Esophageal cancer is one of the most common gastrointestinal malignancies in China. Surgery remains the cornerstone of curative-intent treatment for patients with resectable disease. However, postoperative recurrence and metastasis remain major causes of poor long-term survival. As an essential component of multidisciplinary treatment, postoperative adjuvant therapy aims to eradicate potential minimal residual disease (MRD), reduce the risk of recurrence, and improve survival outcomes. In recent years, perioperative treatment strategies for esophageal cancer, including chemoradiotherapy and immunotherapy, have evolved rapidly. Nevertheless, considerable controversy remains regarding the indications, treatment regimens, and management strategies for postoperative adjuvant therapy across different clinical settings, and standardized clinical practice is still lacking. To further standardize the clinical practice of postoperative adjuvant therapy for esophageal cancer in China, the Esophageal Cancer Committee of the Chinese Anti-Cancer Association convened a multidisciplinary panel of experts to develop the Chinese Expert Consensus on Postoperative Adjuvant Therapy for Esophageal Cancer (2026 Edition). This consensus addresses key issues, including the fundamental principles and management of postoperative adjuvant therapy, treatment strategies across different clinical scenarios, the application of biomarkers, and the management of special populations. A total of 18 recommendations are proposed to provide standardized and individualized guidance for clinical decision-making and to identify priorities for future clinical research.

With the widespread application of robotic-assisted surgical systems in gynecology, robotic-assisted vNOTES (R-vNOTES) has emerged as an important direction in minimally invasive gynecologic surgery. By improving instrument dexterity, establishing an optimal surgical triangulation, providing threedimensional visualization, and enabling precise manipulation, R-vNOTES effectively avoids abdominal wall trauma and enhances the safety and reproducibility of procedures in complex anatomical regions. This expert consensus systematically summarizes the relevant technical specifications, indications, contraindications, and clinical applications of R-vNOTES in procedures such as hysterectomy, adnexal surgery, myomectomy, endometriosis resection, pelvic floor reconstructive surgery, and selected malignant tumor surgeries. It also discusses future directions in artificial intelligence-assisted planning, 5G based remote operation, and standardized training, aiming to provide standardized guidance for the clinical practice of R-vNOTES.

To improve Chinese hysteroscopic surgeons′ awareness of fluid management risks and standardize the prevention and treatment of operative hysteroscopy intravascular absorption syndrome (OHIA), these expert recommendations summarize the pathogenic factors of OHIA, standardized management of uterine distension media, as well as unified diagnosis, treatment and prevention strategies. The recommendations propose adhering to the principle of minimum effective intrauterine distension pressure during hysteroscopy, clarify influencing factors and monitoring key points of fluid deficit, and conclude clinical manifestations, auxiliary examinations of OHIA-related fluid overload and acute dilutional hypokalemia/hyponatremia, alongside the standardized emergency management workflow for OHIA. This paper highlights that prevention is the priority for OHIA control, and puts forward the "4L" rule and "4E" rule for clinical prevention. Finally, it highlights the critical value of fully automated intraoperative hysteroscopic fluid management in reducing OHIA risk, and prospects future research and development directions in this field.

Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease of unknown etiology, characterized by a relapsing and remitting course. Long-term management of UC depends heavily on patients' disease knowledge, treatment adherence, and self-management capabilities. As an essential component of comprehensive UC management, systematic patient education is of no less importance than pharmacological therapy. To standardize and optimize patient education for UC in China, this consensus was developed by experts in gastroenterology and inflammatory bowel disease (IBD). Based on a review of the latest evidence-based medical literature combined with Chinese clinical practice, the consensus comprises 15 recommendation statements across four parts. Part Ⅰ addresses disease cognition education, including establishing correct disease perceptions, understanding the complexity of the diagnostic process, maintaining continuity of care with a fixed IBD team, individualized pharmacotherapy, and discernment of non-evidence-based therapies. Part Ⅱ covers treatment management education, encompassing disease self-monitoring skills, recognition of functional bowel symptoms during remission, promotion of the "Treat-to-Target" concept, and regular follow-up. Part Ⅲ provides lifestyle guidance, including individualized nutritional management and stage-specific exercise interventions. Part Ⅳ focuses on special population management, addressing pregnancy planning in women of childbearing age, recognition of extraintestinal manifestations, surveillance colonoscopy for colorectal neoplasia in long-standing UC, and psychological assessment and intervention. This consensus aims to help UC patients develop accurate disease perceptions, enhance treatment adherence and self-management abilities, achieve long-term stable disease control, and ultimately improve quality of life and long-term prognosis.

Knee osteoarthritis (KOA) is a common degenerative joint disorder that substantially affects the quality of life of a large proportion of the aging population worldwide. Since the publication of ＜the 2018 Expert consensus on the stepped treatment of knee osteoarthritis＞, the stepped treatment of knee osteoarthritis has been widely implemented and clinically validated, demonstrating significant benefits in symptom relief and functional improvement. As a core therapeutic concept, the stepped treatment approach emphasizes the selection of individualized interventions according to disease stage and symptom severity. Through sequential and progressive treatment strategies, it aims to provide effective management for patients with KOA at different stages, alleviate pain, improve joint function, and enhance health-related quality of life. This updated expert consensus retains the fundamental principles of stepped treatment while incorporating recent advances in therapeutic techniques and scientific evidence. Emerging biological therapies have demonstrated potential in the management of early-to moderate-stage KOA, providing additional treatment options within the stepped care framework. Furthermore, the integration of digital-assisted technologies has enabled more personalized and precise treatment strategies, particularly in surgical management, by improving procedural accuracy and potentially optimizing postoperative outcomes. This revision focused on updating novel concepts, emerging approaches, and advances in KOA stepped treatment. The objective of this consensus is to provide evidence-based, standardized, and practical recommendations for healthcare providers, medical institutions, and clinicians at different levels of care, thereby facilitating the effective implementation of stepped treatment t strategies for KOA.

With the continuous improvement of long-term survival rates among solid organ transplantation (SOT) recipients, de novo malignancy (DNM) following transplantation have become a critical factor impairing long-term prognosis and causing non-organ-failure-related mortality. The risk profile and disease spectrum of DNM vary across different types of SOT recipients, modulated by multiple factors including ethnicity, primary underlying diseases, intensity of immunosuppression, regional environmental conditions, and patterns of viral infection. Distinct differences exist in demographic characteristics and cancer epidemiology between Chinese SOT recipients and their Western counterparts, rendering overseas evidence and recommendations not fully applicable to clinical practice in China. Against this backdrop, the Organ Transplantation Rehabilitation Committee of Chinese Association of Rehabilitation Medicine convened multidisciplinary experts to formulate the Clinical Practice Guidelines on De Novo Malignancies After Solid Organ Transplantation in Adult in China. Integrating domestic and international evidence-based medical data alongside real-world clinical experience in China, this guideline proposes clinical recommendations for risk assessment, screening, surveillance and management of post-transplant DNM specifically tailored to adult Chinese SOT recipients, so as to provide evidence-based references for clinical identification, monitoring and standardized management of DNM in this population.

Highly pathogenic fungi are classified as Category Ⅱ pathogenic microorganisms in the Catalogue of Pathogenic Microorganisms Transmissible to Humans. With the increasing use of histopathology, fungal culture, serological assays, mass spectrometry-based identification, and high-throughput sequencing in the diagnosis of difficult-to-identify infections, these pathogens are increasingly detected, isolated, and re-identified from clinical specimens, thereby creating an urgent need for standardized management of diagnosis-related positive cultures, suspected isolates, confirmed strains, and residual infectious materials. The spore-producing nature, prolonged environmental survival, and dimorphic transition confer distinctive biological characteristics that render strain preservation, transport, inactivation, and retirement management particularly challenging. Current regulations provide only general principles for preservation, transport, and inactivation, lacking technical specifications tailored to fungal biology. The Fungal Study Group of the Chinese Medical Association Dermatology Branch, in collaboration with multidisciplinary experts, systematically reviewed domestic and international regulations and literature, conducted preliminary investigations to generate a pool of candidate items, and employed a modified Delphi method to solicit expert opinions. Consensus was defined as simultaneously meeting the following four criteria: (1)≥ 75% of experts scoring 4-5 (agree/strongly agree); (2)<10% of experts scoring 1-2 (strongly disagree/disagree); (3)< 20% of experts scoring 3 (neutral); (4)a median score≥ 4. Evidence levels and recommendation strengths were graded according to the Oxford Centre for Evidence-Based Medicine criteria. Nine recommendations were ultimately formulated, covering seven domains: prerequisites for biological safety level 3 (BSL-3) laboratories, preservation zoning and container management, inbound and outbound inventory verification, intra-hospital and inter-institutional transport, liquid and solid material inactivation, emergency response to leakage, post-exposure medical management, and strain retirement and disposal. This consensus represents China′s first operational technical document specifically addressing preservation, inventory handling, operation, transport and shipping, disposal, risk management, and emergency response of highly pathogenic fungal strains. It aims to translate statutory requirements into fungal-specific, enforceable, verifiable, and traceable technical standards, providing a management framework for qualified laboratories engaged in pathogenic diagnosis, re-identification, and strain management.

Single-port robotic adrenalectomy offers advantages over conventional laparoscopic surgery in terms of reduced postoperative pain and superior cosmetic outcomes, however, there is currently no unified standard for surgical protocols or patient selection criteria either domestically or internationally. This consensus was based on a review of 108 Chinese and English publications and a standardized questionnaire survey involving 45 senior urology experts from 40 tertiary hospitals across China. It provides systematic recommendations covering preoperative evaluation, surgical approaches, equipment and instruments, key procedural steps, complication management, and surgeon training. The consensus recommends that a maximum tumor diameter of <5 cm as the primary indication. Tumor size, location, and patient obesity are important factors affecting the difficulty of single-port surgery, and the transperitoneal approach is preferable for relatively large or inferiorly located tumors. Key operative points for the single-port robotic adrenalectomy are specified. A graded management strategy is proposed for complications, including hemorrhage, visceral injury, incisional hernia, and adrenal insufficiency. This consensus aims to standardize clinical workflows, reduce complication risks, and lay a foundation for the broader adoption of this technique and for future high-quality clinical research.

Urethral catheterization is one of the most fundamental routine clinical procedures. Males are more prone to difficult catheterization due to the anatomical characteristics of the urethra. Blind manipulation may cause iatrogenic urethral injury and long-term urethral stricture, yet unified domestic standards are currently absent in China. Based on the GRADE evidence grading system, combined with domestic and international evidence-based medical data and the actual clinical practice in China, the consensus on the management of difficult male urethral catheterization has been formulated. This consensus clarifies the standardized definition and three-tier clinical grading criteria for difficult male urethral catheterization, and systematically sorts out risk factors including benign prostatic hyperplasia, urethral stricture, pelvic trauma and iatrogenic manipulation. It standardizes preoperative assessment and tiered procedural workflows, and recommends a stepwise management algorithm consisting of conventional catheterization, coude catheterization, guidewire-assisted catheterization, endoscopic-guided catheterization, and suprapubic puncture cystostomy. Strategies for the prevention and treatment of complications such as hemorrhage, false passage, infection and secondary urethral stricture are elaborated in detail, and tiered training for medical staff, procedural quality control and consultation protocols are also proposed. The consensus emphasizes that non-urological practitioners shall promptly refer patients to specialized urologists when encountering high-risk scenarios such as catheter resistance or hematuria, to avoid repeated forceful catheterization. This consensus provides unified, actionable guidance for medical staff at all levels of medical institutions to manage difficult male urethral catheterization, standardizes clinical workflows, and lowers the risk of urethral injury caused by inappropriate catheterization operations.

Artificial intelligence (AI) technologies are rapidly being applied across all segments of colorectal cancer management, including cancer screening, endoscopic diagnosis and treatment, imaging and pathological analysis, therapeutic decision‐making, intraoperative assistance, and follow‐up management. Nevertheless, substantial disparities exist among various AI systems in terms of task definition, data sources, validation methodologies, performance metrics, safety thresholds, and real‐world clinical practicability. There is an urgent need to establish a dedicated evaluation framework tailored to clinical scenarios specific to colorectal cancer. To address this demand, the Colorectal Surgery Group of the Chinese Society of Surgery (Chinese Medical Association), the Colorectal Cancer Committee of China Anti‐Cancer Association, and the Colorectal Surgeon Expert Group of the Surgeon Branch (Chinese Medical Doctor Association) jointly assembled a working group composed of specialists covering colorectal surgery, digestive endoscopy, medical imaging, pathology, medical oncology, radiation oncology, artificial intelligence, medical statistics, medical informatization, medical ethics, and regulations. Through systematic literature retrieval, collation of existing clinical guidelines and regulatory documents, expert letter consultations, and panel discussions, the working group formulated 13 recommendations graded by levels of evidence and strength of recommendation, and developed the Expert Consensus on Evaluation Standards for Artificial Intelligence Applications in Colorectal Cancer (2026 Edition). This consensus establishes a tiered evaluation framework centered on seven core dimensions: algorithmic performance, clinical safety, clinical efficacy, user experience, model interpretability, ethical compliance, and continuous supervision. It further clarifies targeted evaluation requirements for key AI application scenarios, including AI‐assisted lesion detection during endoscopy, AI‐aided diagnosis via imaging and pathological slides, generative AI and clinical decision support, intraoperative AI assistance, and real‐world surveillance of AI systems. The consensus underscores that AI systems shall only serve as auxiliary clinical tools and must not replace clinicians to independently render diagnostic, therapeutic or surgical decisions. Prior to clinical deployment, all AI systems for colorectal cancer shall undergo rigorous validation commensurate with their risk classification, implement disease‐specific safety red lines, mandate mandatory clinician review, and enforce full‐lifecycle supervision throughout clinical use.

In 2026, the American Heart Association/American Stroke Association issued the "2026 guideline for the early management of patients with acute ischemic stroke" (referred to as the "2026 guideline"). This update revises the 2018 guideline and its 2019 addendum, incorporating the latest advances in the field. Key updates of the 2026 guideline include the incorporation of new evidence related to thrombolytic choice and eligibility, determination of eligibility for endovascular thrombectomy, and management of hyperglycemia and dysphagia; a focused consideration for the pediatric population; and an optimized strategy for assessing contraindications to thrombolysis. In order to facilitate the in-depth understanding and better application of the guidelines by medical staff, update points of the 2026 guideline are summarized.