Tumorigenesis and tumor progression are inseparable from the tumor ecosystem consisting of the tumor itself and its microenvironment. The clinical translation from bench to bedside can help breast oncologists develop more comprehensive and effective treatment strategies for breast cancer. The rise of immunotherapy is changing the pattern of systemic treatment of breast cancer. Combination of immunotherapy with traditional treatment can further improve the prognosis of breast cancer patients. In the future, discovering new targets and more accurate predictive biomarkers for anti-tumor immunotherapy are of importance to improve the clinical effect of immunotherapy for breast cancer patients.

Chinese Society of Breast Surgery (CSBrS) has been focusing on promoting the development and standardization of diagnosis and treatment of breast cancer in China since its establishment. During 2017 and 2021, CSBrS published 11 consensuses on fundamental issues of breast surgery and carried out 23 multi-center real world studies. Clinical practice guidelines for breast surgery (2021), using GRADE system based recommendations, conducted by CSBrS will be promulgated soon. It is hoped that these guidelines will lay equal stress on clinical research and guidelines, and promote the development of breast surgery in China.

Chloasma is a disorder of symmetrical distribution of excessive facial melanosis, which usually occurs in middle-aged female and can affect their quality of life. The pathogenesis of chloasma is affected by many factors, including ultraviolet radiation, endocrine disorders, hormone levels change and genetic factors, etc. The pathogenesis remains unclear due to its complexity. There are various treatment methods for chloasma, especially laser treatment, whose accuracy and selectivity are reported to be excellent. Here the authors review relevant research of laser treatment in chloasma.

Postoperative pulmonary complications (PPCs) are one of the main factors affecting the postoperative outcome of elderly patients. In order to reduce the perioperative risk and improve the prognosis of elderly patients, attention should be paid to the prevention and treatment of PPCs. This expert consensus will systematically expound the prevention and treatment strategies for PPCs and make relevant recommendations, including preoperative preparation, intraoperative management, postoperative management, perioperative respiratory function monitoring, and management of special patients.

The serous cavity mentioned in this consensus refers to the pericardial cavity, pleural cavity, and peritoneal cavity. Malignant serous effusion refers to the detection of malignant cells in the serous effusion through exfoliate cytology or the diagnosis of malignant tumor by serosal tissue biopsy. Malignant serous effusion is a special manifestation of tumor metastasis, and it is one of the common complications of patients with advanced malignant tumors. Large amounts of malignant serous effusion can affect the quality of life seriously and be even life-threatening. The treatment concepts for malignant serous effusion are obviously different between China and European and American. Currently, diagnosis and treatment guidelines or norms are insufficient worldwide. The existing expert consensus on the diagnosis and treatment of malignant serous effusion in China was published in 2014. It does not include pericardial effusion and ascites effusion, and some treatment strategies (such as talcum pleurodesis) are not widely used in clinical practice. This consensus mainly includes three parts. The first is to introduce the global treatment status and the main treatment concepts in European and American countries, as well as the progress of treatment in China. The second part gives a detailed introduction to the diagnosis process, including medical history, clinical manifestations, imaging examinations, and tumor marker detection. The focus is on the exfoliative cytology and serosal biopsy methods, including the application of paraffin-embedded section technology of cell blocks in molecular genetic testing that has emerged in recent years. The third part discusses the treatment process, including the principles of local and systemic treatment. In terms of local treatment, the indications, main drug recommendations, drug dosage, infusion time, prevention and treatment of adverse reactions, and treatment methods for special types of malignant effusion are introduced in detail for common fluid drainage or drainage combined with drug infusion therapy. In terms of systemic therapy, clear guidance is also given to the principles of systemic therapy and the choice of systemic drug delivery. In the last part, the indications and operating procedures of external thermo-circulation perfusion chemotherapy are explained briefly. At present, although there is a large amount of Chinese literature on the diagnosis and treatment of malignant serous effusions, the quality of the literature is not high, let alone the level of evidence. However, this consensus has fully considered the actual conditions of different levels of medical institutions, and has universal applicability, strong practicability, and maneuverability.

Breast cancer is the malignant tumor with the highest incidence in the world. At present, breast cancer treatment has entered the era of classified treatment guided by molecular markers. Androgen receptor (AR) is a commonly expressed molecular marker in breast cancer, which regulates breast cancer cell activities. In clinical practice, AR expression has an appreciated correlation with the prognosis of breast cancer patients, and AR-targeted therapy and related combination therapies are under investigation. This article summarizes the application of AR in breast cancer from the aspects of mechanism, expression and clinical value, and related therapies, by reviewing the relevant literature in recent years.

To analyze the different biological phenotypic characteristics of Klebsiella pneumoniae and provide an experimental basis for clinical anti-infection treatment.

Clinical Klebsiella pneumoniae isolates were collected from the Qingdao Municipal Hospital, China from January 2018 to October 2019. VITEK-2 compact automatic bacterial identification/susceptibility sensitivity system was used for identification and drug sensitivity testing of clinically isolated strains. The origin and distribution of Klebsiella pneumoniae specimens were analyzed, and the differences in drug resistance rates of Klebsiella pneumoniae with different biological phenotypes were compared.

A total of 1435 strains of Klebsiella pneumoniae were isolated, among which 316 (22.0%) produced extended-spectrum beta-lactamases (ESBLs), 177 (12.3%) were carbapenem-resistant (CR-KP), and 113 (7.9%) were high-virulent (HvKP). Sputum specimens were the most abundant source, in which 489 strains were detected, accounting for 34.1%; the second was urine specimens, with 220 strains isolated, accounting for 15.3%. The departments involved were mainly intensive care unit, emergency ward, and neurosugical ward, accounting for 21.8%, 15.4%, and 10.8%, respectively. Drug sensitivity results showed that the sensitivity of Klebsiella pneumoniae with different biological phenotypes to commonly used antibiotics was quite different; CR-KP had the highest resistance, with a drug resistance rate to most antibiotics being above 80%, followed by ESBLs, and HvKP strains had the lowest resistance, with a drug resistance rate to most antibiotics being less than 10%.

Klebsiella pneumoniae causing nosocomial infection is widely distributed clinically, which can be manifested as a variety of biological phenotypes, and its sensitivity to commonly used antibacterial drugs is also quite different. Therefore, clinical attention should be paid to pathogen examination in the diagnosis and treatment of infectious diseases.

This paper reviews the efforts and achievements of Chinese scientists in studying the pathogenesis, molecular mechanism, and early diagnosis and treatment of esophageal squamous cell carcinoma (ESCC) based on our work. It is suggested that: (1) ESCC is a typical multifactorial disease, and it is very important to protect the esophagus from various physical and chemical injuries to prevent the development of this malignancy; (2) based on a variety of omics studies, it is necessary to adopt a high-quality prospective population study design, integrate existing results to carry out systematic analysis, and explore potential intervention targets in depth; and (3) in the absence of high attributable risk factors, large-scale screening needs to be evaluated in randomized controlled studies to evaluate its effects and health economic value, and at the same time, existing screening models need to be further improved with regard to precision and individualization.

Deep-learning computer-assisted decision-making (DL-CAD) medical device software has high technical content, high clinical value and high social attention. Center for Medical Device Evaluation (CMDE) has introduced several policies to encourage technological innovation and promote industry development. As an innovative clinical application technology, neither manufacturer nor reviewer has enough experience with registration and evaluation of DL-CAD devices. In consequence, many misunderstanding exist in its clinical evaluation requirement. This article aims to provide reference for investigators, manufacturers and reviewers, as well as summarize elements of clinical trial design, and bias control methods, by investigating and surveying global supervision requirements & experience, academic research achievements.

Knee osteoarthritis is a common degenerative disease among middle and old aged people. The expert consensus on stepwise treatment of knee osteoarthritis was established in 2018, in which a staging system and matched therapeutic regimens have been provided. In our opinion, surgical treatment is more characteristic of steps compared with non-surgical treatment which can be throughout the process of management of knee osteoarthritis. So we put forward the concept of stepwise surgical treatment of knee osteoarthritis, which contains four steps (arthroscopic knee surgery, osteotomy around the knee, partial knee arthroplasty, and total knee arthroplasty) based on the extent of anatomy preservation in the knee, aiming to achieve individualization, precision, minimal invasiveness, and intellectualization during the management of knee osteoarthritis and try to perform the step-down surgery.

To investigate the clinicopathologic features and prognostic factors of inflammatory breast cancer (IBC).

We retrospectively analyzed the clinicopathologic characteristics and outcomes of patients with IBC diagnosed at Peking University First Hospital from January 2012 to December 2018.

A total of 25 patients with IBC were included, accounting for 0.89% (25/2811) of newly diagnosed breast cancer cases at our center. All patients had complete clinicopathologic data and follow-up results. Seventeen (68%) patients had stage Ⅲ IBC, and eight (32%) had stage Ⅳ disease. The numbers of patients with luminal B (HER-2 negative), HER-2 positive, and triple-negative breast cancer were 9 (36%), 5 (20%), and 11 (44%), respectively. Nineteen patients underwent surgery, 94.7% of whom achieved local R0 resection. The median survival time was 18.2 months. The 2-year overall survival rates of patients with prognostic stage ⅢB, stage ⅢC, and stage Ⅳ disease were 72.9%, 66.7%, and 15.6%, respectively; there was a significant difference among them (χ²=13.247, P<0.001).

IBC is a rare, aggressive disease with advanced stage and poor disease outcome. Local R0 resection can be achieved in more than 90% of patients after neoadjuvant therapy.

In this article, we discuss the history, current situation, and future prospect of psychosomatic medicine development in China. The development of psychosomatic medicine in China has distinct characteristics. It emerged early but has never formed a complete system. It was not until 1980s that Chinese psychosomatic medicine developed towards the direction of systematization and discipline under the promotion of relevant organizations and international exchanges. In 1993, the Chinese Society of Psychosomatic Medicine was established to promote the continuous progress of psychosomatic medicine in China in scientific research, clinical practice, education, and international exchanges. In the future, on the basis of carrying forward the characteristics of Chinese medicine, Chinese psychosomatic medicine should draw on the advanced experience of Western psychosomatic medicine and be systematized in an orderly manner to realize its rapid development.

The veins and the lymphatic system are anatomically and functionally interdependent. When the venous and lymphatic systems are abnormal in structure or function, different organ or tissue lesions can occur. Venolymphatic insufficiency patients are distributed in multiple clinical departments, which makes standardized treatment quite difficult. In international guidelines and consensus, venolymphatic insufficiency related diseases and their diagnosis and treatment are gradually updated. In China, there is no clear consensus on the definition of venolymphatic insufficiency and the diagnosis and treatment of its related diseases. In order to deepen the understanding of venolymphatic insufficiency, our expert team standardizes its definition, and elaborates its etiology, pathophysiological changes, clinical manifestations, diseases involved, prevention, and treatment, by combining the existing international and domestic literature and multidisciplinary expert opinions. The consensus developed can provide reference for the standardized treatment of venolymphatic insufficiency related diseases in clinical practice.

To assess the clinical effects of minimally invasive ventriculoperitoneal shunting.

Ninety-two patients who underwent ventriculoperitoneal shunting at the Neurosurgery Department of Beijing Bo'ai Hospital from February 2017 to February 2021 were retrospectively analyzed. Aseptic operation steps, minimizing surgical cavity, and puncturing assisted with simple guide tools were adopted during surgery.

All the ventricular catheters were placed in the ideal position. There was one (1.1%) case of shunt related infection and two (2.2%) cases of delayed hematoma, and the overall rate of complications was 3.3%. The neurological function of the rest cases was improved. The Evan's index decreased, the Mini-Mental State Examination score increased, and the modified Ashworth scale score of extremity muscle tension were all improved significantly (P＜0.05 each).

In the process of ventriculoperitoneal shunting, the perioperative complications can be reduced by minimally invasive techniques.

Comprehensive and strict governance of the Party is the political guarantee for the development of the Party and the state in the new era, and is the fundamental follow of exploring the law of Party building in the development of scientific research and innovation. Party building is the fundamental guarantee of scientific research, which determines the direction, depth, and breadth of scientific research. Strengthening Party building in scientific research is an inevitable requirement for implementing the strategy of rejuvenating the country through science and education, strengthening the country through talents and sustainable development, deepening the reform of scientific and technological system, promoting the development of scientific and technological undertakings, and stimulating the vitality of scientific and technological innovation. How to lead scientific research innovation, strengthen the integration of Party building and business, enhance the comprehensive strength of scientific research institutions, improve the confidence and determination of scientific and technological workers in innovation, more widely transform the basic research into productivity, and benefit the mankind are the key issues that Party workers should face in every scientific research institution.