The "Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition)" was collaboratively completed under the leadership of Professor Han Baohui from the Department of Pulmonary and Critical Care Medicine at Shanghai Chest Hospital and Professor Wang Jie from the Department of Medical Oncology at the Cancer Hospital of the Chinese Academy of Medical Sciences & Peking Union Medical College. The guideline involved the cooperation of more than 50 lung cancer diagnosis and treatment institutions and over 100 experts across China. Since the completion of the first edition in 2018, the guideline is typically revised annually to promptly incorporate the latest advancements in the field of lung cancer. The most distinctive feature of these guidelines is that they exclusively reference the indications approved by the National Medical Products Administration of China. At the same time, particular emphasis is placed on integrating clinical research data from Chinese scholars based on Chinese patients, thereby enhancing the guidelines' authority, applicability, and drug accessibility. The "Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition)" was officially published in September 2025. To better introduce the key points of the guidelines to peers, this interpretation has been prepared.

To understand the epidemiological characteristics and antimicrobial resistance of Esche-richia coli in free-range Tibetan pig populations,fecal samples from these pigs were collected be-tween 2021 and 2023 for pathogen isolation and identification.The isolated strains underwent anal-ysis of pathogenicity categories,phylogenetic grouping,and antimicrobial susceptibility profiles,a-long with resistance gene detection and mouse pathogenicity testing.The results showed that 123 strains of E.coli were isolated from 132 fecal samples.Enteropathogenicity tests revealed that 42.28％were EAEC(52/123),7.32％were EPEC(9/123),and 3.25％were STEC/EHEC(4/123).Phylogenetic analysis indicated that 78.86％(97/123)belonged to group A,while 11.38％(14/123)belonged to group B1.Antimicrobial susceptibility tests for 22 drugs showed the highest resistance rate to amoxicillin at 98.37％(121/123),followed by sulfamethoxazole at 73.98％(91/123).Resistance rates for ampicillin,tetracycline,erythromycin,and trimethoprim ranged from 48.78％to 51.22％.Furthermore,78.86％(97/123)of the isolates were resistant to three or more antibiotics.The detection of 52 drug-resistance genes in 10 categories showed that 15 drug-resist-ance genes were detected,and the detection rate was 28.85％(15/52).Among individual resistance genes,tetA had the highest detection rate at 63.41％(78/123),followed by tetB and qnrS with de-tection rates of 48.78％(60/123)and 38.21％(47/123),respectively.This study demonstrates that EAEC is the predominant strain of E.coli in free-range Tibetan pigs,with groups A and B1 being the major phylogenetic groups.The isolates exhibited a high degree of multidrug-resistant pheno-types,and the detection rates of resistance genes were also high.E.coli carrying virulence genes cause different degrees of pathological changes in the mouse ileum.The research results have sig-nificant public health implications and provide theoretical basis for the prevention,treatment,and clinical medication of E.coli disease in Tibetan pigs.

The "Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition)" was collaboratively completed under the leadership of Professor Han Baohui from the Department of Pulmonary and Critical Care Medicine at Shanghai Chest Hospital and Professor Wang Jie from the Department of Medical Oncology at the Cancer Hospital of the Chinese Academy of Medical Sciences & Peking Union Medical College. The guideline involved the cooperation of more than 50 lung cancer diagnosis and treatment institutions and over 100 experts across China. Since the completion of the first edition in 2018, the guideline is typically revised annually to promptly incorporate the latest advancements in the field of lung cancer. The most distinctive feature of these guidelines is that they exclusively reference the indications approved by the National Medical Products Administration of China. At the same time, particular emphasis is placed on integrating clinical research data from Chinese scholars based on Chinese patients, thereby enhancing the guidelines' authority, applicability, and drug accessibility. The "Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition)" was officially published in September 2025. To better introduce the key points of the guidelines to peers, this interpretation has been prepared.

To understand the epidemiological characteristics and antimicrobial resistance of Esche-richia coli in free-range Tibetan pig populations,fecal samples from these pigs were collected be-tween 2021 and 2023 for pathogen isolation and identification.The isolated strains underwent anal-ysis of pathogenicity categories,phylogenetic grouping,and antimicrobial susceptibility profiles,a-long with resistance gene detection and mouse pathogenicity testing.The results showed that 123 strains of E.coli were isolated from 132 fecal samples.Enteropathogenicity tests revealed that 42.28％were EAEC(52/123),7.32％were EPEC(9/123),and 3.25％were STEC/EHEC(4/123).Phylogenetic analysis indicated that 78.86％(97/123)belonged to group A,while 11.38％(14/123)belonged to group B1.Antimicrobial susceptibility tests for 22 drugs showed the highest resistance rate to amoxicillin at 98.37％(121/123),followed by sulfamethoxazole at 73.98％(91/123).Resistance rates for ampicillin,tetracycline,erythromycin,and trimethoprim ranged from 48.78％to 51.22％.Furthermore,78.86％(97/123)of the isolates were resistant to three or more antibiotics.The detection of 52 drug-resistance genes in 10 categories showed that 15 drug-resist-ance genes were detected,and the detection rate was 28.85％(15/52).Among individual resistance genes,tetA had the highest detection rate at 63.41％(78/123),followed by tetB and qnrS with de-tection rates of 48.78％(60/123)and 38.21％(47/123),respectively.This study demonstrates that EAEC is the predominant strain of E.coli in free-range Tibetan pigs,with groups A and B1 being the major phylogenetic groups.The isolates exhibited a high degree of multidrug-resistant pheno-types,and the detection rates of resistance genes were also high.E.coli carrying virulence genes cause different degrees of pathological changes in the mouse ileum.The research results have sig-nificant public health implications and provide theoretical basis for the prevention,treatment,and clinical medication of E.coli disease in Tibetan pigs.

Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition) has been published this year. The 2022 edition has been updated in the aspects of lung cancer screening, pathology, standards of thoracic surgery, treatment of metastatic lung cancer. In this study, we tried to introduce those updated aspects in the guideline of 2022 edition.

Background and objective Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been widely applied in diagnosing mediastinal and hilar adenopathy. hTis study is further to evaluate value and safety of EBUS-TBNA in diagnosing intrathoracic metastasis from extrapulmonary malignancy. Methods Prospectively analysis of 41 patients suspected intrathoracic metastasis from previous diagnosed/concurrent extrapulmonary malignancies in Shanghai Chest Hospital, with radiologic ifndings showing mediastinal/hilar lymph node enlargement or intrapulmonary lesion requiring EBUS-TBNA examination for pathological diagnosis. Results 41 candidate patients enrolled, and 67 mediastinal/hilar lymph nodes and 5 intrapulmonary lesions were aspirated. 14 intrathoracic metastasis, 10 primary lung cancer, 9 reactive lymphadenitis, 4 sarcoid-like reactions, and 1 tuberculosis was diagnosed by EBUS-TBNA. Sensitivity and accuracy of EBUS-TBNA in diagnosing intra-thoracic metastasis was 87.50%and 95.12%, respectively. Immunohistochemistry (IHC) was performed in 18 malignant tumors to obtain deifnite type or origin, twelve intrathoracic metastasis and 6 primary lung cancer were further conifrmed. Conclusion EBUS-TBNA is a safe, effective method for the diagnosis of intrathoracic metastasis from extrapulmonary malignancy. IHC can provide additional evidence for distinguishing extrapulmonary malignancy from primary lung cancer.

Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in intrathoracic tuberculosis(TB).Methods We retrospectively analyzed patients underwent EBUS-TBNA with a final diagnosis of intrathoracic TB at Shanghai Chest Hospital from October 2009 to March 2013 and observed that the diagnostic efficacy by pathology and microbiology and safety of EBUS-TBNA for intrathoracic TB.Results 75 patients were diagnosed with pulmonary TB or intrathoracic tuberculous lymphadenitis,and accuracy was 80％ (60/75) by EBUS TBNA.A total of 60 patients had pathology,acid-fast bacilli(AFB) staining and mycobacterial culture test results,of whom 52 (86.67％)were diagnosed.Pathological findings were consistent with TB in 77.33％ patients (58/75),in 20.31％ (13/64) the smear were positive for AFB and in 46.67％ (28/60) were positive for cuhure.One hundred and twenty-nine mediastinal or hilar lymph nodes and 10 intrapulmonary lesions were biopsied in 75 patients,the average target number of per patient were 1.85.Pathological findings were consistent with TB in 66.19％ samples(92/139),in 13.91％ (16/115) were positive for AFB and in 38.32％ (41/107) were positive for culture.Multivariate regression revealed that short-axis diameter was an independent risk factor associated with positive pathology,smear and euhure.Additionally,more aspiration times cause higher pathology positive rate,pathology showing necrosis and positive smear were independent risk factors associated with positive cuhure.There were two patients occurred complications during operation.Conclusion EBUS-TBNA was a safe and effective method for the diagnosis of intrathoracic tuberculosis.

Background and purpose: The overall survival time of extensive-stage small cell lung cancer is not satisfactory. No chemotherapy schemes more effective than etoposide combined with cisplatin, and other optimum combinations should be under evaluation. The aim of this study was to investigate the survival advantage of IEP followed by EP chemotherapy in the treatment of extensive-stage small cell lung cancer compared with EP chemotherapy alone. Methods: From Jan 2004 to Sep 2007, 68 extensive-stage small cell lung cancer patients were enrolled in this project and were randomly divided into research group and control group in the ratio of 1:1. In the research group, 34 patients accepted IEP chemotherapy at least two times followed by EP chemotherapy maintenance therapy. 34 patients as control group accepted EP chemotherapy only. Statistical significance was defined as P<0.05. Results: The median overall survival time of the research group was 15.32 months and the control group was 9.30 months. There were no significant differences between the two groups (P=0.0787). The median time to progression of the research group was 7.83 months and 6.92 months for the control group, respectively. There were no significant differences between the two groups (P=0.0164). It is suggested that IEP followed by EP chemotherapy in treatment of extensive-stage small cell lung cancer could get a better progression free survival, but the overall survival time has not been improved. Conclusion: We conclude that those patients with extensive-stage small cell lung cancer could get better progression free survival by accepting IEP chemotherapy.

Small cell lung cancer(SCLC)is regarded as one of the most chemotherapy and radiotherapy sensitive malignant solid tumors.With regimens based on platinum-etoposide,which is still the standard of first-line treatment in extensive-stage SCLC,objective responses are seen in 50% to 70% of cases.With combined chemoradiotherapy,the probability of attaining a complete response increases to 40% to 50%.The majority of patients with SCLC will eventually develop a tumor relapse.For the patients with relapse,so far only single-agent topotecan represents a most effective therapeutic option.Integration of chest radiotherapy with standard chemotherapy,optimization of timing and fractionation of radiation therapy,and the introduction of prophylactic cranial radiation have led to an obvious improvement in 3-year survival.