Volume 106 ·  Issue 20 ·  2026

Congenital ossicular chain malformation constitutes a pivotal etiological factor in conductive hearing loss. Despite its relatively low clinical incidence, the diagnosis and management of this condition persist as a formidable challenge in contemporary otological practice. In recent years, the expeditious evolution of high-resolution imaging modalities, minimally invasive endoscopic surgical techniques, innovative artificial ossicular prostheses, advanced hearing implant systems, and artificial intelligence (AI)-assisted clinical decision-making frameworks has precipitated a paradigm shift in diagnostic and therapeutic paradigms. This article systematically elaborates on the diagnostic strategies, therapeutic modalities, and future research directions pertaining to congenital ossicular chain malformation, with the overarching goal of advancing the precision and individualization of clinical care for affected populations.

Based on the 2023 consensus, the Chinese Breast Cancer Endocrine Therapy Consensus Group systematically reviewed the key points of endocrine therapy in the neoadjuvant, adjuvant, and metastatic settings, and updated the 2026 edition consensus. We interpreted the key points of the consensus in this article. In precision testing, the consensus emphasized the standard immunohistochemical test for hormone receptor and human epidermal growth factor receptor 2 (HER2) receptor, defined HER2-low and ultra-low expression, clarified the timing and methods of genetic testing. For different treatment stages of breast cancer, the consensus defined the eligible population for neoadjuvant endocrine therapy, expanded adjuvant cyclin-dependent kinases 4/6 (CDK4/6) inhibitor application in moderate and high-risk patients, optimized treatment strategies for first-line endocrine therapy plus CDK4/6 inhibitors in metastatic breast cancer, and recommended preferred regimens for post-CDK4/6 inhibitor patients. In conclusion, clinicians should follow the consensus recommendations, so as to achieve precise and individualized treatment for patients with hormone receptor-positive breast cancer.

The prevalence of type 2 diabetes mellitus has been rising continuously in China. However, glycemic control rates remain suboptimal, posing a significant public health challenge. Although traditional intensive insulin strategies are effective in improving glycemic control, they are often associated with risks such as hypoglycemia and weight gain. Fixed-ratio combinations of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1RA) offer complementary mechanisms of action, enhancing efficacy and safety while simplifying treatment regimens, making them a key focus of clinical development. Insulin icodec/semaglutide fixed-ratio combination (IcoSema), the first once-weekly dual-component preparation combining a basal insulin and a GLP-1RA, utilizes advanced formulation technology to achieve stable co-formulation of the ultra-long-acting once-weekly basal insulin and the once-weekly GLP-1RA, with the two components acting in a complementary and synergistic manner. The Phase 3 COMBINE clinical trial program demonstrated that, compared with insulin icodec, semaglutide(1.0 mg), or basal-bolus insulin regimens, IcoSema provides superior or equivalent glycemic control, and the risk of clinically significant or severe hypoglycemic events is comparable to that of semaglutide(1.0 mg). Once-weekly administration helps to simplify the treatment regimen and improve treatment adherence. The clinical application of IcoSema is expected to alleviate the dilemma in Chinese type 2 diabetes management of balancing effective glycemic control with safety and simplicity, offering a new therapeutic option for patients requiring insulin intensification that combines efficacy, safety, and convenience.

In response to the challenges of insufficient precision and limited safety associated with traditional techniques in the diagnosis and treatment of complex spinal diseases, intelligent technologies—represented by 3D visualization, additive manufacturing (3D printing), surgical navigation and robotics, artificial intelligence, and telemedicine—are driving spine surgery into a new era of precision and personalized treatment. However, there is currently a lack of standardized protocols or guidelines for the clinical application of these intelligent technologies in spine surgery. To standardize and promote their clinical use, this guideline was developed through an initiative led by the Spinal Trauma Group of the Chinese Association of Orthopaedic Surgeons (CAOS) and the Intelligent Orthopaedics Group of CAOS, in collaboration with Shaanxi Medical Doctor Association Professional Committee on Orthopaedic Minimally Invasive Surgery. Multidisciplinary experts participated, formulating recommendations based on evidence-based medicine and multi-center Delphi expert consensus. This guideline systematically summarizes the application scope of intelligent technologies in spine surgery, covering six aspects: 3D visualization, 3D printing, surgical navigation and robotics, artificial intelligence, telemedicine, and the implementation of intelligent technologies. It finally forms 15 recommendations, clarifies the applicable scenarios, evidence levels, and recommendation strength for each technology, and aims to promote their scientific, standardized, and efficient application, provide practical suggestions for medical institutions at different levels, and ultimately enhance the overall clinical diagnosis and treatment level and clinical decision-making support capacity in spine surgery.

Transarterial interventions (TAI) for hepatocellular carcinoma (HCC) include transarterial chemoembolization (TACE), transarterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy (SIRT). TACE remains the first-line treatment for unresectable HCC. Chinese College of Interventionalists (CCI) previously issued and updated the Chinese Clinical Practice Guidelines of TACE for HCC in 2018, 2021, and 2023, which have played a pivotal role in standardizing TACE procedures in China. In recent years, the application of HAIC and SIRT has become increasingly widespread and standardized in China. With the continuous advancement of TAI techniques, the evolution of therapeutic concepts, and the emergence of high-level evidence, CCI has comprehensively revised and expanded its previous guidelines. The updated Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition) now formally incorporates TACE, HAIC, and SIRT as standard treatment modalities. With the aims to further standardize the use of TAI in the management of HCC, this guideline is developed based on the most current evidence-based medical research, integrates China-specific clinical practices, and incorporates the latest advancements in TAI for HCC. It elaborates on clinical diagnostic criteria and staging, patient indications and contraindications, operational procedures and requirements, perioperative management, common complications management, follow-up and efficacy evaluation, combination therapy, quality control, as well as hot topics and prospects.

Congenital ossicular chain malformation (COCM) is a congenital developmental disorder that impairs hearing function. It most commonly presents unilaterally, either as an isolated anomaly or in association with a variety of systemic syndromes; in severe cases, it may coexist with malformations of the auricle and external auditory canal. Owing to its insidious onset and the presence of an intact tympanic membrane, affected children are frequently misdiagnosed with secretory otitis media. Bilateral COCM, if left untreated in a timely manner, can hinder speech and cognitive development, while specific anatomical variants may elevate the risk of cholesteatoma formation. Diagnosis is predicated on the presence of persistent conductive hearing loss from early childhood, with preoperative high-resolution temporal bone CT scanning serving as a pivotal tool for anatomical evaluation. The management of COCM is primarily guided by patient and family preferences, with therapeutic options encompassing hearing aid fitting and surgical intervention. To standardize the diagnosis and treatment of COCM, optimize the selection of surgical strategies, and enhance clinical outcomes, domestic otology experts have jointly developed the "Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)". This consensus is grounded in the latest research evidence and accumulated clinical experience, systematically summarizing the epidemiology, pathogenesis, clinical manifestations, auxiliary examinations, treatment principles, and complications of non-syndromic COCM. Building upon existing classification systems, the consensus introduces a novel clinical classification framework centered on stapes footplate mobility and the integrity of suprastapes structures, which directly informs surgical decision-making. This new classification prioritizes guiding surgical strategy formulation and predicting postoperative outcomes, thereby providing a robust reference for the standardized diagnosis and clinical management of COCM.

Public health is the cornerstone of addressing multiple health challenges and safeguarding the health of the whole population. At present, it is urgent to build a more accurate, systematic and active risk prevention and control system through deep cross-integration and technical method innovation. This "Medical Frontier Thirty Academic Conference" focuses on six frontier hot issues in the fields of public health and preventive medicine: new pollutants and health research focuses on broad-spectrum identification, mixed exposure assessment and risk management and control; Climate change (air pollution) and health research focuses on revealing the synergistic health effects of pollution and climate, and develops individualized risk assessment, intelligent early warning decision-making system and integrated intervention path of medical and prevention integration for key areas and key populations; The study of toxicity effects and mechanisms relies on the systematic toxicology paradigm empowered by multi-omics, organoid models and artificial intelligence to promote the transformation from toxicity pathway analysis to health effect prediction, and from single endpoint evaluation to multi-scale and multi-organ comprehensive evaluation; In the field of occupational (special environment) hazards and health, we pay attention to the hidden hazards of emerging industries and special environments, and build a full-chain protection system relying on the intersection of medical and industrial technologies, intelligent monitoring and individualized protection technologies; Food nutrition and safety research is committed to achieving precision nutrition and full-chain risk control, and solving the problems of accurate assessment of dietary exposure and evidence-based transformation and application; Children and maternal and child health research integrates genetics, environmental exposure and artificial intelligence to promote precise prevention and control of key diseases and early warning of risks. Experts at the meeting suggested that cross-integration and collaborative research among the six major fields should be strengthened, and through interdisciplinary and cross-field organized scientific research, efforts should be made to build a modern public health science and technology system covering all factors, all scenarios, all chains and all people, so as to provide scientific support for comprehensively improving the health level of the whole people and accelerating the realization of high-quality development.