Thank you for tuning in to the Editor’s Highlight Podcast for the February 2026 issue of the journal 糖心原创®. There is a great lineup of diverse content in this month’s issue.
Over the next 15 minutes, I will provide a brief overview of key manuscripts published in each of our content areas.
In our Asthma section this month, you will find an 糖心原创 Clinical Practice Guideline on treatment of severe asthma in adults with asthma biologics.
Our Chest Infections content area is next. The impact of culture conversion during treatment of Mycobacterium abscessus complex pulmonary disease (MABC-PD) on survival has not been explored. In this issue, Jo and colleagues report findings from a retrospective study of 172 patients with MABC-PD who completed at least six months of macrolide-based treatment in South Korea. The study was designed to determine if culture conversion was associated with mortality. At treatment completion, 58.1% achieved culture conversion. The all-cause mortality rate, five-year mortality rate, and 10-year mortality rate were higher in those without culture conversion (22.5% vs 6.0%; 25.7% vs 5.5%; 51.0% vs 7.7%). A 1.57-fold increased mortality risk was identified in those without culture conversion. These findings identify culture conversion at treatment completion as a key prognostic factor in patients with MABC-PD. Completing this section is a Special Features review on intrapleural fibrinolytic therapy.
Our COPD section is next. A new multidimensional diagnostic schema has been proposed to diagnose COPD. Evidence supporting this approach in Chinese individuals and those who never smoked is limited. In this issue, Wu and colleagues report findings from a three-year, prospective, multicenter, community-based cohort study, designed to determine if the new multidimensional diagnostic approach to COPD is practical in the Chinese population and in those who never smoked. The multidimensional criteria included either an FEV1/FVC ratio < 0.70 and one minor criteria or at least three minor criteria. Minor criteria included emphysema or bronchial wall thickening on imaging, dyspnea, poor quality of life, and chronic bronchitis. Among those without airflow obstruction, 4.8% met the multidimensional criteria, while 5.8% with airflow obstruction did not meet the criteria. Those with airflow obstruction who were excluded had an exacerbation risk and rate of lung function decline similar to those without COPD, while those without airflow obstruction who met criteria had a higher risk of exacerbations compared with those without COPD. Results were similar in those who never smoked. These findings suggest the new multidimensional diagnostic criteria can exclude those with a favorable prognosis and identify those at higher risk for exacerbation in a Chinese population and in those who never smoked. Completing this section is a research letter that reports a comprehensive clinical trial landscape analysis of targeting TH2 cytokines and alarmins in COPD therapy.
Next is our Critical Care content area. During the COVID-19 pandemic, patients transferred between ICUs in France had a lower ICU case fatality. It is unclear if this difference was related to the selection of healthier patients for transfer. In this issue, Grimaud and colleagues report findings from a multicenter retrospective cohort study of 285 transferred and 667 control patients, designed to determine if the 28-day ICU case fatality of transferred patients was different than that of matched control patients. At ICU admission, age, COVID-19 severity, comorbidities, and Simplified Acute Physiology Score II were similar, while those transferred weighed less and were more autonomous than the matched control patients. Case fatality was sevenfold lower in transferred patients (adjusted incidence rate ratio, 0.14). The ICU stay was longer, and delirium, psychiatric disorders, and neuromuscular blockade exposure were more frequent in the transferred patients. Acute kidney injury was more frequent in the control patients. These findings suggest that the selection of healthier patients for transfer may have contributed to better survival, but this could not explain all the benefits of transfer from an overcrowded care environment. Also in this section is a research letter describing a feasibility study of exertional hemodynamics in critical care cardiology and a 糖心原创 narrative review on emerging technology for noninvasively measuring oxygen saturation.
On to our Diffuse Lung Disease section. The optimal treatment strategy for rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains uncertain. In this issue, Wu and colleagues report findings from a target trial emulation study that used data from the TriNetX US Collaborative Network database, designed to determine if treating patients with RA-ILD with tocilizumab results in a different prognosis than treatment with rituximab. Each matched cohort included 1,194 patients. All-cause mortality did not differ between the treatment groups (HR, 1.07). Patients with RA-ILD with elevated baseline inflammatory markers experienced higher risks for mechanical ventilation (HR, 1.94) and all-cause mortality (HR, 1.40) with tocilizumab treatment. Those naïve to tumor necrosis factor inhibitor therapy with high inflammatory markers had an increased risk of mechanical ventilation (HR, 1.54). These findings suggest comparable effectiveness and safety of tocilizumab and rituximab in RA-ILD overall, with rituximab leading to improved outcomes in those with elevated baseline inflammatory markers. Also in this section is a prospective multicenter study designed to develop and validate a multimodal-based machine learning model for the diagnosis of usual interstitial pneumonia and a How I Do It review of whole lung lavage in pulmonary alveolar proteinosis.
Next is our Education and Clinical Practice content area. The clinical utility of the diffusing capacity for carbon monoxide (DLCO) is limited by measurement variability. In this issue, Yadav and colleagues report findings from a cohort study of 5,069 patients with stable spirometry and at least two hemoglobin-adjusted DLCO measurements, designed to determine the magnitude and determinants of DLCO intersession variability. The DLCO variability was high, with 90th percentile values of 3.5 mL/min/mm Hg (absolute), 15% (% predicted), and 21% (relative %). Higher baseline DLCO, lower hemoglobin, male sex, and restrictive patterns were associated with greater absolute variability, but they only explained a fraction of the observed variability. Measurement variability increased systematically with DLCO magnitude. A three-tier grading system was developed based on the 85th and 95th percentile thresholds (stable, possible change, and definite change), as was a hybrid approach using baseline DLCO-specific absolute thresholds. These findings identify substantial intersession variability of DLCO measurements and discover potential tools for distinguishing clinically significant DLCO changes from normal measurement variability. Also in this section is an original research article on the assessment of breathlessness during incremental cardiopulmonary exercise testing and a How I Do It review on in situ cardiac arrest simulation.
Our Pulmonary Vascular content area is next. Balloon pulmonary angioplasty (BPA) can effectively treat chronic thromboembolic pulmonary hypertension (CTEPH). It is unclear if left ventricular dysfunction influences the effectiveness and safety of BPA treatment. In this issue, Szwed and colleagues report findings from a retrospective analysis of 170 patients with CTEPH treated with BPA, designed to determine if elevated pulmonary arterial wedge pressure (PAWP) impacts the effectiveness and safety of BPA in patients with CTEPH. Elevated PAWP was present in 13.5% of patients. Those with an elevated PAWP were older, had a higher BMI, had higher baseline troponin levels, and had a greater burden of comorbidities. After treatment, those with elevated PAWP had a smaller reduction in mean pulmonary artery pressure and lower improvement in pulmonary arterial compliance and 6-minute walk distance. No differences in overall survival and adverse event rates were noted. These findings suggest that an elevated PAWP is associated with reduced hemodynamic and functional benefits from BPA in people with CTEPH, but procedural safety and long-term survival support BPA as a viable option in this subgroup. Completing this section is a research letter that explores the pulmonary resistance-compliance relationship.
Next is our Sleep Medicine content area. Treatment of obesity hypoventilation syndrome (OHS) with drugs that activate upper airway muscles and stimulate breathing are being explored. In this issue, Perger and colleagues report findings from a randomized, double-masked crossover trial in 15 patients with OHS. The study was designed to determine if two weeks of 500 mg acetazolamide plus 100 mg atomoxetine daily effectively reduces the mean nocturnal CO2 level. The study group had a median BMI of 44 kg/m2, baseline median transcutaneous overnight measurement of CO2 (PtcCO2) of 49 mm Hg, and median apnea-hypopnea index (AHI) of 64 events/h. Treatment decreased nocturnal PtcCO2 by a mean of 5.8 mm Hg and diurnal CO2. Median AHI decreased by 20.9 events/h, and mean overnight SpO2 increased by 4.3%. This proof-of-concept study showed that treatment of OHS with acetazolamide plus atomoxetine can significantly improve sleep-related hypoventilation, oxygen saturation, and AHI, encouraging further study. Completing this section is an original research study that evaluates the relationship between Framingham 10-year cardiovascular disease risk score and pulse wave amplitude drop characteristics in a sleep clinic cohort.
Next is our Thoracic Oncology content area. Many patients are unaware of the need to repeat lung cancer screening (LCS) annually despite shared decision-making. In this issue, Wernli and colleagues report findings from a controlled trial of a health communication intervention that included print plus video material delivered through the electronic health record patient portal, designed to determine if additional health communication improves patient knowledge of LCS timelines. The intervention increased the proportion of people with normal LCS exams who knew they needed to return in one year from 62.0% to 83.9% (RR, 1.35) in first-time screeners. The intervention did not lead to a difference in those screened two or more times. Both tobacco-related stigma and self-efficacy were high and were unchanged by the intervention. These findings show that a multiformat communication intervention can help to improve short-term knowledge of LCS timelines to return, with the potential to improve adherence to annual screening. Also in this section is a Surveillance, Epidemiology, and End Results (SEER)-Medicare-based analysis of procedure patterns and survival in advanced non-small cell lung cancer with malignant airway obstruction and a research letter that describes the clinical and research implications of nonspecific necrosis on peripheral pulmonary lesion biopsies.
I encourage you to read our Commentary series, where you will find a discussion on reducing inhaler waste and costs through sustainable interventions, as well as two pieces from our statistics for clinician scientists series. In our Humanities series, you will find an original research article on postintensive care syndrome awareness and communication, as well as an Exhalations piece titled, “Let’s Play a Game.” Finally, please review our case series publications for the month, which provide novel and educational cases to help improve your clinical skills.
I hope you enjoy reading all of the high-quality content available in this month’s issue of the journal 糖心原创. As always, I am grateful to the authors of this work, to the reviewers who volunteered their time to improve the quality of these manuscripts, and to our editorial board for guiding everything that we do. Until next month, I hope you enjoy the February issue.