The 2026 Annual Congress of the Chinese Thoracic Society (CTS 2026), themed “Focusing on High-Quality Clinical Research and Improving Respiratory Healthcare,” brought together experts and young physicians from across China to discuss advances in respiratory critical care, chronic obstructive pulmonary disease, asthma, respiratory infections, lung cancer, interstitial lung disease (ILD), pulmonary vascular diseases, sleep-related breathing disorders, rare diseases, and other areas.
At CTS 2026, young physicians were not only learners listening to the latest advances, but also active participants who took the stage, joined panel discussions, and exchanged ideas with colleagues. Through these interactions, they gained a clearer understanding of their own strengths and limitations while identifying new directions for their clinical and academic development.
Four young physicians—Dr. Ting Qiu from Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Dr. Xiaoxiao Yuan from Inner Mongolia People’s Hospital; Dr. Qian Luo from Xinjiang Production and Construction Corps Hospital; and Dr. Huaiya Xie from Peking Union Medical College Hospital—shared their experiences and reflections from CTS 2026.
Ting Qiu — Writing Research Around Patient Benefit and Turning Clinical Questions into Evidence from China
As a young respiratory physician, and particularly as a clinician who has been closely involved in the diagnosis and management of interstitial lung disease, what impressed me most at this meeting was not any particular new drug or technology, but a question that seemed to run throughout the entire congress: What makes clinical research truly valuable?
After several days of learning and discussion, my answer has become increasingly simple: research should begin with bona fide clinical questions and ultimately return to patient benefit. This to me is at the heart of high-quality clinical research.
Rethinking ILD Through New Classification Concepts, professor Huaping Dai’s presentation on the evolving classification and management of interstitial pneumonia left a particularly strong impression on me. ILD remains one of the most challenging areas in respiratory medicine. It is not a single disease, but a highly heterogeneous group of disorders. Similar radiographic patterns may reflect very different underlying causes, disease behaviors, and prognoses, and may therefore require completely different treatment strategies.
In clinical practice, we have traditionally focused on establishing the most likely diagnosis for a patient. However, emerging concepts in disease classification are encouraging us to reconsider a more fundamental question: What is the ultimate purpose of classification? The 2025 international multidisciplinary classification of interstitial pneumonias developed by ERS/ATS represents an important evolution, including the incorporation of secondary ILD into a more unified framework and further emphasizing the distinction between morphological patterns and clinical disease diagnoses. The significance of this change goes beyond terminology. A more standardized multidisciplinary diagnostic and classification framework should ultimately serve patient management.
This made me realize that classification should never be an end in itself. What clinicians truly need to determine is: Why has this patient developed ILD? At what stage is the disease? Is it likely to progress? Should the patient receive anti-inflammatory therapy, immunomodulatory treatment, or antifibrotic therapy? When should treatment be initiated or modified? And, ultimately, how can we determine whether a treatment has truly benefited the patient? When classification is viewed through the lens of disease behavior and long-term outcomes, the questions we ask in clinical research also begin to change.
ILD and Lung Cancer: Making “Patient Benefit” a Concrete Question. Professor Xiaoju Zhang’s presentation on early recognition, diagnosis, and treatment strategies for lung cancer in patients with ILD gave me an even more concrete understanding of what “patient benefit” means. For patients with ILD, lung cancer is an important comorbidity that cannot be overlooked in clinical practice. The challenge is not simply determining whether a tumor is present. Rather, clinicians must navigate a series of complex decisions arising from the interaction between two serious diseases.
How can suspicious lesions be identified earlier against the complex radiographic background of fibrotic lung disease? Once lung cancer is diagnosed, how can we balance the potential benefits of cancer treatment against the risks of acute exacerbation of ILD and treatment-related lung injury? How should surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy be selected? These questions require close collaboration among respiratory physicians, radiologists, pathologists, thoracic surgeons, oncologists, and other specialists.
This is where the value of clinical research becomes most tangible. We do not simply need to know whether a treatment is “effective”. We need to understand: Which patients benefit? At what point should treatment be initiated? How large is the benefit? What are the risks? And, ultimately, does the treatment help patients live longer and live better? Particularly in complex clinical settings such as ILD complicated by lung cancer, many questions remain inadequately addressed by high-quality prospective evidence. Large-scale prospective studies are still needed to develop treatment strategies that are better suited to this unique patient population. This has also helped me understand why the 2026 congress placed high-quality clinical research and improving respiratory healthcare within the same overarching theme.
The Quality of Research Should Ultimately Be Measured by Its Impact on Patient Care. For young physicians, confidence in research is often hidden within the unanswered questions we encounter every day. When we think about research, it is easy to focus first on our limitations: perhaps our institution is not large enough, our patient cohort is relatively small, our methodological skills are still developing, or we do not yet have access to the extensive resources of established research teams. When confronted with large multicenter clinical studies and high-impact publications, we may sometimes feel that such research is far beyond our reach. But after attending this congress, I increasingly feel that we may underestimate one of the most important advantages young clinicians possess: We are close to our patients.
An ILD patient may experience a continuous decline in pulmonary function, while clinicians remain uncertain about when treatment should be initiated or modified. A small pulmonary nodule may be difficult to characterize against the background of fibrosis—whether it represents inflammation, fibrosis, or an early-stage malignancy. A patient may develop an unexpected clinical problem while receiving treatment according to current recommendations—an issue that existing guidelines do not fully address. These questions arise every day in our outpatient clinics and hospital wards. Perhaps what we lack is not research questions, but the ability to recognize clinical uncertainty and transform it into a scientific question.
Professor Bin Cao, Chair of the congress, summarized the purpose of clinical research with the phrase: “Find the truth, change the practice.” He emphasized that clinical research should begin with genuine clinical problems, generate reliable evidence, and ultimately return to clinical decision-making and improve patient care. This message is particularly meaningful for young physicians.
Research confidence does not mean believing that we will immediately conduct a study capable of changing clinical guidelines. Rather, it means believing that the unanswered question we encounter at the bedside today is worth investigating seriously. Turn clinical questions into evidence from China. Chinese respiratory medicine now has a stronger research foundation than ever before. Experts from CTS and ERS have also recognized the substantial growth in both the quantity and quality of respiratory research from China over the past decade, with an increasing number of Chinese studies entering the international respiratory literature.
For young physicians, this means that our research goals should also evolve. The goal should not simply be to “publish a paper,” but to generate evidence that addresses important clinical questions faced by Chinese patients.
China has a large population of patients with respiratory diseases and a remarkably diverse range of real-world clinical scenarios. The composition of ILD subtypes, patterns of disease progression, treatment responses, and the early detection, risk stratification, and treatment of lung cancer in patients with ILD all require more evidence from Chinese populations and more prospective research.
The starting point of a young clinician’s research may be nothing more than an unanswered question encountered at the bedside. But the endpoint should not simply be publication. From emerging concepts in ILD classification and management to the early recognition and treatment of lung cancer in patients with ILD, we are ultimately working toward the same goal: to identify disease earlier, assess prognosis more accurately, select treatments more rationally, and ultimately improve outcomes for our patients.
As young respiratory physicians, the confidence we need to develop is not the confidence that we will publish a certain number of papers. It is the confidence that our clinical questions are worth pursuing, that rigorous research can provide meaningful answers, and that Chinese physicians can use evidence from Chinese patients to address clinical questions shared by the international medical community.
Write our research around patient benefit. Turn clinical questions into evidence from China. Perhaps this is the most important message CTS 2026 has left with me, and a direction toward which our generation of young respiratory physicians can continue to work for many years to come.
Xiaoxiao Yuan — Learning to Fill the Gaps, and Putting Knowledge into Practice
I participated in the Young Physicians’ English Session on Lung Cancer and Pleural Diseases at CTS 2026 and served as a panel discussant during the afternoon session on September 19. As a newly appointed young committee member, this was my first experience participating in a major academic congress organized by the society. Immersing myself in a fully English-speaking academic environment was both challenging and highly rewarding.
The entire young physicians’ session was conducted in English. Speakers presented their latest research findings in English, while participants engaged in discussions and questions in English, focusing on current challenges and emerging topics in lung cancer and pleural diseases. For me, actively participating in these discussions and interactions was a valuable opportunity for practical training. At the same time, it made me more aware of the areas in which I still need to improve.
During spontaneous academic discussions in English, I realized that my professional English communication was not yet as fluent as I would like, particularly when responding to questions and different viewpoints in real time. This experience showed me that high-level international academic communication requires young physicians to develop not only clinical and research expertise, but also the ability to communicate and think critically in an international setting.
The theme of CTS 2026—“Focusing on High-Quality Clinical Research and Improving Respiratory Healthcare”—also deepened my understanding of the responsibilities of young physicians. High-quality clinical research requires rigorous methodology and meaningful results, but it also requires researchers to communicate their findings clearly, present them in appropriate academic language, respond thoughtfully to questions, and engage constructively with peers. For Chinese respiratory medicine to participate more actively in international academic dialogue and further strengthen its global academic presence, young physicians need to take the initiative and contribute.
This congress allowed me to confront my own limitations while also clarifying the direction in which I need to grow. Going forward, I will continue to strengthen my clinical and research foundations, improve my academic English and ability to respond to questions in real time, and move forward steadily along my path in clinical research.
Qian Luo — From the Frontier to the Greater Bay Area, Our Commitment to Respiratory Health Remains the Same
As a respiratory physician working in a frontier region of China, I was honored to attend CTS 2026 in Guangzhou as a young committee member.
At the opening ceremony, I participated in the choral performance “One Breath, One Journey, One Blooming Future”. Standing on the stage and singing together with respiratory physicians from across the country, I was deeply reminded that although we may work in very different geographical settings—from frontier regions to the Greater Bay Area—we are united by the same commitment to respiratory health.
I also participated as a discussant in the young physicians’ English session on COPD and asthma. The session focused on recent advances in COPD and asthma, including COPD-associated sarcopenia, refractory cough, precision phenotyping and biomarkers in asthma, artificial intelligence-assisted pulmonary rehabilitation, and county-level COPD management. The presentations covered both basic research and practical approaches to improving respiratory care at the primary-care level. Drawing on our clinical experience in respiratory medicine within the Xinjiang Production and Construction Corps, I shared perspectives on standardized management and longitudinal care for patients with COPD and asthma and exchanged ideas with experts and colleagues.
These discussions helped me recognize both the progress we have made and the areas where further work is needed. In particular, there remains considerable room for improvement in standardized management and long-term follow-up of patients with COPD and asthma in primary-care settings in frontier regions.
This congress also reminded me that respiratory medicine is increasingly integrating different areas of expertise while placing greater emphasis on translating research findings into clinical practice.
From frontier regions to the Greater Bay Area, our geographical environments may be different, but our goal remains the same: to protect and improve the respiratory health of our patients. After returning to clinical practice, I hope to translate what I have learned into better patient care and help more patients benefit from advances in respiratory medicine.
Huaiya Xie — At CTS, Young Physicians Can See Where High-Quality Research Begins
My opportunity to attend CTS 2026 came from being invited to present a case in the Respiratory Genetics and Rare Disease MDT & Case Presentation session.
Case Presentation: The Critical Details Across Clinical Medicine, Imaging, and Pathology
At CTS, I presented a rare case of systemic light-chain (AL) amyloidosis with diffuse pulmonary involvement and progressive pneumothorax. Before the presentation, I already knew that this was an unusual and instructive case. The patient had experienced a ten-month diagnostic journey before admission and had previously been treated for pulmonary tuberculosis and diffuse parenchymal lung disease without significant improvement.
During hospitalization, careful physical examination by the resident physician revealed several subtle but critical clues: hypotension, low voltage on limb-lead ECG, and macroglossia. Together, these findings pointed toward the possibility of amyloidosis. Subsequent serum free light-chain testing and tongue biopsy confirmed systemic AL amyloidosis. Advanced AV45 PET/CT imaging further demonstrated pulmonary involvement, completing a coherent diagnostic chain.
However, while preparing for the presentation, my initial understanding of the case focused primarily on its rare clinical manifestations and the application of new technologies. The comments from experts in pathology and imaging provided a much deeper perspective. They connected the pathological findings through a potential sequence: vascular amyloid deposition → vascular occlusion and tissue necrosis → peripheral pulmonary cystic changes → pneumothorax. This helped explain the unusual clinical manifestation from a pathophysiological perspective. I realized that I am often attracted by new technologies and novel methodologies, while sometimes overlooking the importance of careful clinical, radiological, and pathological observation. This case served as an excellent reminder. It began with a resident physician recognizing subtle clinical clues and helping answer “What is the diagnosis?” It ultimately became much more meaningful when experts integrated the imaging and pathological findings to explain “Why did this happen?”
Poster Presentation — A Seemingly Simple Clinical Study
While waiting for the case presentation, I visited a colleague’s poster and took the opportunity to study his research project, “A Clinical Comparison of Pulmonary Function Testing Using Ultrasonic and Differential-Pressure Spirometers.” The study demonstrated consistent systematic differences between pulmonary function measurements obtained using the two types of spirometers. The ultrasonic spirometer produced significantly higher measurements of FEV1, FVC, and TLC, while DLCO measurements were lower. Although FEV1 and DLCO showed relatively good agreement, the clinical agreement rates for FVC and TLC were only 68% and 27%, respectively. These findings have practical implications for outpatient follow-up. When we observe changes in pulmonary function values over time, we need to consider not only changes in the underlying disease, but also the possibility of systematic differences introduced by changing measurement devices.
This was a seemingly simple study: 73 patients underwent paired measurements using two pulmonary function systems over a period of two months. Yet its findings were clinically relevant and were recognized by senior colleagues as the result of careful work. It reminded me of the times when I had hesitated to submit a small study because I felt that it was not sufficiently significant or sophisticated. But perhaps a study does not need to answer a grand question to be meaningful. If the data are carefully collected, the analysis is rigorous, and the study addresses a genuine question in clinical practice, even a small study can contribute something worth sharing.
Annual Advances, Seeing the Starting Points Behind Landmark Research
After the case presentation, I walked through the corridor on the second floor of Block 3, where the most prominent displays were those highlighting the Annual Advances in Respiratory Medicine. I saw the lung cancer section highlighting the development of Sunvozertinib for advanced NSCLC with EGFR exon 20 insertion mutations, as well as the rare disease section presenting a new screening questionnaire for primary ciliary dyskinesia (PCDSOS).
Seeing these high-impact studies published in journals such as The Lancet Respiratory Medicine, Journal of Clinical Oncology, and BMC Medicine initially made these achievements seem distant. I was reminded of how one of our professors described the origins of research into hereditary bronchiectasis: it began with a single case of cystic fibrosis and gradually developed through years of clinical observation, research, and collaboration. The impressive achievements we see today were never created overnight. They were built upon one clinical case after another and one research project after another.
The theme of CTS 2026 was “Focusing on High-Quality Clinical Research and Improving Respiratory Healthcare.” Reflecting on the congress, I have come to realize that high-quality research may begin with nothing more than a clinical case that deserves a second look, or a dataset that raises an important question. Perhaps next year, I will begin with a submission of my own—a new case report or a small clinical study—and then return to CTS to continue learning and growing as a young physician.
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