Objective To propose a whole-life cycle management model for valvular heart disease (VHD), systematically elucidate its underlying logic and implementation pathways, and concurrently review and analyze its preliminary application outcomes. Methods Since 2020, West China Hospital of Sichuan University has established a management system encompassing "assessment-decision-intervention-follow-up", including: (1) a risk-stratified, tiered management pathway; (2) six core functions ("promotion, screening, prevention, diagnosis, treatment, and rehabilitation") coordinated by disease-specific managers; (3) an intelligent decision support information platform; and (4) a collaborative network of multidisciplinary teams and regional academic alliances. To evaluate the effectiveness of this management model, we retrospectively included three cohorts: (1) the population screened by echocardiography from 2020 to 2024, analyzing the detection rate of aortic valve disease and risk stratification; (2) patients enrolled in the whole-life cycle management from April 2021 to December 2024, assessing follow-up outcomes, hospital satisfaction, and changes in quality of life; (3) patients who underwent transcatheter aortic valve replacement (TAVR) from January 2022 to January 2024, evaluating the one-year all-cause mortality rate, perioperative complications, and improvements in New York Heart Association (NYHA) classification. Results Between 2020 and 2024, a total of 583 874 individuals underwent echocardiographic screening. A total of 48 089 patients with aortic valve disease were identified, including 3 401 (7.1%) high-risk patients, 18 657 (38.8%) moderate-risk patients, and 26 031 (54.1%) low-risk patients. Among them, 2 417 patients were enrolled in whole-life cycle management. Patient satisfaction scores showed a yearly increase, rising from 73.89 points before 2020 to 93.74 points in 2024. The 1-year mortality rate in the TAVR cohort decreased to 5.3%, significantly lower than the 8.2% observed under early standard management between 2014 and 2019 (P<0.01). Conclusion Through process optimization and resource integration, the VHD whole-life cycle management model has demonstrated significant effectiveness in standardizing diagnostic and follow-up procedures, enhancing patient satisfaction and quality of life, and reducing mortality. These outcomes highlight its practical value for broader implementation in China.
Tuberculosis (TB) is a major global public health issue. Although China has achieved remarkable results in TB prevention and control, it still faces challenges such as a large number of cases and difficulty in drug-resistant TB control, and the single prevention and control model can no longer adapt to the new situation. The concept of joint construction, joint governance and shared benefits provides a new idea for the comprehensive prevention and control of TB. Based on theories such as multiple stakeholders, this paper defines the definition and connotation of social co-governance for TB prevention and control, and proposes its implementation framework: optimizing the prevention and control service system, strengthening government leadership and consolidating the responsibilities of various departments; improving the integration model of medical treatment and prevention, cultivating interdisciplinary talents, and promoting information and resource sharing; activating the vitality of social organizations to play their role as bridges and material guarantees; and stimulating community potential to enhance public participation. The study holds that integrating the concept of social co-governance and implementing the four-party responsibilities can form a joint force in prevention and control, provide support for achieving the goal of ending TB epidemic, and help promote the construction of Healthy China and the modernization of national governance capacity.