Thank you for tuning in to the Editor’s Highlight Podcast for the March 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 a 糖心原创 Narrative Review on asthma and pregnancy.
Our Chest Infections content area is next. The role of adjunctive corticosteroids in non-HIV-associated Pneumocystis jirovecii pneumonia (PJP) is unclear. In this issue, Pulsipher and colleagues report findings from a multicenter retrospective cohort analysis of 375 adults without HIV who are immunocompromised and were hospitalized with proven or probable PJP, 351 of whom (93.6%) received corticosteroids. The study was designed to determine if there is a dose-response relationship between adjunctive corticosteroids and outcomes in adults who are immunocompromised with non-HIV PJP requiring supplemental oxygen. Of those included, 56% required ICU care, and 44% died within 90 days. Greater cumulative corticosteroid dose was associated with increased risk of 90-day mortality (HR, 1.01 per 100 mg prednisone equivalent). Corticosteroid exposure was not associated with risk of intubation or faster liberation from advanced respiratory support. These findings suggest that higher cumulative corticosteroid exposure, beyond doses of trial-tested regimens, should be approached with caution. Completing this section is a research letter that assesses the association between incident nontuberculous mycobacteria isolation and antibiotic exposure in patients with bronchiectasis.
Our COPD section is next. Clinical tools for predicting major adverse cardiovascular events (MACEs) in patients with COPD have underperformed. In this issue, de-Torres and colleagues report findings from an observational cohort of 529 patients with COPD who underwent a chest CT scan and clinical, functional, and laboratory testing, 24% of whom had a MACE during 98 months of follow-up. The study was designed to determine if a combination of cardiovascular risk score (CVRS) and coronary artery calcium score (CACS) improves risk assessment for MACEs in patients with COPD. Using thresholds of CVRS calculation of 10% and CACS of 3, patients were divided into four groups (low-low, high-low, low-high, and high-high). The HR for MACEs for group IV (high-high) was 7.6, group III was 3.1, and group II was 2.6. The areas under the receiver operating characteristic curve for predicting MACEs were 0.72 for the combination score, 0.69 for CVRS, and 0.66 for CACS alone. These findings suggest that the CVRS and CACS provide complementary risk stratification in patients with COPD. Completing this section is a 糖心原创 Narrative Review on small airways disease in patients with COPD.
Next is our Critical Care content area. Atelectasis, mainly caused by secretion accumulation, frequently occurs in patients with impaired consciousness who are receiving invasive mechanical ventilation. In this issue, Hu and colleagues report findings from a multicenter, single-blind, randomized controlled trial that included 80 patients from 11 hospitals in China, and it was designed to determine if continuous high-frequency oscillation (CHFO) therapy improves lung aeration and reduces atelectasis in adults with impaired consciousness (Glasgow Coma Scale score ≤ 8) who were mechanically ventilated. On day five, the decrease in nonaerated lung tissue from day one to day five, measured by CT scan, was greater in the CHFO group (-51.3% vs -37.6). The CHFO group also had a higher number of ventilator-free days, a lower clinical pulmonary infection score, and a shorter ICU stay. This study showed that five days of CHFO treatment significantly reduces nonaerated lung tissue in patients with impaired consciousness who are mechanically ventilated. Completing this section is an original research article that assesses timely primary care follow-up after hospitalization for pediatric critical illness.
On to our Diffuse Lung Disease section. The impact of dietary interventions on weight loss and prognosis in patients with fibrotic interstitial lung disease (F-ILD) is unknown. In this issue, Kahai and colleagues report findings from a pilot randomized controlled trial, in which patients with F-ILD experiencing low weight or weight loss were randomized to either a 12-week specialist dietary intervention or were provided with a dietary information sheet. The study was designed to determine the feasibility of a randomized controlled trial of specialist dietary intervention in F-ILD, with an exploratory outcome of weight change from baseline. Of those screened, 40 of 128 patients were randomized over 7 months, and all 40 completed the study. Eight of 19 (42%) in the intervention arm and one of 21 (4.8%) in the control arm gained at least 1 kg at 12 weeks (OR, 14.2). The estimated rate of weight change from weeks four to 12 was -0.25 kg/month in the control arm and 0.40 kg/month in the intervention arm. These findings suggest that a definitive multicenter randomized controlled trial is feasible and warranted. Also in this section is an original research article exploring international stakeholder engagement on clinical care and research for sleep assessment and nocturnal hypoxia in pulmonary fibrosis and a 糖心原创 Narrative Review on the role of MRI in interstitial lung diseases.
Next is our Education and Clinical Practice content area. Empirical evidence about the association of olfaction with lung health is lacking. In this issue, Ding and colleagues report findings from a study of 1,951 participants from the Health, Aging, and Body Composition Study who had completed the 12-item Brief Smell Identification Test and spirometry. The study was designed to determine if poor olfaction is associated with lower pulmonary function in older adults. Participants with poor olfaction had lower FEV1 and FVC at clinical visits in years five, eight, and 10. At year five, compared with those with good olfaction, FEV1 was 44 mL lower in those with moderate olfaction and 63.5 mL lower in those with poor olfaction. Olfaction was not associated with the FEV1/FVC ratio. These findings suggest that poor olfaction is associated with worse pulmonary function in older adults, calling for confirmation and assessment of potential mechanisms. Also in this section is a longitudinal analysis of lung function changes across the menopausal transition and an assessment of a gastroesophageal balloon tamponade simulation-based mastery learning curriculum for critical care fellows. Completing this section is a 糖心原创 Narrative Review on the mitral valve and the lungs.
Our Pulmonary Vascular content area is next. Growth differentiation factor-15 (GDF-15) has been reported to be associated with the prognosis of patients with pulmonary arterial hypertension (PAH). In this issue, Wang and colleagues report findings from a nationwide, multicenter retrospective study of 435 patients with PAH, designed to determine if the addition of GDF-15 improves the performance of existing prediction models for PAH. Elevated levels of GDF-15 were associated with an increased risk of mortality (HR, 1.68 in the discovery cohort and 1.98 in the validation cohort). A risk model incorporating GDF-15, and based on the COMPERA model, demonstrated improved discrimination for mortality prediction and enhanced fit, with an increase in the C-index from 0.743 to 0.767 in the discovery cohort and 0.658 to 0.687 in the validation cohort. These findings show that GDF-15 may improve the predictive effects of existing PAH all-cause mortality risk assessment strategies. Also in this section is an original research article that evaluates a noninvasive model to predict exercise hemodynamics in patients with chronic thromboembolic pulmonary disease with exercise pulmonary hypertension and a research letter that reports on the development of pericardial effusions with the use of sotatercept.
Next is our Sleep Medicine content area. The impact of heart failure (HF) on in-hospital outcomes in patients with or at risk for obesity hypoventilation syndrome (OHS) is unclear. In this issue, Kaw and colleagues aimed to determine the outcome of patients with OHS who experience HF in 72,385 patients hospitalized for OHS from the National Inpatient Sample. Of the patients, 58.8% had an underlying diagnosis of HF, and 26.3% were discharged with HF as a primary diagnosis. Those with OHS and HF were older, were more frequently White, had a longer length of stay, and had a need for noninvasive ventilation (NIV), mechanical ventilation (MV), and NIV plus MV. They had a lower likelihood of discharge to home, more in-hospital deaths, and more frequent adverse cardiovascular outcomes. When NIV and MV were required, there was a higher inpatient mortality, more acute kidney injury, and more major adverse cardiovascular events. These findings identify comorbid HF frequently accompanying OHS and associated with worse outcomes. Also in this section is a research letter that explores hypoglossal nerve stimulation in the context of noncontinuous PAP therapy in patients with OSA and a 糖心原创 Narrative Review on the association of OSA with reproductive aging and screening challenges in women.
Next is our Thoracic Oncology content area. As cannabis use increases globally, particularly among younger individuals, understanding its impact on lung cancer is critical. In this issue, Pradère and colleagues report findings from a multicenter prospective study of 150 patients, aged < 60 years, who were consecutively diagnosed with primary lung cancer. The study was designed to assess the impact of dual cannabis and tobacco smoking in young patients with lung cancer. Of the patients, 39% smoked cannabis and tobacco. This group had similar hair cotinine concentrations and cigarette pack-years compared with those who smoked tobacco only. Compared with patients who smoked exclusively tobacco, patients who smoked cannabis and tobacco were younger, more often reported chest pain at diagnosis, had higher rates of aggressive lung cancers, had more emphysema, and had lower gas diffusing capacity. These findings suggest that dual cannabis and tobacco smoking is prevalent in young patients with lung cancer and is associated with distinct clinical patterns, including a higher incidence of emphysema and aggressive tumor types. Several other original research articles appear in this section. The first is an evaluation of tension physiology and predicting outcomes with pleural manometry in pneumothorax. The next is a UK biobank study that assesses lung cancer risk in preserved ratio impaired spirometry and airway obstruction. Another is an evaluation of long-term major respiratory mortality among five-year survivors of adolescent and young adult cancer. Completing the section is a national evaluation of intercostal chest drain removal strategies.
I encourage you to read our Commentary series, where you will find thoughtful pieces on clarification of diagnostic yield in bronchoscopy research and the integration of tumor biology with anatomy as the future of lung cancer staging. Within our Humanities series, you will find two Exhalations pieces, the first titled, “Nonpareil, the Song Within,” and the second titled, “The Note Taker.” 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 March issue.