts.The first part covers the overall situation of medical services for cardiovascular disease,mainly analyzing the overall medical service volume,patient characteristics,and the implementation of key diagnostic and treatment technologies.The second part covers the analysis of key quality control indicators for cardiovascular disease subspecialties,which analyzes the medical service volume,patient characteristics,process quality control indicators,and outcome quality control indicators for 12 specialties including coronary heart disease,heart failure,hypertension,atrial fibrillation,pulmonary hypertension,cardiomyopathy,cardiac surgery,major vascular surgery,structural heart disease intervention,arrhythmia intervention,extracorporeal circulation and extracorporeal life support,and cardiovascular imaging.The analysis focuses on key points of medical quality control and makes in-depth comparisons of regional differences in medical quality and the homogeneity of medical quality among hospitals within regions.The report provides evidence-based support for health administrative departments at all levels to formulate corresponding policies and offers important data support for enhancing the scientific and refined management of medical quality and safety of cardiovascular disease in China.

Objectives:To establish the Chinese Healthy Lifestyle Index(CHLI),which can be applied to comprehensively assess healthy level of lifestyle among Chinese population.Methods:Potential indicators were screened through literature review.Enrolled indicators were determined by the Delphi expert consultation method and the weight of the indicator was assessed by the analytic hierarchy process(AHP).Finally,the CHLI was obtained though weighted sum.Results:In both rounds of correspondence,the positive coefficients were 92.9% and 93.8%,and the expert authority coefficients were 0.846±0.027 and 0.861±0.030,respectively.The coordination coefficients Kendall's W of the importance scores on primary/secondary indicators were 0.482/0.451 and 0.535/0.557 for the first and second round of consultation,respectively(all P<0.001),indicating a good coordination between expert opinions.The final index system of CHLI includes 5 primary indicators and 28 secondary indicators.Regarding the weights of primary indicators,the highest weight was assigned to diet(0.239),followed by psychological health(0.220),physical activity(0.198),nicotine exposure(0.175)and sleep health(0.167).The combined weights of the secondary indicators ranged from 0.009 to 0.198.The consistency ratios of the AHP judgment matrices were all less than 0.1,indicating the results were credible.Conclusions:The CHLI can be used to comprehensively evaluate the healthy level of lifestyle among Chinese population.

The"Report on Cardiovascular Health and Diseases in China"is compiled by the National Center for Cardiovascular Diseases under the guidance of the National Health Commission.Since its inception in 2005,the report has spanned two decades.It has consistently adhered to the principles of professionalism,cutting-edge insights,representativeness,and authority.By continuously collecting,analyzing,and disseminating data on changes in cardiovascular health-related factors and disease trends,the report serves as a critical reference for policymakers in formulating public health strategies,identifying priority intervention areas,evaluating the effectiveness of prevention and control measures,and optimizing resource allocation.Cardiovascular diseases(CVD)remain the leading cause of death among urban and rural residents in China,accounting for 48.98%of rural deaths and 47.35%of urban deaths in 2021,and 2 out of every 5 deaths were CVD-related.The Healthy China 2030 initiative includes a dedicated"Cardiovascular and Cerebrovascular Disease Prevention and Control Action"among its 15 key campaigns,setting a clear target:reducing CVD mortality to 190.7 per 100 000 or lower by 2030.To achieve this goal,more refined action plans and high-quality multidimensional data are needed to track the CVD prevention progress.This includes not only monitoring and reporting CVD incidence,prevalence,mortality,disease burden,and healthcare quality but also actively promoting and tracking improvements in cardiovascular health indicators,such as tobacco consumption,diet,physical activity,sleep,body mass index(BMI),blood pressure,cholesterol,blood glucose,and environmental factors.

The Third Plenary Session of the 20th Central Committee of the Communist Party of China clearly stated that it is necessary to"implement the health-first strategy and improve the public health system",which is the foundation for promoting the development of China's health services and also points out the development direction of China's health services in the future.Lifestyle medicine is an inevitable choice following the development mode of modern medicine and the change of disease spectrum,and lifestyle intervention is the most effective and economical means of disease prevention.At present,the development of lifestyle medicine in China faces significant challenges,majoring in the following four respects:lack of mechanism researches and evidence-based researches,difficulty to get paid for provided services,shortage of professionals,and lack of effective promotion and popularization measures.In view of this,we propose five major initiatives to promote the popularization of healthy lifestyle:It is recommended to vigorously promote the national healthy lifestyle campaign;It is recommended to set up lifestyle medicine departments in all public hospitals with the potential capacity;It is recommended that all medical schools and medical colleges in China should establish lifestyle medicine majors;It is suggested to cooperate with social forces to promote the development of lifestyle medicine industry;It is recommended to hold the national healthy lifestyle medicine conference.

Objectives:To establish a comprehensive system of Cardiovascular Academic Performance Evaluation(CAPE)and rank global TOP100 medical institutions in the fields of cardiovascular diseases(CVD). Methods:CVD-related terms were extracted from Medical Subject Headings(MeSH),Embase thesaurus(EMtrees)and International Classification of Diseases(ICD)by CVD-related professionals,as well as by librarians and information professionals.Terminology databases(named as Fuwai Subject Headings)were established,and nine sub-disciplines were proposed,including ischemic heart diseases,hypertension,vascular diseases,arrhythmia,pulmonary vascular diseases,heart failure,congenital heart diseases,cardiomyopathy,and valvular heart diseases.The mapping patterns of sub-discipline,cardiovascular terminology and entry terms were pre-defined.The CVD-related research literature published from January 1,2016 to December 31,2022 were retrieved from Web of Science,PubMed and Scopus.Based on this,metadata were fused and duplicates were excluded.Fuwai Subject Headings were searched and matched into four respects for each literature,including subject words,titles,keywords,and abstracts,which was used to generate an information table of"Position—CVD terminology—Frequency",and to calculate CVD correlation scores and sub-discipline scores.We standardized the names of medical institutions and scholars,and make a ranking system for CAPE based on original articles with strong cardiovascular correlation(correlation score≥4).When evaluating the science and technological performance for Chinese hospitals in cardiovascular diseases,National Natural Science Foundation Projects,authorized invention patents,prize achievements,research platforms,and registered data of drug clinical trials in Center for Drug Evaluation(CDE)were considered besides research papers. Results:During 2016 and 2022,1 545 103 CVD research literatures were found worldwide.After excluding meeting abstracts,books,biographies,news,videos,audio texts,retracted publications,and corrections,1 178 019 CVD research literatures were further evaluated.518 058 literatures were indexed as"strongly correlated to CVD"using Fuwai Subject Headings.Besides papers,other data sources were also collected,including 11 143 CVD-related Natural Science Foundation Projects,19 382 CVD-related effective authorized invention patents,103 CVD-related national prize achievements,24 CVD-related national research platforms,and 2 084 CDE registered data of CVD-related drug clinical trials.Research teams from nine sub-disciplines reviewed and validated research literature in respective fields,and classification rules of corresponding sub-disciplines were created and improved based on their opinions.Finally,eleven individual indexes were chosen to construct CAPE system for ranking global TOP100 medical institutions in overall CVD field and TOP30 in nine sub-disciplines.From 2016 to 2022,the number of cardiovascular disease research papers published by Chinese institutes has increased by 123.5%,with a total of approximately 76.8 thousands papers published(about 30 papers per day on average),ranked the second under the United States(approximately 114.1 thousands papers).However,the proportion of papers published by the Chinese Journal Citation Reports(JCR)and the Chinese Academy of Sciences only ranked eighth in the world.In the comprehensive academic performance of original cardiovascular research papers in global hospitals from 2020 to 2022,only two Chinese medical institutions ranked in the TOP20 as evaluated by CAPE system. Conclusions:Based on multi-source data from 2016 to 2022,CAPE initiated to establish a cardiovascular academic performance evaluation system.

Background::The ability to generate functional hepatocytes without relying on donor liver organs holds significant therapeutic promise in the fields of regenerative medicine and potential liver disease treatments. Clustered regularly interspaced short palindromic repeats (CRISPR) activator (CRISPRa) is a powerful tool that can conveniently and efficiently activate the expression of multiple endogenous genes simultaneously, providing a new strategy for cell fate determination. The main purpose of this study is to explore the feasibility of applying CRISPRa for hepatocyte reprogramming and its application in the treatment of mouse liver fibrosis.Method::The differentiation of mouse embryonic fibroblasts (MEFs) into functional induced hepatocyte-like cells (iHeps) was achieved by utilizing the CRISPRa synergistic activation mediator (SAM) system, which drove the combined expression of three endogenous transcription factors— Gata4, Foxa3, and Hnf1a—or alternatively, the expression of two transcription factors, Gata4 and Foxa3. In vivo, we injected adeno-associated virus serotype 6 (AAV6) carrying the CRISPRa SAM system into liver fibrotic Col1a1-Cre ER; Cas9 fl/fl mice, effectively activating the expression of endogenous Gata4 and Foxa3 in fibroblasts. The endogenous transcriptional activation of genes was confirmed using real-time quantitative polymerase chain reaction (RT-qPCR) and RNA-seq, and the morphology and characteristics of the induced hepatocytes were observed through microscopy. The level of hepatocyte reprogramming in vivo is detected by immunofluorescence staining, while the improvement of liver fibrosis is evaluated through Sirius red staining, alpha-smooth muscle actin (α-SMA) immunofluorescence staining, and blood alanine aminotransferase (ALT) examination. Results::Activation of only two factors, Gata4 and Foxa3, via CRISPRa was sufficient to successfully induce the transformation of MEFs into iHeps. These iHeps could be expanded in vitro and displayed functional characteristics similar to those of mature hepatocytes, such as drug metabolism and glycogen storage. Additionally, AAV6-based delivery of the CRISPRa SAM system effectively induced the hepatic reprogramming from fibroblasts in mice with live fibrosis. After 8 weeks of induction, the reprogrammed hepatocytes comprised 0.87% of the total hepatocyte population in the mice, significantly reducing liver fibrosis. Conclusion::CRISPRa-induced hepatocyte reprogramming may be a promising strategy for generating functional hepatocytes and treating liver fibrosis caused by hepatic diseases.