Non-infectious arthritis (NIS) mainly includes osteoarthritis and inflammatory arthritis. With the aging of the population, chronic disease management of NIS patients in China will face great challenges, such as long disease duration, multi-system involvement, high demand for personalized diagnosis and treatment, lack of patient awareness, and difficulty in managing co-morbidities. To address these challenges, a systematic strategy for chronic disease management of NIS needs to be developed at the national level, which encompasses increasing popularization of science, improving the referral system, using artificial intelligence (AI) technology to assist in early diagnosis, and implementing interventions including optimized pharmacological/surgical treatments and multidisciplinary collaboration. In the future, with the deepening of the research on the application of AI technology and novel biologics, the management of chronic disease management of NIS will become more intelligent and personalized.

In recent years, respiratory infectious disease outbreaks have been continually emerging internationally, posing significant challenges to global public health and healthcare systems. How to promptly implement a tiered screening and detection strategy that systematically covers common clinical infectious pathogens causing acute respiratory infections, pathogens causing chronic respiratory infections, and rare respiratory infectious pathogens, while focusing on potential newly emerging respiratory infectious pathogens, and quickly identifying the causative microorganisms, has become a critical issue in clinical diagnosis. To address this issue, the Chinese Hospital Association Clinical Microbiology Laboratory Specialized Committee assembled a multidisciplinary group of experts to summarize the practical experience accumulated in domestic laboratory testing.Incombination with the latest international research progress, they developed the Expert Consensus on Tiered Detection of Newly Emerging and Outbreak Respiratory Infectious Pathogens (2024). This consensus analyzes the major characteristics of newly emerging and outbreak respiratory infections, considers patient population characteristics, and proposes a three-tiered detection strategy that includes traditional microbiological morphology, culture, immunology, molecular biology, and metagenomic sequencing methods. It defines the target pathogens and recommends detection methods at different stages, providing guidance and reference for improving the diagnostic capacity for newly emerging and outbreak respiratory infectious diseases.

Updates to the modern diagnosis of GERD: Lyon consensus 2.0 was published online in September 2023. It presents 23 consensus statements that update the modern definition of gastro-esophageal reflux disease (GERD) and optimize the diagnosis and management of GERD, providing an up-to-date basis for the diagnosis and treatment of GERD. The international consensus is based on the evaluation of studies conducted since the original consensus was published. However, due to the limitations of evidence-based evidence and the differences in national conditions, populations, and economic levels of different countries, it is necessary to interpret its applicability in China, so as to better promote the dissemination of its content and its implementation, and provide patients with the most appropriate guidance for clinical practice.

Osteoarthritis (OA) is a degenerative joint cartilage disease characterized pathologically by osteophytes formation and subchondral bone damage. It leads to pain, stiffness, deformation and even disability in the patients, and increases the risk of comorbidities. As its pathophysiological mechanisms are not well understood, it is hard to identify the specific targets of OA and standardize its pharmacological treatments. Some scholars believe that synovial inflammation is the main factor of pain and progression of OA, so disease-modifying anti-rheumatic drugs (DMARDs) for inflammatory arthritis could be used to treat OA. However, others hold opposing views, arguing that inflammation is not the core driving factor of OA, and the available research results are not sufficient to support the application of DMARDs in OA. In addition, the side effects and monitoring requirements limit the application value of DMARDs in treatment of OA, especially for elderly OA patients with comorbidities. This article analyzes and discusses this debate based on the mechanisms of OA inflammation and pain, and in conjunction with relevant research findings from domestic and international studies.

Gestational trophoblastic neoplasia (GTN) patients can be classified into low-risk and high-risk patients based on the International Federation of Gynecology and Obstetrics(FIGO) staging and scoring system. High-risk patients have a higher risk of resistance to single-agent chemotherapy and require combination chemotherapy. Even worse, there are some high-risk patients who develop resistance to combination chemotherapy or experience recurrence after cure. These patients exhibit strong heterogeneity and pose significant challenges to subsequent treatment, thus attracting considerable attention in recent years. Therefore, this article aims to review the risk factors and treatment strategies for high-risk resistant and recurrent GTN patients, in order to provide a basis for early identification of high-risk patients and their precise treatment.

Ehlers-Danlos syndromes (EDS) are a group of rare hereditary connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Short stature is defined as a height that is two standard deviations or more below the average height for individuals of the same age, sex, and race. The etiopathogenesis of short stature is complicated. Early detection and appropriate intervention are essential in disease treatment. However, short stature is not common among all EDS subtypes. It is frequently observed in patients with rare subtypes, such as spondylodysplastic EDS, dermatosparaxis EDS, and musculo-contractural EDS. Besides, height may be affected by other factors including spinal curvature and malnutrition. Deep phenotyping and multidisciplinary team approaches are recommended for the diagnosis and management. Short stature in patients with EDS has not been sufficiently acknowledged in China. There is currently a lack of high-level evidence for the treatment of EDS-related short stature. Therefore, this review aims to present recent progress of diagnosis and management of short stature in patients with EDS. Further studies focusing on short stature in rare subtypes are necessary to advance precision medicine and enhance patient care.

With the increasing prevalence of chronic kidney disease, the incidence of renal secondary hyperparathyroidism (SHPT) has also reached a high level. At the beginning of the course of SHPT, medical treatment is the main method, but nearly 10% of patients eventually need to undergo parathyroidectomy. The perioperative management of such operations requires comprehensive consideration of the influence of primary disease, secondary pathophysiological changes and surgical factors, which poses a challenge to anesthesiologists. This article summarizes the pathophysiological characteristics, treatment status and anesthesia points of SHPT, with the aim of providing reference for the implementation of safer and better anesthesia management for SHPT patients.

Polymyxins, a class of cyclic peptide antibiotics, have become the last line of defense against gram-negative bacterial infections as the number of multidrug-resistant bacteria continues to rise. Heteroresistance refers to the presence of subpopulations within the same strain with varying sensitivities to antibiotics, which cannot be detected by standard clinical tests and may result in treatment failure. In several common gram-negative bacteria, mutations in the PhoPQ and PmrAB two-component systems are key contributors to polymyxin heteroresistance. This review aims to summarize recent research on the mechanisms of polymyxin heteroresistance in gram-negative bacteria, so as to provide insights for developing rapid detection methods and improving clinical treatment strategies.