Macrophages， key cells in the heart's innate immune system， are highly heterogeneous and plastic， playing dual roles in cardiac physiology and pathology. In recent years， macrophage-derived exosomes have drawnsignificant attention for their regulatory mechanisms and potential therapeutic applications in heart disease， as they serve as crucial mediators of intercellular communication. This paper aims to comprehensively summarize the origin， distribution， and function of cardiac-resident macrophages. It also explores the roles of M1and M2 macrophages in cardiac inflammatory responses and tissue repair， and delves into the regulatory mechanisms and therapeutic application prospects of macrophage exosomes in heart disease. In the acute phase of cardiac injury， M1 macrophages secrete pro-inflammatory cytokines to induce inflammation and clear cellular debris. Nevertheless， their overactivation can result in myocardial cell damage and fibrosis. During the recovery phase，M2 macrophages take the lead， releasing anti-inflammatory cytokines and growth factors to inhibit inflammation and facilitate tissue repair. Macrophage exosomes， which contain proteins， lipids， and nucleic acids， can regulate inflammation， tissue repair， and angiogenesis. In various types of heart disease， including myocardial infarction， ischemia-reperfusion injury， atherosclerosis， myocarditis， and dilated cardiomyopathy， macrophage exosomes exhibit different functions. While M1-derived exosomes often exacerbate cardiac damage through pro-inflammatory actions， M2-derived exosomes protect cardiac tissue via anti-inflammatory and pro-repair effects. These findings offer new insights and targets for developing macrophage-exosome-based heart disease therapies， which is expected to promote the innovative development of diagnosis and treatment for heart diseases， improve patients' prognosis， and alleviate the burden of public health.

Objective:To evaluate the healthcare accessibility and quality of diagnosis and treatment services of Internet hospitals in China.Methods:One hundred and eighty Internet hospitals in 60 cities were seleted based on the sampling of development levels in the eastern, central and western regions of China. From April to May 2023, standardized patients methodology was applied to evaluate the accessibility(including the number of Internet hospitals, functional settings, online doctor status, the doctor′s attending rate and consultation fees) and diagnosis and treatment service quality(including the diagnosis and treatment services quality, response speed and patient′s evaluation) of Internet hospitals.Results:The average opening rate of Internet hospitals in China was 52.9% (560/1 058), the average online rate of doctors was 64.2% (1 099/1 713), the average doctor′s attending rate was 33.6% (112/333), the average consultation fee was 4.85 yuan, the average score of consultation was 1.92 out of 9, the average score of diagnosis and treatment was 1.12 out of 4, the average score of the response speed was 1.70 out of 3, and patient satisfaction was 2.73 out of 3.Conclusions:The Internet hospital accessibility in China is unevenly developed, and the overall quality of diagnosis and treatment is low. It is recommended to accurately position and optimize the function of Internet hospital, establish the incentive mechanism for online consultation doctors, construct and improve the regulatory system of Internet hospital diagnosis and treatment, so as to improve the accessibility and quality of diagnosis and treatment of Internet hospitals.