Background and Aims:Pancreatic cancer is one of the most aggressive malignancies of the digestive system and is associated with an inferior prognosis.In recent years,its incidence has shown a trend toward younger onset.Early-onset pancreatic cancer(EOPC),defined as pancreatic cancer diagnosed at≤50 years of age,has been increasing annually and may possess distinct biological and prognostic characteristics.Given the limited data from China,this study aimed to investigate the clinicopathological features and prognostic outcomes of EOPC patients.Methods:Clinical data of 113 patients with EOPC admitted to Xiangya Hospital,Central South University,from January 2017 to December 2023 were retrospectively analyzed.Variables included demographic characteristics,clinicopathological features,and survival information.Kaplan-Meier survival curves were plotted,and differences in survival between the surgical and non-surgical groups were compared.Results:The median age at diagnosis was 46(42-49)years,and males accounted for 65.49%of cases.Blood type A(40.71%)and type O(34.51%)were most common.The main presenting symptoms were abdominal pain(69.91%),weight loss(62.83%),jaundice(43.36%),and abdominal distension(36.28%).Imaging findings showed bile duct dilation in 32.74%,pancreatic duct dilation in 39.82%,vascular invasion in 59.29%,and distant metastasis in 52.21%of patients.Histopathology revealed that adenocarcinoma and ductal adenocarcinoma accounted for 93.81%of all cases,with predominantly moderate or poor differentiation(76.10%).Tumors were the most frequently located in the pancreatic head(65.42%).TNM staging showed lymph node metastasis in 77.88%and stage Ⅳ disease in 52.21%.Laboratory tests demonstrated markedly elevated CA19-9 levels.Kaplan-Meier analysis indicated a median overall survival of 18.6 months for the entire cohort,with significantly longer survival in the surgical group compared with the non-surgical group(29.4 months vs.13.8 months,P=0.001 5).Conclusion:EOPC predominantly affects males and tends to arise in the pancreatic head.It is often diagnosed at an advanced stage or with distant metastasis and is characterized by poor differentiation and strong invasiveness.Surgical resection markedly improves survival and remains the key to prolonged prognosis.Young individuals presenting with unexplained abdominal pain,weight loss,or jaundice should be carefully evaluated through imaging to enable early diagnosis and timely surgical intervention.Future multicenter,large-sample prospective studies are warranted to validate these findings further.

In 2025,the International Association of Pancreatology(IAP),in collaboration with the American Pancreatic Association,European Pancreatic Club,Indian Pancreas Club,and Japan Pancreas Society,released the International Association of Pancreatology revised guidelines on acute pancreatitis 2025.This edition represents a comprehensive revision of the 2013 guidelines,based on high-quality evidence accumulated over the past decade,particularly randomized controlled trials.The guidelines encompass 18 key areas-including pain management,fluid therapy,nutritional support,management of infected necrosis,complication control,discharge and follow-up,and recurrence prevention-offering a total of 96 recommendations that emphasize individualized treatment.These updates provide important guidance for standardizing clinical practice and improving outcomes in acute pancreatitis,while also indicating future research directions such as the development of targeted therapies.However,some recommendations remain limited by lower evidence quality,uncertain applicability in specific clinical settings,and insufficient consideration of economic burden and cost-effectiveness.

Background and Aims:Pancreatic cancer is one of the most aggressive malignancies of the digestive system and is associated with an inferior prognosis.In recent years,its incidence has shown a trend toward younger onset.Early-onset pancreatic cancer(EOPC),defined as pancreatic cancer diagnosed at≤50 years of age,has been increasing annually and may possess distinct biological and prognostic characteristics.Given the limited data from China,this study aimed to investigate the clinicopathological features and prognostic outcomes of EOPC patients.Methods:Clinical data of 113 patients with EOPC admitted to Xiangya Hospital,Central South University,from January 2017 to December 2023 were retrospectively analyzed.Variables included demographic characteristics,clinicopathological features,and survival information.Kaplan-Meier survival curves were plotted,and differences in survival between the surgical and non-surgical groups were compared.Results:The median age at diagnosis was 46(42-49)years,and males accounted for 65.49%of cases.Blood type A(40.71%)and type O(34.51%)were most common.The main presenting symptoms were abdominal pain(69.91%),weight loss(62.83%),jaundice(43.36%),and abdominal distension(36.28%).Imaging findings showed bile duct dilation in 32.74%,pancreatic duct dilation in 39.82%,vascular invasion in 59.29%,and distant metastasis in 52.21%of patients.Histopathology revealed that adenocarcinoma and ductal adenocarcinoma accounted for 93.81%of all cases,with predominantly moderate or poor differentiation(76.10%).Tumors were the most frequently located in the pancreatic head(65.42%).TNM staging showed lymph node metastasis in 77.88%and stage Ⅳ disease in 52.21%.Laboratory tests demonstrated markedly elevated CA19-9 levels.Kaplan-Meier analysis indicated a median overall survival of 18.6 months for the entire cohort,with significantly longer survival in the surgical group compared with the non-surgical group(29.4 months vs.13.8 months,P=0.001 5).Conclusion:EOPC predominantly affects males and tends to arise in the pancreatic head.It is often diagnosed at an advanced stage or with distant metastasis and is characterized by poor differentiation and strong invasiveness.Surgical resection markedly improves survival and remains the key to prolonged prognosis.Young individuals presenting with unexplained abdominal pain,weight loss,or jaundice should be carefully evaluated through imaging to enable early diagnosis and timely surgical intervention.Future multicenter,large-sample prospective studies are warranted to validate these findings further.

In 2025,the International Association of Pancreatology(IAP),in collaboration with the American Pancreatic Association,European Pancreatic Club,Indian Pancreas Club,and Japan Pancreas Society,released the International Association of Pancreatology revised guidelines on acute pancreatitis 2025.This edition represents a comprehensive revision of the 2013 guidelines,based on high-quality evidence accumulated over the past decade,particularly randomized controlled trials.The guidelines encompass 18 key areas-including pain management,fluid therapy,nutritional support,management of infected necrosis,complication control,discharge and follow-up,and recurrence prevention-offering a total of 96 recommendations that emphasize individualized treatment.These updates provide important guidance for standardizing clinical practice and improving outcomes in acute pancreatitis,while also indicating future research directions such as the development of targeted therapies.However,some recommendations remain limited by lower evidence quality,uncertain applicability in specific clinical settings,and insufficient consideration of economic burden and cost-effectiveness.

Nipah virus is a highly pathogenic zoonotic virus.The viral characteristics,epidemiological features,viral life cycle and pathogenic mechanisms of Nipah virus were summarized in the article,and the alternative drugs tar-geting various stages of the viral life cycle,including antibody drugs,peptide drugs,and small molecule com-pounds,were systematically reviewed.The current challenges confronting the process of research and development of alternative drugs for Nipah virus were analyzed,and an outlook was also made on future research direction of candidate drugs for Nipah virus,aiming to provide comprehensive and in-depth theoretical reference for prevention and control of Nipah virus as well as the development of drugs and to facilitate the further development of related fields.

Nipah virus is a highly pathogenic zoonotic virus.The viral characteristics,epidemiological features,viral life cycle and pathogenic mechanisms of Nipah virus were summarized in the article,and the alternative drugs tar-geting various stages of the viral life cycle,including antibody drugs,peptide drugs,and small molecule com-pounds,were systematically reviewed.The current challenges confronting the process of research and development of alternative drugs for Nipah virus were analyzed,and an outlook was also made on future research direction of candidate drugs for Nipah virus,aiming to provide comprehensive and in-depth theoretical reference for prevention and control of Nipah virus as well as the development of drugs and to facilitate the further development of related fields.

BACKGROUND: Few studies have explored the modifications by family stress and male gender in the relationship between early exposure to traffic-related air pollution (TRAP) and allergic rhinitis (AR) risk in preschool children. METHODS: We conducted a case-control study of 388 children aged 2-4 years in Shenyang, China. These children AR were diagnosed by clinicians. By using measured concentrations from monitoring stations, we estimated the exposures of particulate matter less than 10 μm in diameter (PM RESULTS: The prevalence of AR in children aged 2-4 years (6.4%) was related to early TRAP exposure. With an IQR (20 μg/m CONCLUSIONS Family stress and male gender may increase the risk of AR in preschool children with early exposure to PM
Air Pollution/adverse effects* ; Case-Control Studies ; Child, Preschool ; China/epidemiology* ; Cities ; Family/psychology* ; Female ; Humans ; Male ; Prevalence ; Rhinitis, Allergic/epidemiology* ; Risk Factors ; Stress, Psychological/complications* ; Traffic-Related Pollution/adverse effects*

Objective:To investigate the prevalence of carotid artery plaque (CP) in the population undergoing health examinations and to assess the association between CP and Helicobacter pylori (Hp) infection.Methods:The subjects were 3066 patients who underwent carotid ultrasonography examination and 13C urea breath test (UBT) at the health examination center of China-Japan friendship hospital from January 2019 to December 2019. The subjects were divided into CP and non-CP groups; the differences of physicochemical parameters and UBT positive rate between the two groups were analyzed by independent sample t test, Mann-Whitney U test, and Chi-squared test. The association between UBT positive and CP was analyzed by logistic regression. Results:The proportion of CP positive subjects was significantly higher in males than in females (33.4% vs 19.5%, P<0.001); the proportion of Hp positive subjects was not significant in sex composition (29.1% vs 30.9%, P=0.245); the age [(59.39±10.24) vs (46.44±9.88) years], P<0.01), BMI [(25.44±3.23) vs (24.21±3.54) kg/m 2, P<0.01], SBP [(135.91±19.07) vs (123.03±16.66) mmHg, P<0.01], DBP [(79.64±11.47) vs (75.10±11.55) mmHg, P<0.01], TC [(4.96±0.98) vs (4.86±0.98) mmol/L, P=0.004], TG [1.43 (1.03, 2.06) vs 1.20 (0.82,1.88) mmol/L, P<0.001], LDL-c [(3.21±0.93) vs (3.04±0.83) mmol/L, P<0.01)], FBG [5.55 (5.11,6.47) vs 5.16 (4.83,5.56) mmol/L, P<0.001], UA [(339.13±79.92) vs (319.85±87.62) mmol/L, P<0.01] and Hcy [13.10 (11.30,15.60) vs 11.7 (10.00,13.90) mmol/L, P<0.001] were significantly higher in the CP group than that in the non-CP group; HDL-c was significantly lower in the CP group than in the non-CP group [1.12 (0.95,1.32) vs 1.20 (1.00,1.43) mmol/L, P<0.001]. The proportion of male (62.4% vs 44.6%, P<0.01), prevalence of tobacco smoking (31.9% vs 19.6%, P<0.01), hypertension (33.8% vs 12.5%, P<0.01), and diabetes (13.45% vs 3.5%, P<0.01) were significantly higher in the CP group than that in the non-CP group. The proportion of UBT positive subjects was significantly higher in the CP group than in the non-CP group (34.5% vs 28.4%, P=0.001). Logistic regression analysis showed a significantly positive association between CP and UBT positive after adjusted confounding factors ( OR=1.270, P=0.028). Conclusions:The formation of CP is related to many risk factors; Hp infection is also an important risk factor. Controlling Hp infections might be one of the effective methods for the prevention and control of carotid plaque formation.

Objective:To analyze the application value of the mechanical thrombectomy system in the treatment of acute limb ischemia.Methods:The clinical data of 50 patients with lower limb ischemia who were treated with the Rotarex mechanical thrombectomy system from Jun 2017 to Sep 2019 were retrospectively analyzed.Results:In 4 cases of popliteal artery rupture occurred during the operation. The success rate of the operation was 92%. Catheter-directed thrombolysis was used in 7 cases, percutaneous transluminal angioplasty was used in 4 cases and percutaneous transluminal angioplasty combined with stent implantation was used in 39 cases. The ankle-brachial index of these 50 patients before and after operation was 0.18±0.24 and 0.64±0.28 respectively ( t=12.87, P<0.001). Treatment was successful in 43 cases. Follow-up ranged from 1 to 24 months, 5 cases were amputated, 2 cases had no improvement of toe ulcer gangrene, 9 cases had thrombus recurrence, and no complications such as bleeding were observed. The primary patency rates at 3, 6 and 12 months were 92%, 84% and 74%, respectively. Conclusion:The mechanical thrombectomy system is safe and effective in the treatment of acute lower limb ischemia with ideal short-term patency.

Mild encephalitis/encephalopathy with reversible splenial lesion has special clinical-imaging features. According to the extent of lesion involvement, it can be divided into type Ⅰ and type Ⅱ. Clinically, type Ⅰ is more common, and type Ⅱ is rare. A rare case of recurrent type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion is reported. The patient presented with typical type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion for the first time, involving the corpus callosum and the deep white matter, and the lesions disappeared after a short-term reexamination. Two years later, the lesions recurred, and the scope of the lesions was similar to that of the first time, and the lesions disappeared after a short-term reexamination. The clinical and imaging findings are analyzed in combination with relevant literatures review in order to deepen the understanding of the disease and improve the level of diagnosis and treatment.