In the face of the "cliff-like" decline in the price of centralized mining, how to deal with the heart stent enterprises?

Sheng: the "past lives" of heart stent

Cardiac stent, also known as coronary stent, is a high-value consumable commonly used in percutaneous coronary intervention (PCI), which has the function of dredging arterial blood vessels and is recognized as a conventional treatment for cardiovascular diseases. Since the first generation of stents went on the market in 1997, the development of cardiac stents has gone through three stages, the first generation is the balloon expansion era, the second generation is the bare metal stent era, the third era is the drug-eluting stent era, and it is now moving towards the fourth generation of completely degradable stents. With the continuous evolution of materials, the performance is more and more optimized. The main features of each generation of cardiac stents are as follows:

Fig. 1 development of cardiac stent

At present, non-degradable drug eluting stent,DES) is still the mainstream choice for clinical application, and fully degradable stent is still in the early stage of product development and clinical application. At present, the mainstream cardiac stents in the market are still drug-eluting stents, and the market share has remained at around 99% since 2012, and balloons and bare metal stents have been completely replaced by them. Biodegradable stents (BRS) can be gradually absorbed in the body, which can significantly reduce the formation of stent thrombosis and restenosis, at the same time, it will not affect MRI and CT scanning, and also facilitate the re-intervention process. It is the main direction of stent research and development in the world, and has attracted extensive attention from medical device companies at home and abroad. At present, the fully degradable heart stents put into research and development are mainly divided into two categories: degradable metal materials and degradable polymer materials.

Fig. 2 Types of mainstream cardiac stents currently in use

(A) In recent years, the demand for cardiac stents has been increasing, and the scale has steadily increased.

1. The number of PCI interventions in China ranks first in the world, and the number of PCI interventions has increased by over 15% annually in recent five years.

From 2015 to 2019, the number of cases of percutaneous coronary intervention (PCI) in China increased steadily, with an average annual increase of 16.0%. Among them, the number of percutaneous coronary intervention (PCI) in China in 2019 was 1.03 million, ranking first in the world, with an increase of 12.6% compared with 2018. It is conservatively estimated that there will be nearly 1.2 million cases of percutaneous coronary intervention (PCI) in China in 2020.

Fig. 3 Trends of PCI operation volume in China from 2015 to 2020 (data source: analysis by Health Research Institute).

In 2020, the market value of heart stents in China is close to 17.5 billion yuan.

From 2015 to 2019, the number of cardiac stents implanted in China showed a steady growth trend year by year, with an annual growth rate of 15%-20%. In 2019, the number of cardiac stents implanted in China was 1.6 million. In terms of market value, the market value of heart stents in China increased from 9.75 billion yuan to 15.97 billion yuan from 2015 to 2019, with an average annual growth rate of 15.2%. It is estimated that the market value will be close to 17.5 billion yuan in 2020.

Fig. 4 Trend chart of cardiac stent implantation quantity and scale in China from 2015 to 2020 (data source: analysis by Health Research Institute).

(B) The "market just needs+policy orientation+technology promotion" troika escorts the rapid development of the cardiac stent industry.

1. The market just needs:The two major trends of younger coronary heart disease and aging population have once again "expanded" the cardiac stent market.

Younger coronary heart disease:Cardiovascular disease has become the number one health killer in the world, accounting for nearly 30% of the total global deaths. According to China Cardiovascular Health and Disease Report 2019, the number of cardiovascular patients in China reached 330 million, accounting for more than 45% of the deaths of residents, ranking first among all diseases. Among them, the number of patients with coronary heart disease has reached 11 million, with more than 3 million new patients each year and more than 1 million patients with sudden infarction. In addition, the younger trend of coronary heart disease (CHD) is increasing. According to a survey of cardiovascular diseases among more than 20,000 people in Shanghai, the number of patients with CHD accounts for nearly 30%, of which 27.0% are over 70 years old, 40.0% are 51-70 years old, and 33.0% are under 50 years old. CHD is no longer a "patent" for the elderly, and it is obese, stressful and stressful.

Figure 5 Proportion of cardiovascular disease population structure (data source: public information)

Aging:According to statistics, in 2019, the population aged 65 and above accounted for 12.6% in China. From the development trend, the population aging speed and scale in China are unprecedented. After 2022, China will enter a deeply aging society with a proportion of over 14.0%, a super aging society with a proportion of over 20.0% around 2033, and then it will continue to rise to 35.0% in 2060. The arrival of the era of deep aging will undoubtedly raise the "ceiling" of the heart stent industry.

Figure 6 Structural trend of population aging in China (data source: public information)

With the development of younger coronary heart disease and aging population, and considering the impact of centralized procurement on the price of cardiac stents and the improvement of people’s health awareness, the number of PCI operations per capita in China will be in line with that of developed countries in the future (the number of PCI operations per million population in China is 736, that in the United States is about 3,135, and that in Japan is about 2,047, which is 4.3 times and 2.8 times that in China, respectively). According to the extreme analogy method (referring to the number of PCI operations per million people in Japan, mainly considering that China and Japan are similar in race and incidence), it is estimated that the peak number of PCI operations will reach 2.87 million in the future. Considering the average number of stents implanted in PCI (about 1.5 stents/case), the corresponding peak number of cardiac stents implanted is about 4.3 million, which has a large long-term permeability and market space.

Fig. 7 Comparison of the number of percutaneous coronary intervention (PCI) between China and major developed countries (data source: analysis by Health Research Institute).

2. Policy orientation:Front-end encouraging innovation and end-collection specification help the market demand of cardiac stents to be released continuously.

In recent years, the state has launched a series of favorable policies for the medical device industry to support the rapid development of enterprises:

innovateEncourage the acceleration of the transformation and upgrading of medical devices, develop high-end interventional products such as fully degradable vascular stents, and stimulate the development of new cardiac stents market segments; Priority is given to the review and approval of qualified innovative medical devices. Under the promotion of innovation policy, the fully degradable polymer matrix drug (rapamycin) eluting stent system (NeoVas) independently developed by Lepu Medical and the fully degradable polylactic acid stent (Xinsorb) independently developed by Academician Ge Junbo of China Academy of Sciences have all entered the special approval procedures for innovative medical devices.

circulateFrom the national level to the provinces and cities, the centralized purchasing scheme of high-value consumables has been launched one after another, constantly rationalizing the price system of high-value medical consumables and improving the supervision and management of the whole process. In October 2020, coronary stents became the first batch of purchased varieties, and the national level started the collection of high-value medical consumables.

Table 1: Main policies related to high-value consumables such as cardiac stents from 2016 to present:

3. Technology promotion:The iterative upgrading of products and the improvement of interventional surgery level greatly enhance patients’ confidence and willingness to receive interventional therapy.

Iterative upgrade of products: cardiac stent has experienced the development from balloon expansion to drug-eluting stent, and the restenosis rate of stent implantation has decreased by nearly 20%, and the incidence of thrombosis in stent has decreased to about 1%, which effectively reduces the risk of complications for patients;

Improving the level of interventional surgery: China has successively established the training base of cardiovascular interventional diagnosis and treatment of the Ministry of Health and the national quality control center of PCI, and adopted a unified training model to carry out systematic training nationwide, and issued certificates after passing the examination, and carried out quality control and index monitoring on related work. In 2018, the mortality rate of interventional therapy for patients with coronary heart disease was 0.26%, far lower than that in the United States.

(III) Competition pattern: Domestic substitution in the cardiac stent industry has basically been completed.

After decades of development, the technical generation gap among major enterprises has gradually narrowed, and the industry pattern has been basically stable, mainly relying on the launch of new products to enhance market share. Judging from the competition pattern, the concentration of cardiac stent industry is high, and the market share of domestic drug stent products exceeds 70%, and the domestic substitution is basically completed. Among them, domestic brands such as Weichuang, Lepu and Jiwei rank among the top three, with a total market share of over 65%.

Figure 8 Market share of domestic cardiac stent brands in 2019 (data source: analysis by Health Research Institute)

In 2019, the revenues of cardiac stents (including balloons, catheters and other ancillary products) of minimally invasive medical care, Lepu medical care and Jiwei medical care were 1.83 billion yuan, 1.79 billion yuan and 1.74 billion yuan respectively, with growth rates of 33.0%, 26.7% and 24.9% respectively. As can be seen from the figure, cardiac stents of minimally invasive medical care showed a trend of "double high" in sales growth rate and market share.

Figure 9 Market share and revenue growth rate of cardiac stent head enterprises (data source: analysis by Health Research Institute)

Change: the national "group purchase" triggered a major change in the heart stent industry.

With the landing of the national heart stent collection, the "suicide" price reduction of enterprises has also brought infinite reverie to the future direction of the industry. Will the heart stent industry under centralized procurement be a "broken wrist" or a "rescue" in the future? Is it "price for quantity" or "innovation and transformation"?

(A) the change in scale

Centralized procurement of cardiac stents directly affects the purchase price. According to the recent centralized purchasing list published by the Medical Insurance Bureau, the number of intentional purchases in the first year exceeded 1.07 million, involving 27 products. Based on the published average price quoted by the winning bidder (1682 yuan/piece) and the amount of coronary stents implanted in 2021, the market value in 2021 is about 3.19 billion yuan. It should be emphasized that the market value forecast here does not consider the impact of the decline in centralized purchasing price on the improvement of patients’ willingness to operate.

Fig. 10 Market value forecast of cardiac stent in 2021 (data source: analysis by Health Research Institute)

According to the previous estimation of the amount of cardiac stent implantation in China, when the amount of PCI operation per 100 people reaches the Japanese level, the peak amount of cardiac stent implantation in China is 1400 x 2047 x 1.5 = 4.3 million. According to the heart stent of 1682 yuan/piece (the average price of centralized procurement), the corresponding market value of heart stent is 7.23 billion yuan:

Fig. 11 Market value of China cardiac stent corresponding to peak value (data source: analysis by Health Research Institute)

From the above analysis, it can be seen that under the influence of centralized procurement policy, the market value of heart stents in China in the next 1-3 years is expected to be in the range of 3-7 billion yuan.

How much money can patients save after centralized collection?

As we all know, the "floor price" of centralized purchasing has a great influence on patients who are unwilling to undergo interventional surgery because of the high price. This paper analyzes the payment situation of patients before and after centralized purchasing (according to the conventional reimbursement policy):

Fig. 12 Comparison of patients’ self-funded amount before and after centralized purchasing (data source: analysis by Health Research Institute)

As can be seen from the above figure, according to the same reimbursement policy, the out-of-pocket medical expenses of patients decreased from 6520 yuan to 308 yuan before and after centralized purchasing, and the personal burden was only 4.7% of the original, which greatly eased the economic burden.

(2) Changes in business

In addition to the industry scale being affected, the business tentacles of heart stent enterprises will also be adjusted:

1. Stent market: form a low-cost medical insurance centralized procurement market+off-standard non-medical insurance high-end alloy stents+medical insurance stainless steel stents+non-medical insurance ultra-high-end degradable stents.

In the short term, the market of cardiac stent products will form a pattern of low-cost medical insurance centralized procurement market+off-standard non-medical insurance high-end alloy stent+medical insurance stainless steel stent+non-medical insurance ultra-high-end degradable stent:

On the one hand, from the current attitude of centralized mining, bare metal stents are not included in the list of centralized mining, and the price of stainless steel stents will be under pressure due to the price reduction of centralized mining in the short term, and the price inversion with alloy stents will not last long; In the long run, stainless steel stents are not as good as alloy stents in terms of support and passability. As a more backward technology than Co-Cr alloy and Pt-Cr alloy, stainless steel stents will face marginalization in the future. However, in view of the fact that the use of stainless steel coronary stents still accounts for about 40% of the market share in 2019, stainless steel coronary stents will be coasting for a period of time in the future.

On the other hand, with the continuous promotion of cardiac stent collection, the trend of differentiation and stratification of end patients will become more obvious, and the group of self-paid high-priced stents may expand. Degradable stents and metal stents belong to two price bands, so it is impossible to talk about the market share substitution after the huge change of centralized purchasing price. Moreover, the proportion of consumables in the cost of PCI surgery has further decreased, and the audience’s marginal willingness to pay for innovative products is likely to increase. In the medium term, the development rhythm of fully degradable stents will continue to be stable, in order to get as much clinical data as possible, enhance the recognition and acceptance of products by more experts, doctors and patients, and enhance the high-end market share.

Figure 13 Future product layout of cardiac stent

2. Business reshaping: cultivate and expand new medical formats around the cardiovascular field, and make a forward-looking and diversified layout.

On the one hand, it conforms to the latest concept of "intervention without implantation" of the current interventional instruments, and extends upstream and downstream around the coronary intervention chain:

Product chain: the price reduction of metal stents will be the norm in the future, and the fully degradable stents and drug balloons with "intervention without implantation" will become the core of future development. Facing the policy impact of centralized stent mining, it will be an effective hedging means to extend the layout of coronary intervention chain. In addition to completely degradable stents, a new generation of drug-coated balloon (DCB) has also become the core of future development under the new concept of "interventional non-implantation". The data shows that the usage of drug-coated balloons in some hospitals or individuals in Europe has reached 50%-90% of all PCI, and Japan has reached 4,000 per month, accounting for about 15% of Japanese PCI. In addition, auxiliary consumables (balloons, catheters, guide wires, etc.) related to coronary intervention will also become the profit growth point that enterprises pay attention to.

Technical service chain: The further decline in the proportion of consumables in the cost of PCI surgery has prompted enterprises to speed up the layout of medical services and health management sectors. Conditional enterprises will cooperate with primary hospitals to provide equipment consumables, drugs and medical technical services needed for interventional diagnosis and treatment, and promote the grassroots promotion and popularization of new interventional technologies, which will become an important exploration for coronary intervention enterprises to face the centralized procurement of high-value consumables.

On the other hand, the centralized procurement of cardiac stents has prompted enterprises to expand from coronary intervention to peripheral intervention, and continuously enrich their product lines:

Make full use of enterprise stent balloon design and precision manufacturing platform technology, constantly innovate and develop, expand the company’s products from coronary intervention to peripheral intervention, continuously enrich the cardiovascular disease product line, and concentrate on improving the company’s marketing network structure to cope with market risks brought about by policy uncertainty.

Figure 14 Possible business development direction of cardiac stent enterprises under the background of centralized procurement

(C) changes in the market

Under the general trend and background of medical insurance fee control and national centralized procurement, it has a great influence on the competition pattern of domestic medical industry. Medical device enterprises will face more fierce market competition, as well as the realistic problems of product prices and product profit margins falling sharply. For the leading enterprises in the industry, although they can seize more market share by winning the bid at a low price, the problem of shrinking scale and declining profit rate cannot be underestimated.

In the foreseeable future, the scope of domestic medical insurance control fees will only increase, so as to more effectively reduce the pressure of medical insurance expenditure, reduce the prices of drugs and devices and benefit the people’s livelihood. In addition, the situation in the field of devices may appear in the previous pharmaceutical field, and importers may take more aggressive quotations to seize the domestic market after they are familiar with the rules.

For domestic cardiac stent enterprises, facing the policy risks of centralized procurement and medical insurance control, they need to seize the domestic share, turn their attention to the international market and participate in the international market competition. In fact, domestic heart stent head enterprises have also started the international strategic layout, among which minimally invasive medical care, Lepu medical care and Lan Fan medical care are typical representatives.

Turn: Transforming into a strategic choice for heart stent enterprises to overtake in corners.

In the face of major changes in the national medical device policy, cardiac stent enterprises actively predict the development trend, plan ahead, and focus on developing products and new businesses related to centralized procurement while strengthening product technology innovation. For domestic heart stent enterprises, what transformation layouts have been made at present? What is the possible key direction of development in the future?

(1) Adjust the business strategic map and form a multi-sector support system.

1. Diversification of business lines-minimally invasive medical treatment

Through business diversification, we will continuously broaden profit points and enhance comprehensive competitiveness. In recent years, Minimally Invasive Medical Devices Co., Ltd. (hereinafter referred to as "Minimally Invasive Medical") has continuously enriched its product line and expanded its business field through outreach acquisition and endogenous development. Products gradually changed from early cardiovascular stents to diversified business systems covering cardiovascular intervention, orthopedic medical devices, heart rate management (pacemaker), arterial and peripheral vascular intervention, and nerve intervention products.

In 2019, the business revenue was 5.55 billion yuan, of which 33.4% came from cardiovascular interventional products, 29.3% from orthopedic medical devices, 26.3% from heart rhythm management business, 6.1% from arterial and peripheral vascular interventional products, and 3.5% from neurological interventional products. In 2012, the revenue of minimally invasive medical cardiovascular interventional products (stents) accounted for 83.8%.

Figure 15 Comparison of the proportion of minimally invasive medical business segments in 2012 and 2019 (data source: minimally invasive medical annual report)

2. Product line "from one to four", and build a platform business model of "equipment+medicine+medical service+new medical care"-Lepu Medical.

Lepu (Beijing) Medical Devices Co., Ltd. (hereinafter referred to as "Lepu Medical"), as one of the earlier enterprises engaged in the research and development of cardiovascular interventional medical devices in China, has been accelerating the business integration, optimization and layout in recent years, and has developed from a single stent business in 2013 to four business segments covering "devices+drugs+medical services+new medical care" at present, with the goal of building a platform-based business model around the whole life cycle service for cardiovascular patients.

Figure 16 Main contents of each business segment of Lepu Medical

Dual track of medical devices and medicines: In terms of revenue, the revenue of Lepu Medical in 2019 was 7.80 billion yuan, a year-on-year increase of 22.6%. Among them, the medical device sector achieved operating income of 3.62 billion yuan, accounting for 46.4%, and the pharmaceutical sector achieved revenue of 38.5%, accounting for 49.4%. Among them, the revenue of coronary stent system only accounts for 20% of the total revenue of Lepu Medical. In addition, the market share of the company will be directly increased after winning the bid, and the negative impact of centralized procurement is relatively limited.

Figure 17 Revenue Ratio of Lepu Medical in 2019 (Source: Lepu Medical Annual Report)

3. "Health protection+medical equipment" two-wheel drive-Lan Fan Medical

Lan Fan Medical Co., Ltd. (hereinafter referred to as "Lan Fan Medical") is a leading enterprise in the field of medical gloves in the world, accounting for 22% of the global market. In 2018, it successfully acquired the fourth-ranked cardiac stent company in the world, Singapore Baisheng International Group, and realized its layout in the field of medical devices. Subsequently, Lan Fan Medical implemented the "A+X" industrial strategy, and set up four business divisions with a total of seven tracks:

Figure 18 Layout of Lan Fan Medical Industry

At present, Lan Fan Medical has two business series products, namely health protective gloves and heart stents, which are continuously extended to the whole chain of emergency care, cardiovascular and cerebrovascular diseases, forming a multi-business sector collaborative model combining low-value, medium-value and high-value consumables products, with complementary modes and risk hedging. In 2019, Lan Fan Medical achieved a revenue of 3.48 billion yuan, of which the revenue of health protective gloves was 1.68 billion yuan, accounting for 48.3%, and the revenue of cardiac interventional devices (including self-produced and agents) was 1.74 billion yuan, accounting for 50.0%.

Figure 19 Revenue Ratio of Lan Fan Medical in 2019 (Source: Lan Fan Medical Annual Report)

(2) Expand the cardiovascular product chain and form a diversified ecological closed loop.

1. Strategic positioning of big heart-minimally invasive medical treatment

Based on its own existing technology and platform, minimally invasive medical care constantly lays out big heart tracks: coronary heart disease, arrhythmia, structural heart disease and heart failure.

Development contextMinimally invasive medical care started from coronary stent, then cut into radiofrequency ablation, and then extended to pacemaker business. Later, with the further development of interventional technology, structural heart disease entered the era of minimally invasive surgery, and minimally invasive medical care opened up the technical path of completing heart valve replacement by interventional method (representative product VitaFlow transcatheter aortic valve system). Compared with these business units with mature products, Minimally Invasive has begun to "plan the layout" of the treatment solution for heart failure, which is also an important pawn for the future layout of Minimally Invasive and the key to completing the closed loop of the big heart business.

2. Optimize iterative coronary medical devices, enrich and innovate the implantable product line-Lepu Medical.

Lepu Medical has built a rich product group of devices in the cardiovascular field:

1) Accelerate the industrial chain matching of coronary intervention devices. In 2019, Lepu medical coronary stent products achieved operating income of 1.53 billion yuan, a year-on-year increase of 23.3%; Supporting auxiliary consumables (balloon catheter, guide wire, etc.) realized an operating income of 260 million yuan, up 51.0% year-on-year. Under the background that most of the auxiliary PCI interventional materials such as balloon catheter guide wire are monopolized by foreign capital, Lepu Medical is the only R&D and manufacturing enterprise in China that can provide all the consumables for coronary intervention. At present, more than ten necessary consumables such as pre-expanded and post-expanded balloon catheter, PTCA guide wire, guide catheter, contrast guide wire, contrast catheter, sheath, Y valve, triple tee, pressure extension tube, pressure pump, ring handle syringe, pressure sensor and hemostasis compressor have all been mass-produced.

2) Coronary balloon products and NeoVas bioabsorbable stents are expected to form new growth points. In February 2019, NeoVas, an international second-generation bioabsorbable drug stent independently developed by Lepu Medical, was approved for listing in China, and opened a new era of PCI technology "intervention without implantation". In July 2019, the first-generation coronary balloon was approved by GMP for the first time. Three products of the second-generation drug balloon series are about to start clinical trials, and the third-generation rapamycin drug balloon technology has made breakthrough progress, and animal experiments will be carried out soon.

In addition, in recent years, Lepu has actively developed peripheral products of degradable and drug balloons based on the Group’s coronary stent and balloon platform technology, and its business scope has expanded from coronary intervention to peripheral intervention.

3. Layout of coronary artery, valve, nerve intervention and peripheral intervention-Lan Fan Medical.

At the time when the medical device industry entered the golden period of development, Lan Fan Medical continuously accelerated the overall layout of cardiovascular and cerebrovascular devices based on the leading edge of Baisheng International Cardiology Department:

In the field of coronary intervention: all kinds of stent products produced by Singapore Baisheng International are sold to more than 90 countries and regions around the world, with a sales volume of 400,000. At present, BioFreedom, a drug-coated stent of BA9? without polymer carrier, has been introduced into European and Japanese markets, and it is expected to be listed in the United States and China in the near future. From the perspective of stent technology, the upgrading of technology is still the theme of stent industry and the driving force of sales growth. The increase in the proportion of high-end stents such as BioFreedom and Excrossal, as well as the development of foreign markets, have helped to enter the new product bonus period. In addition, taking the cardiac stent as the fulcrum, we will enrich, expand and improve the product line combination related to PCI surgery, such as contrast guide wire, contrast catheter, guide wire, guide catheter, pre-expanded balloon, post-expanded balloon, puncture needle, arterial sheath and pressure extension tube.

Cardiovascular related product lines: Apart from coronary artery, valve, nerve intervention and peripheral intervention are also the tracks that Lan Fan Medical keeps cutting in. By continuously expanding and expanding related product lines such as valve, nerve intervention, peripheral intervention and drug balloon, the competitiveness of product portfolio will be enhanced. The capital is undoubtedly the quickest way for Lan Fan Medical to broaden the track. In June, 2020, Lan Fan Medical acquired the fifth manufacturer of TAVR in the European market. NVT’s main business is the research and development, production and sales of interventional valves for structural heart disease. Through the acquisition of TAVR, a gold track for medical devices, NVT officially entered the field of minimally invasive interventional structural heart disease therapy with broad prospects.

(C) the implementation of internationalization strategy to enhance the international market share of products.

1. Actively deploy the global mainstream market-minimally invasive medical care.

Since 2014, minimally invasive medical care has set its sights on overseas and accelerated the export of China native coronary stents to overseas markets. In 2019, the overseas business of minimally invasive medical drug-eluting stents achieved revenue of 160 million yuan, a year-on-year increase of 72.4%. Sales in 25 countries or regions and registration certificates in 13 countries or regions. Among them, Firebird2TM’s overseas revenue increased by 186.9% year-on-year, FirehawkTM’s revenue increased by 54.6% year-on-year, and it has been sold in several major European countries. In addition, the group has also submitted the application for registration of FirehawkTM stent to the Japanese medical device review and approval authority, and actively deployed the global mainstream market.

Figure 20 Sub-regional Income Ratio of Minimally Invasive Medical Care in 2019 (Source: Minimally Invasive Medical Annual Report)

2. Establish an international business department to increase the market share of international innovative products-Lepu Medical.

Lepu Medical put internationalization on the agenda after the first round of domestic drug collection in 2018, and proposed to further increase the market share of international innovative products. At present, the original foreign trade business and departments of all subsidiaries have been integrated, and the international business department has been established to strengthen the international influence on the upstream and downstream of the medical industry chain in the cardiovascular field. Explore the possibility of setting up R&D centers and production bases overseas. Overseas R&D centers have been planned to accelerate the clinical registration of innovative products (degradable stents, TAVR3.0, renal artery ablation, artificial intelligence ECG and artificial intelligence monitoring) in the world.

It is reported that Lepu Medical’s business revenue from abroad in the first half of 2020 was 870 million yuan, an increase of 320 million yuan compared with the whole year of 2019. Guo Tongjun, senior deputy general manager and secretary of the board of directors of Lepu Medical, said at the reception of listed companies that the company’s overseas market target remains unchanged, and the proportion of overseas market revenue will continue to increase to 20%-30% in the next 3-5 years.

Figure 21 Lepu Medical Internationalization Strategic Measures

summarize

National centralized procurement is not only a reshuffle of the cardiac stent industry, but also an impetus to the cardiovascular segmentation field. Heart stent enterprises still have a long way to go, but whether they are facing the "change" of the industry calmly or actively responding to the "turn" of the industry, there are undoubtedly two ways to go: First, strengthen the technological innovation and product iteration of heart stents in order to obtain new user markets; The second is to realize business diversification and risk hedging with the heart stent as the fulcrum.

Japanese beauty "ambassador" wears miniskirts to promote popular culture in various countries (photo)


  Fujioka Jingxiang (second from left) introduced the highlights of wearing school uniforms at the "Japanese Culture Festival" held in Bangkok, Thailand in March. (Kyodo)



The picture shows Shizuka Fujioka, who was appointed as "Ambassador Kawaii" by the Japanese Ministry of Foreign Affairs. (Kyodo)


  BEIJING, April 30 (Xinhua) In order to promote the popular culture of young people in Japan, the Japanese government recently sent "lovely ambassadors" led by beautiful women to Thailand and other places to participate in promotional activities.


  According to the Kyodo News Agency, the Japanese Ministry of Foreign Affairs is actively carrying out related activities about three "Japanese pop culture communicators" (nicknamed "Kawaii Ambassador", that is, the Ambassador of Love) recently appointed to widely publicize the culture of Japanese young people overseas. Among them, Fujioka Jingxiang, an artist known as the "school uniform magician" for leading the trend of school uniforms for female high school students, participated in the activities in Thailand, and the other two will go to Paris in July.


  ▽ Wear freely and match.


  According to the report, Fujioka wore a school uniform and attended the "Japanese Culture Festival" held in Bangkok, Thailand, in March, and taught him the skills of freely matching clothes. The young Thai woman who was present praised "the school uniform is very cute. I want to go to Japan to see. " Influenced by Japanese campus cartoons, the fashion of school uniforms is becoming more and more popular in the local area. It can also be seen from the photographers who seized the favorable position at the front of the venue that the media are quite interested in this.


  The Japanese Ministry of Foreign Affairs plans to send two other Kawaii ambassadors, Misako Aoki and Yuki Kimura, to Paris, France, to attend the "Japan Expo" held from July 2 to 5. Aoki is a fashion model who advocates the girl’s "Loli style", while singer Kimura is very famous among young people in Harajuku, Tokyo because of her style of overlapping old clothes.


  There are also many young people in France who are keen on Japanese animation and cosplay. It is expected that the number of people attending this "Japan Expo" will exceed more than 100,000 last year.


  Target overseas young people


  In order to make it easier for foreigners to get close to Japan, Japan’s Ministry of Foreign Affairs has carried out a series of exchange activities through traditional culture and arts such as kabuki and Nero. Recently, it has been noticed that Japanese pop culture such as animation has been welcomed by young people all over the world, and it is very important to target young people who can be called "pro-Japanese factions" in the future and take measures against them, so at the end of February this year, three "Kawaii Ambassadors" were selected as standard bearers.


  Prime Minister Taro Aso, who calls himself a "comic geek", set up the "International Comic Award" when he was foreign minister, and personally promoted "pop culture diplomacy". This has also become the driving force for this series of activities.


  ▽ Must be based on the reality of other countries


  However, this new attempt to use "Kawaii" as a slogan also made some people in Japan frown. At the Foreign Affairs Committee of the House of Representatives on the 24th, Kazuo Maruya of the Komeito Party pointed out: "The Kawaii Ambassadors are wearing miniskirts around the world, hoping that (the Ministry of Foreign Affairs) will attract attention and not let this matter be unnecessarily criticized. Some cultures need to spend taxes to spread, but some cultures can spread without deliberate propaganda. "


  Kenjiro, Minister of Cultural Exchange of Japan’s Ministry of Foreign Affairs, responded: "It is important for the other country to accept [Japanese pop culture]. We will strive to effectively promote implementation on the basis of fully basing ourselves on local actual conditions. "


  Fujioka Shizuka, as a "lovely ambassador", said: "When I go to some countries, as long as there is a person there who thinks I am very’ kawaii’, it will be beneficial to Japanese national interests."

Editor: Chen Chang ‘e

Comment immediately | Suzhou Zoo dug up the old version of A Dream of Red Mansions? Why do old rumors become fine?

In the past few days, you have probably seen such a "big news" in your circle of friends: On February 27, 2018, the first shovel of the renovation project of Shihushan in Suzhou Zoo accidentally opened an ancient tomb. Among more than 300 cultural relics unearthed, the most legendary complete version of A Dream of Red Mansions was named "A Trial Evaluation of the Addition and Deletion of Wu’s Stone Story" by the academic circles, and many mysteries of the Red Mansion for hundreds of years were solved! Hu Shi, Zhou Ruchang and other Redology masters worked so hard to build the Redology Building, and suddenly collapsed!
It’s the old copy of The Red Mansion unearthed, and it’s the collapse of the redology building. Even the time and place are so obvious that netizens don’t believe it. This article has already won 100,000+.
However, in fact, the so-called "Wu’s Stone Story" is an old rumor for 10 years. In 2008, "He Lili" (pseudonym, male, junior high school education) handed over the so-called "Wu’s Stone Story" to Liu Junjun to upload it to the Internet, and the rumor began. "He Lili" said: Grandparents accidentally got a copy of A Dream of Red Mansions that year; Only He Lili has ever read this set of books and copied the contents with his cousins. then what Such a precious codex disappeared, leaving only the electronic version of "Wu’s Stone’s Addition and Deletion Trial Review" uploaded by "He Lili".
"He Lili" claimed that this manuscript was written in the year of Guiyou in the lunar calendar, that is, in 1753 AD, one year earlier than the female parent of Jiaxuben, the earliest banknote copy of A Dream of Red Mansions discovered so far in the red circle! Is it subversive enough? Even more subversive, they claimed that the author of the book was Wu Meicun in the late Ming and early Qing Dynasties, not Cao Xueqin! So A Dream of Red Mansions has to be called "Wu’s Stone"!
This low-level rumor can’t be logically consistent. It has been said to be an ancient manuscript, but several netizens kept revising it. By the time Guiyouben released the so-called "third anniversary edition" online edition in 2011, the content had been changed to "Fan Sixth Edition" (original text). Several authors who faked together finally even set up their own businesses and compiled several versions of Gui You Ben. Some authors wrote anonymous, while others wrote Cao Xueqin.
The writing of "Wu’s Stone Story" is vulgar, and even the modern "humane" saying of "fellow villager" and "help us for the sake of understanding" appears in the article; The plot is even more absurd and vulgar, and netizens call it "spicy eyes": Mrs. Wang, who believes in Buddhism, wants Baoyu to marry a nun, Baoyu becomes an adulterer, Sister Lin becomes an armed leader and leads slaves to defend the Grand View Garden, and Baochai seduces Baoyu …
When popular science professionals disdain to refute it, such information garbage is occupying people’s brains and occupying valuable information channels. On February 27th this year, Guangming Daily published a report on "The Collapse of Wu’s Stone".
However, Guangming Daily has just started a rumor, and now the rumor has put on a new vest: "On February 27th, the renovation project of Shihushan in Suzhou Zoo was dug up …", The rumor maker deliberately chose such a day, which can be regarded as naked provocation and fooling. The media sentenced it to death on that day, and it chose to be resurrected with blood on that day.
A netizen with junior high school education pretended to be a female netizen, and wrote such a "Stone Story" directly with the keyboard and posted it on the Internet. The plot was spicy and the text was vulgar, but just say: This is the "Dream of Red Mansions" handed down from my family! Some people believe it. In the past ten years, such low-level rumors have not disappeared, but they have captured a bunch of hardcore fans, and they have created new tricks from the development of the media and won 100,000+. This communication phenomenon itself deserves attention.
Who is continuing this rude rumor? The answer may be ourselves.
The key to self-media communication based on social attributes lies in the fission of users, and the more shocking the content, the easier it is to achieve viral communication through user sharing, and the form of communication itself has nothing to do with the authenticity of the content. The "nipple music" of network information makes us happy to spread more bizarre information "free".
The information field is increasingly filled with headline parties and low-level rumors, which is punishing our laziness and impulsiveness. We don’t read the full text, but we want to forward bizarre news and get praise from friends. We clearly know that this expression is extreme and ridiculous, but we are happy to join in this excitement. This is a typical "silent spiral". When you see a sensational content, you are eager to forward it, or even don’t look at the forwarded content at all. Is it irrelevant?
For example, a few days ago, the article "14 bureau-level leaders of China Welfare Lottery Distribution Center embezzled 136 billion yuan" was screened. However, the article was accompanied by confession videos of relevant officials released by CPC Central Commission for Discipline Inspection, which did not mention the figure of 136 billion yuan at all, and other channels did not talk about this figure. For another example, the "one kilometer of expressway will charge one yuan in the future" which was screened two days ago is also a typical title party, and there is no such content in the text.
If we spend 1% of the forwarding impulse on reading the full text of the article to be forwarded, our circle of friends will probably be much cleaner. Rumors such as "Wu’s Stone Story" can be "refined" in 10 years, which is actually the vanity and greed of the devil when he uses us to spread from the media.
You will find that communication is becoming more and more convenient and efficient, but the cost of information fraud is getting lower and lower, even as Suzhou Zoo dug up an old version of A Dream of Red Mansions, without a live photo of PS; Netizens with junior high school education "edited" a "Stone Story" without providing a photo to prove that it is an old manuscript at home.
When we watch mobile phone videos, we have to double or even five times fast forward, and the greed for information curiosity has just become the demon of widespread rumors. Once upon a time, I was slow, and I could only write a Dream of Red Mansions in my life. Now, you can turn 10 rumors and 100,000+in one morning.
Reporting/feedback

The illegal handling of renting a car and buying a car on the license … These six new measures for public security traffic control will be implemented on September 20.

  CCTV News:Nowadays, people go out to play, and more and more people choose to rent cars for self-help tours, and new situations have emerged. After the traffic violation occurred in the process of renting a car, it is more troublesome to deal with it because the rented driver has left the incident. The Ministry of Public Security will launch six new traffic control measures from tomorrow (September 20th), which will effectively solve this problem.

  According to statistics, there are more than 20,000 car rental enterprises in China at present, and it is often difficult to deal with traffic violations according to the current procedures because most of the leased drivers are not in the illegal places or the places where motor vehicles are registered.

  Chen Dong, Deputy Director of Legal Affairs Department of Traffic Management Bureau of Ministry of Public Security:According to the original handling method, it is necessary to rent a driver to the illegal handling window of the traffic management department where the traffic violation occurred or where the motor vehicle was registered, and in the process of handling, it is necessary to show the driving license of the rented car.

  In order to facilitate leased drivers and leasing companies to deal with traffic violations of leased cars in time and reduce unnecessary travel and time costs, the Ministry of Public Security has specially formulated the Measures for Punishment of Road Traffic Safety Violations during Motor Vehicle Leasing. The traffic of the rented car recorded by traffic technology monitoring is illegal, and the lessee is allowed to handle it by the "12123" mobile APP; Leased drivers are no longer required to provide the rental car driving license when dealing with the illegal behavior or the window of the traffic control department where the motor vehicle is registered. Instead, the public security traffic control information system will automatically check the lease relationship. This measure will benefit more than 3 million leased drivers every year.

  Chen Dong, Deputy Director of Legal Affairs Department of Traffic Management Bureau of Ministry of Public Security:According to the lease contract information provided by the leasing company, there will be the driver’s license number of the leased driver, and we will automatically match the lease relationship between the leased driver and the leased car according to the driver’s license number, and automatically record this lease relationship to the platform of the "12123" mobile APP, as well as to the traffic violation handling window. In this case, we can check this lease relationship through the system, and we don’t need to rent the driver to add other jobs in the mobile APP or in the traffic processing window.

  In view of the traffic violations that the leased driver fails to deal with in time, the public security traffic control department can transfer the illegal records to the leased driver’s name upon the application of the leasing enterprise, and inform the leased driver in time through the contact information confirmed in the lease contract.

  It is understood that this new measure will be piloted in Jiangsu and Sichuan from tomorrow and will be promoted nationwide before the end of the year.

  Buy a car and get a license. Inspection and audit preposition

  Starting from tomorrow (September 20th), the fast agency of vehicle registration and sales enterprises and a number of measures to facilitate the handling of temporary entry vehicles and personnel licenses will also be implemented.

  Carry out fast agency registration of motor vehicle sales enterprises

  For car owners, after buying a car, they should bring relevant materials to the vehicle management department to get the number, queue up, go through the formalities and get the license plate. After the whole process goes down, most of the time will be gone. The Ministry of Public Security will implement the fast registration of motor vehicle sales enterprises, and complete this series of "running errands" before the owner buys a car. After the motor vehicle arrives at the sales enterprise, the vehicle pre-inspection, data pre-audit and information pre-entry will be implemented, and the motor vehicle sales enterprise will provide the whole process services such as vehicle purchase, insurance purchase, tax payment and number selection registration, so that the masses can complete all the links of car purchase registration in the motor vehicle sales enterprise.

  Liu Yupeng, Deputy Inspector of the Traffic Management Bureau of the Ministry of Public Security:In fact, the vehicle management office has completed the basic information and inquiry work on this car. After the masses arrive at the 4S shop and buy the car, they only need to enter their personal information, so all the processes of selecting the number and handling the cards have been completed. After this number selection, he can drive home with a temporary number plate, and then mail the official number plate to his home.

  Starting from tomorrow, this measure will be first implemented in large and medium-sized cities such as municipalities directly under the central government, provincial capitals, autonomous region capitals and cities with separate plans, and will be fully implemented throughout the country before the end of the year, which will benefit more than 15 million car owners every year and save at least 200 million yuan in transportation costs every year.

  Temporary entry vehicle license is convenient to handle.

  In order to further facilitate the entry and driving of overseas personnel, the Ministry of Public Security has also introduced a number of measures to facilitate the travel of temporary entry vehicles. First of all, those who apply for temporary driving licenses for cars and motorcycles can apply directly with their entry-exit identity documents, overseas driving licenses and their Chinese translations, and there is no need to conduct physical examination and submit physical condition certificates.

  For those who stay in the country for a short time, they can apply for a temporary driving license valid for 3 months; If the stop or residence time exceeds 3 months, the validity period can be extended to 1 year.

  Wang Guoqiang, Deputy Researcher, Vehicle Management Department, Traffic Management Bureau, Ministry of Public Security:Originally, the validity period was no more than three months, but this time it was extended to no more than one year, which is consistent with the time limit for entry of entry personnel, and at the same time, it can be used for multiple entry within the validity period without repeated application.

  For less than 7 non-operating mini passenger cars and motorcycles registered overseas for less than 6 years, apply for temporary entry motor vehicle license plate, and be exempted from safety and technical inspection.

  Wang Guoqiang, Deputy Researcher, Vehicle Management Department, Traffic Management Bureau, Ministry of Public Security:In addition, we will also instruct local traffic control departments to set up traffic control service windows and service stations at airports and ports where immigrants are concentrated, as well as in our Pilot Free Trade Zone, so that immigrants can do it nearby and conveniently after entering the country.

  It is understood that these traffic control service stations will provide one-stop services such as compulsory insurance purchasing, vehicle confirmation, voucher verification, study and education, and license issuance.

  Promote the online transfer of passenger car transfer information

  Now it is more and more convenient to do things online, and the new measures implemented by the Ministry of Public Security from tomorrow also include a number of Internet-related services. Let’s have a look.

  Comprehensively promote the online transmission of passenger car transfer information.

  From tomorrow, the number of cities that transmit the information of passenger car transfer to the internet will increase from the existing 120 to 300, and it will be fully implemented nationwide before the end of the year. In other words, if a non-operating passenger car is transferred to another place, it can apply directly to the place where the vehicle moves in, and it is no longer necessary to go to the vehicle management office of the place where it moves out to pick up the file and inspect the car, thus reducing the number of people going back and forth between the two places.

  Fully implement online perfect score education and verification education.

  It is understood that drivers who need to attend full-mark education and study when their driver’s license is scored 12 points in a scoring cycle, and drivers who need to attend verification education when their drivers are deducted during the scoring cycle, will all go to the site to study. This way will gradually become online education and study in the future.

  Liu Chunyu, Deputy Director of Publicity and Education Department of Traffic Management Bureau of Ministry of Public Security:Snapshots will also be taken from time to time during the learning process to ensure that drivers are always learning online. Drivers who study through the internet will try their best to pass the background supervision and spot check to ensure that they are drivers’ learning. In this process, if it is found that it is a substitute for learning or taking the test, the driver and the substitute for learning and taking the test will be blacklisted, and there will be some punitive measures to restrict him from receiving full marks and verification education through the Internet for three years.

  Full implementation of online navigation tips for traffic accident-prone points and sections

  In addition, the traffic control department will also promote cooperation with Internet map navigation application enterprises and strengthen the timely early warning and push of service information.

  Wang Bingbing, Deputy Director of Accident Countermeasures Department of Traffic Management Bureau of Ministry of Public Security:In the next step, we have to push the information of road occupation, traffic accidents and traffic control, including the information of previous accident-prone points, to the driver in time through navigation software. (CCTV reporter Li Wei)

Use these 100 photos to show you the beautiful scenery of China! See where you have punched in.

Great China, five thousand years of cultural heritage,

Towering mountains and rivers,Vast territory!

With a land area of over 9.6 million square kilometers,

Ranked third in the world!

River and sea,Famous mountains stand tall,

The long river rushes, the vast grassland,

Beautiful mountains and rivers, outstanding people and outstanding people,

Endless national spirit,

On this vast land

Has nurtured countless magnificent scenery,

A profound culture that has spread for thousands of years.intellectual ability!

Maybe you have seen all kinds of photos of China.

Maybe you’ve been there,

Next, with these 100 photos,

Let’s watch the beautiful scenery of China!

1. The Forbidden City in Beijing

2. Wan Li Great Wall

3. Jiuzhaigou, Sichuan

4. Niubei Mountain in Sichuan

5. Sichuan Daocheng Yading

6. xinduqiao, Sichuan

7. Sichuan Bipenggou

8. Sichuan Hailuogou

9. Mount Emei in Sichuan

10. Siguniang Mountain in Sichuan

11. Sichuan Zoige

12. Dangling in Sichuan

13. Sichuan Ganzi Seda

14. Hongyadong, Chongqing

15. Chongqing Three Gorges

16. Lugu Lake, Yunnan

17. Yulong Snow Mountain in Yunnan

18. Yuanyang Terrace

19. Yunnan Luoping

20, Yunnan Puzhehei

21, Yunnan rain collapse

22. Dayan Ancient Town, Lijiang, Yunnan

23. Yarlung Zangbo Grand Canyon in Tibet

24. Linzhi, Tibet

25. Namco, Tibet

26. Potala Palace in Tibet

27, Tibet Lulang Linhai

28. Bangong Lake in Tibet

29. Zhada Tulin, Tibet

30. Qi Feng, Gangrenbo, Tibet

31. Gangbu Glacier in Tibet

32. Pumoyongcuo, Tibet

33. Danghe River in Gansu Province

34. Paradise Lake in Tibet

35. Danxia, Zhangye, Gansu

36. Zhagana, Gansu

37. Crescent Spring in Mingsha Mountain, Gansu Province

38. Kanas, Xinjiang

39. Hemu in Xinjiang

40. Mysterious Grand Canyon in Tianshan Mountain, Xinjiang

41. Sailimu Lake in Xinjiang

42. Wuerhe Fengcheng, Xinjiang

43. Nalati Grassland in Xinjiang

44. Bayinbuluke, Xinjiang

45. Taheman Wetland in Xinjiang

46. Tarim Desert in Xinjiang

47. Anji Sea Grand Canyon in Xinjiang

48. Tianchi Lake in Tianshan, Xinjiang

49. Rainbow Beach, Xinjiang

50. Duku Highway in Xinjiang

51. Qinghai Lake

52. Oboliang in Qinghai

53. Chaka Salt Lake in Qinghai

54, Qinghai Dachaidan Emerald Lake

55. Eye of the Earth in Qinghai

56. Delingha, Qinghai

57. Qinghai Annual Jade Protection Policy

58. Yangshuo, Guilin, Guangxi

59. Landscape of Lijiang River in Guangxi

60. Detian Waterfall in Daxin, Guangxi

61. Weizhou Island, Guangxi

62. Longji Terrace in Guangxi

63. Zhangjiajie, Hunan

64. Langshan Mountain in Hunan Province

65. Xiaodongjiang, Hunan

66. Flying Tianshan Mountain in Hunan Province

67. Enshi Grand Canyon in Hubei Province

68. Shennongjia, Hubei

69. Huangguoshu Waterfall in Guizhou

70. Wan Fenglin, Xingyi, Guizhou

71. Qianhu Miao Village in Xijiang, Guizhou

72. Hulunbeier, Inner Mongolia

73. Aershan, Inner Mongolia

74. Ejina Banner, Inner Mongolia

75. Wulanhada volcano in Inner Mongolia

76. Tianchi Lake in Changbai Mountain, Jilin Province

77. Hukou Waterfall of Shaanxi Yellow River

78. Big Wild Goose Pagoda in Xi ‘an, Shaanxi

79. Nanwutai, Qinling Mountain, Shaanxi Province

80. Taihang Mountain Grand Canyon in Shanxi Province

Laojun Mountain in Luoyang, Henan Province

82. Longmen Grottoes in Henan Province

83. Huangshan, Anhui

84. West Lake in Hangzhou, Zhejiang Province

85. Wuyi Mountain in Fujian

86. Fujian Tulou

87. Danxia Mountain in Guangdong

88. Longhu Mountain in Jiangxi Province

89. Sanqingshan, Jiangxi

90. Lushan Mountain in Jiangxi Province

91. Wuyuan, Jiangxi

92. Shanghai Bund

93. Shenzhen

94. Guangzhou

95. Boundary Island in Hainan

96. Xisha Islands in the South China Sea

97. Sun Moon Lake in Taiwan

98. Taiwan Hualien Cliff

99. Victoria Harbour, Hong Kong

100. Macau

Thanks for living in this country,

This is the land of China that we love.

This is the home guarded by countless people with their blood.

The beauty of the motherland is far more than these 100 photos.

There are more extreme beauty,

It is said that the horizon will take everyone around one by one.

This magical land!

Have more expectations in life,

Yearning for poetry and distance,

The ultimate scenery that I never forget,

Explore and find more exciting,

An unimaginable world!

These 100 places,

Which ones have you been to?

What other good places have you been?

Leave a message in the comment area, let’s talk together!

The latest annual salary of Guangdong men’s basketball players is exposed. Ren Junfei has the highest annual salary, and Hu Mingxuan ranks fourth!

Ren Junfei 8 million, Zhao Rui 6 million, Yi Jianlian 3 million, Hu Mingxuan 3 million, Jeff 300,000, Du Runwang 300,000, Zhao Xuhong 300,000, Wang Qikai 300,000, Wang Qikai 300,000, Zhang Haojia 300,000, Li Yingbo 300,000, Zhao Jinyang 300,000, Liu Quanbiao 2.5 million, Zhang Mingchi 2.5 million and Xu Xin 2.5 million. Ren Junfei is 8 million, Zhao Rui is 6 million, Yi Jianlian is 3 million, Hu Mingxuan is 1.5 million, and the salary of five people is 18.5 million, accounting for one-third of the salary of the whole team. Ren Junfei and his partner, that is, a one-year contract, Zhao Rui ranks second. In terms of his ability, Zhao Rui’s salary is really too small, so Guangdong Basketball should consider increasing Zhao Rui’s salary this summer, otherwise, he will also.