2026年 · 第139卷第20期

To the Editor: Emphysema is a common concomitant pulmonary disease in patients with lung cancer, with an incidence ranging from 20% to 50%.^[1]This association is due to common risk factors, such as smoking and chronic inflammation. Pathologically, emphysema is characterized by reduced elasticity of airspaces distal to the terminal bronchioles, overexpansion, hyperinflation, and increased lung volume and is often accompanied by destruction of the airway wall.^[2]In clinical practice, emphysema is typically diagnosed via chest computed tomography (CT), radiography, and pulmonary function tests. Low attenuation areas (LAAs) are often regarded as emphysematous regions; thus, the extent of emphysema is assessed on the basis of the percentage of LAA. The association of chest CT-defined emphysema with the risk of lung cancer has been well clarified.^[3]However, to our knowledge, whether quantitative CT-defined emphysema is a poor prognostic indicator in patients with lung cancer has not been systematically demonstrated or evaluated. In addition, whether the prognostic impact of CT-defined emphysema is influenced by several parameters, such as treatment modality and pathological type, remains unclear. Therefore, this study aimed to comprehensively and systematically identify the predictive role of the presence and severity of quantitative CT-defined emphysema for long-term survival and treatment-related adverse events in patients with lung cancer.

To the Editor: Obstructive sleep apnea (OSA), the most prevalent form of sleep-disordered breathing, affects approximately one billion adults globally.^[1]One severe OSA-related complication is cognitive dysfunction. Numerous rodent studies have indicated that intermittent hypoxia (IH), an important pathophysiological characteristic of OSA, impairs cognitive function. However, heterogeneity across effect sizes, rodent characteristics, and IH patterns has precluded definitive conclusions. This study aimed to evaluate the impact of IH on cognition and explore the influence of rodent characteristics and IH patterns on cognitive outcomes.

To the Editor: The rising prevalence of type 2 diabetes (T2D) imposes a significant global disease burden.^[1]T2D is associated with multiple complications, of which cardiovascular disease (CVD) is the most common one. Hemoglobin A1c (HbA1c) is a crucial metric for evaluating glycemic control and serves as the primary surrogate marker for T2D-related complications. Most clinical guidelines recommend HbA1c levels <7.0% in adults with T2D.^[2]Some guidelines, such as the American Association of Clinical Endocrinology,^[3]suggest a more stringent target (HbA1c ≤6.5%). In general, HbA1c levels <5.7% are considered normal. In China, the Chinese Diabetes Society recommends more stringent HbA1c targets (e.g., <6.5% or near-normal levels) for younger patients with T2D who do not present with complications.^[4]

To the Editor: Compared with the general population, hemodialysis patients suffer a higher incidence, reinfection rate and mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.^[1]Although the number of newly confirmed COVID-19 cases have shown a downward trend worldwide, SARS-CoV-2 continues to mutate, leading to reinfection. Therefore, in the post-pandemic era, hemodialysis patients still need to be closely monitored and early identification of patients at a high risk of poor prognosis is critical for the optimization of treatment.

To the Editor: T cells are key components of the immune system, playing a critical role in defending against infections and tumors. Dysregulated T-cell immunity can trigger and exacerbate autoimmune diseases.Themis, independently identified by five research groups in 2009,^[1,2,3,4,5]is crucial for T-cell development and function. In peripheral T cells,Themissignificantly influences CD8⁺T cell homeostasis and enhances the responsiveness of TH1 cells to foreign antigen stimulation, playing a pivotal role in immune responses during infection and inflammation.^[6,7,8]