With the rapid advancements in pancreatic cancer diagnosis and treatment research,the Chinese Society of Clinical Oncology(CSCO)has released two editions of pancreatic cancer diagnosis and treatment guidelines in 2022 and 2024.The present article systematic-ally compares the differences between the two editions in terms of diagnostic stratification,treatment pathways,and supportive manage-ment.By integrating insights from cutting-edge international research,the scientific rationale and clinical value of the underlying guideline revisions are explored.Clinicians are encouraged to adopt the new guidelines to dynamically assess the biological characteristics and treat-ment tolerance of patients,thereby formulating personalized diagnosis and treatment plans that ultimately lead to the synergistic enhance-ment of both survival benefits and quality of life for patients.

Background Polycyclic aromatic hydrocarbons (PAHs) are widely known atmospheric pollutants, which can cause serious harm to human body and ecological environment. Objective To analyze the concentrations and sources of PAHs in atmospheric PM_2.5 in Zhifu District and Longkou City during the heating period in Yantai. Methods Two monitoring sites in Zhifu District and Longkou City of Yantai were selected, and PM_2.5 sample collection was carried out from April 2023 to March 2024. Gas chromatography-mass spectrometry was applied to analyze the concentrations of PAHs in atmospheric PM_2.5 during the heating period (from November 2023 to March 2024) and the non-heating period (from April to October 2023). The concentrations of PAHs in the two periods were compared and the sources of PAHs during the heating period were analyzed by characteristic ratio method. Results During the heating period, the total concentration ranges of PAHs in atmospheric PM_2.5 at the monitoring sites in Zhifu District and Longkou City of Yantai were (1.59-23.70) ng·m⁻³ and (2.08-149.72) ng·m⁻³ respectively, and the medians (M) and the 25th and 75th percentiles (P₂₅, P₇₅) were 4.99 (2.61, 8.09) ng·m⁻³ and 15.46 (8.15, 29.05) ng·m⁻³ respectively. The PAHs concentrations in Longkou City were significantly higher than those in Zhifu District in all months (P<0.05). The highest median total concentrations of PAHs in both sites were reported in January (8.14 ng·m⁻³ and 81.56 ng·m⁻³ respectively). In the non-heating period, the M (P₂₅, P₇₅) of the total PAHs concentrations at the two sites were 1.59 (1.59, 2.78) ng·m⁻³ and 4.11 (2.94, 7.97) ng·m⁻³ respectively, much lower than those in the heating period (P<0.01). The order of composition of PAHs by ring number in PM_2.5 at both sites was 4-ring> 5-ring> 6-ring, with the 4-ring contributing the largest proportion (65.33% and 46.39% respectively). Fluoranthene had the highest concentration among PAHs at both sites, with concentrations M (P₂₅, P₇₅) of 1.29 (0.51, 1.78) ng·m⁻³ and 2.32 (1.30, 3.82) ng·m⁻³ respectively. The characteristic ratios of fluoranthene/(fluoranthene + pyrene), fluoranthene/pyrene, benzo[a]anthracene/(benzo[a]anthracene + chrysene), pyrene/benzo[a]pyrene, benzo[a]pyrene/(benzo[a]pyrene + chrysene), benzo[a]pyrene/benzo[g,h,i]pyrene, and indeno[1,2,3-c,d]pyrene/(indeno[1,2,3-c,d]pyrene + benzo[g,h,i]pyrene) in Zhifu District were 0.62, 1.65, 0.41, 4.48, 0.50, 0.93 and 0.47 respectively, and those in Longkou were 0.57, 1.35, 0.40, 2.89, 0.29, 0.79 and 0.47 respectively. The results showed that PAHs pollutants were generated by combination of coal combustion, vehicle exhaust emissions and gasoline combustion. Conclusion During the heating period in Yantai area, the total concentration of PAHs in atmospheric PM_2.5 is significantly higher than that in the non-heating period. Among them, during the heating period, the pollution level in Longkou City is significantly higher than that in Zhifu District. The local PAHs may be sourced from mixed pollution, and the main sources include gasoline, and coal combustion and vehicle exhaust emissions.

Osteoporosis(OP)is a prevalent metabolic bone disease with a complex pathogenesis that has not yet been fully elucidated.Recent studies have revealed that the Toll-like receptor 4(TLR4)signaling pathway plays a significant role in the development and progression of OP.TLR4,a crucial immune receptor primarily expressed in immune cells,is involved in inflammatory responses and immune regulation.The TLR4 signaling pathway influences bone metabolism and remodeling through multiple mechanisms.Therefore,investi-gating the role of the TLR4 signaling pathway in OP is of great significance for its prevention and treatment.Re-search targeting the TLR4 signaling pathway provides novel insights and approaches for OP therapy.Future studies should further explore the mechanisms of the TLR4 signaling pathway,develop therapeutic agents that modulate this pathway,and validate their efficacy in OP through clinical trials,thereby offering more options for the clinical management of OP.

Objective Exploring the expression of sterol regulatory element-binding protein 1(SREBP1)and acetyl-CoA carboxylase alpha(ACCα)in prostate cancer tissues and their impact on proliferation,migration and in-vasion of prostate cancer cells DU145.Methods The expression levels of SREBP1 and ACCα in prostate cancer tis?sue were analyzed using online databases including TIMER,UALCAN,GEPIA,and THE HUMAN PROTEIN ATLAS.Paraffin?embedded specimens from 58 cases of prostate cancer(PCa)and 58 cases of benign prostatic hyper?plasia(BPH)diagnosed at the Fifth Affiliated Hospital of Zunyi Medical University from January 2016 to December 2018 were collected.Immunohistochemistry was used to detect the expression of SREBP1 and ACCα in these tissues.Following the knockdown of SREBP1 in DU145 cells using shRNA,the changes in ACCα expression were assessed by qRT?PCR.The CCK?8 assay was employed to evaluate cell proliferation,while flow cytometry was used to analyze cell cycle distribution.Western blot was performed to measure the expression of SREBP1 and ACCα.Transwell assays were conducted to assess changes in migration and invasion capabilities after silencing SREBP1 in DU145 cells.Scratch assays were used to examine the impact of SREBP1 knockdown on the healing capability of DU145 cells.EdU assays were performed to detect changes in cell proliferation following the silencing of SREBP1.Oil Red O staining was utilized to observe changes in lipid content within prostate cancer cells after interference with SREBP1 expression.Results Analysis using online databases such as TIMER and UALCAN revealed that ACCα expression was signifi?cantly elevated in prostate cancer tissues compared to normal prostate tissues(P<0.001).After silencing SREBP1,the proliferation,migration and invasion capability of DU145 cells were significantly reduced compared to the control group(P<0.01),and flow cytometric analysis showed G1 phase arrested in DU145 cells(P<0.01).Knockdown of SREBP1 resulted in a significant decrease in lipid content in prostate cancer cells(P<0.01).Conclusions SREBP1 may promote the proliferation,migration and invasion of prostate cancer cells through regulating the expres?sion of ACCα.

Objective To investigate the expression of circZNF652 in prostatic cancer(PCa)tissues and PCa cell lines,and its impact and possible mechanism on proliferation and migration.Methods Differential ex-pression of circRNAs in plasma tissues from PCa patients and benign prostatic hyperplasia(BPH)patients were detected by using gene chip technology.The expression levels of circZNF652 in PCa cell lines(22RV1,LNCaP,DU145,PC3)and normal prostate epithelial cells were measured by quantitative real-time PCR(qPCR).The correlation between different circZNF652 expression levels with the overall survival(OS)time and clinicopathological features of PCa patient were analyzed.The effects of interfering circZNF652 on PCa cell proliferation,colony formation,invasion and migration ability were assessed through CCK-8 assay,colony formation assay,Transwell assay,wound healing assay and EdU cell proliferation assay.The online database TargetScan was used to predict the binding sites between circZNF652 and miR-140-3p,and the dual-luciferase reporter gene assay and RNA pull-down assay confirmed the interaction of circZNF652 and miR-140-3p.This interaction was further validated in PC3 and DU145 cells by interfering circZNF652 as well as in blood sam-ples from PCa and BPH patients.StarBase predicted the binding sites between miR-140-3p and HMGB1,and the HMGB1 expression levels were tested after miR-140-3p overexpression in PC3 and DU145 cells.Western blot was used to detect the HMGB1 expression levels in PCa and BPH patient,PCa cell lines(DU145,PC3)as well as RWPE-1 cells.The dual-luciferase reporter gene assay,RNA immunoprecipitation(RIP)and RNA pull-down were conducted to verified the interaction between miR-140-3p and HMGB1,and the HMGB1expression in PC3 and DU145 cells were detected after transfecting different constructs(si-NC,si-cir-cZNF652#1,si-circZNF652#1+inhibitor NC,si-circZNF652#1+miR-140-3p inhibitor)to further confir-ming that miR-140-3p directly regulates HMGB1.Results The gene chip and qRT-PCR results showed that the expression level of circZNF652 in the plasma of PCa patients was higher than that in BPH patients,com-pared with low-grade PCa and BPH patients,the plasma cirZNF652 expression level in the patients with high grade PCa was upregulated(P<0.001,P<0.01).Compared with normal prostate epithelial cells,the expres-sion levels of circZNF652 in 22RV1,LNCaP,DU145 and PC3 cell lines were upregulated(P<0.05,P<0.05,P<0.001,P<0.01);The OS time in the PCa patients with circZNF652 high expression was shorter than that in PCa patients with circZNF652 low expression.Clinicopathological features analysis revealed that the circ-ZNF652 expression was correlated with the PCa stage(T stage and N stage)and Gleason score.Knocking down circZNF652 expression inhibited the proliferation,invasion and migration in DU145 and PC3 cells.The online database TargetScan predicted that there was the complementary sequences between circZNF652 and miR-140-3p,and dual-luciferase reporter gene and RNA pull-down assays confirmed thatcircZNF652 acted as a sponge for miR-140-3p in PCa cells,interfering circZNF652 experiment in PC3 and DU145 cells also proved this point.The expression of miR-140-3p in the plasma of PCa patients was significantly decreased compared with BPH patients(P<0.05),and the expression level of miR-140-3p was negatively correlate with the ex-pression level of circZNF652(r=-0.888,P<0.001).The database StarBase analysis results showed that there are complementary sequences of HMGB1 mRNA 3'-UTR and miR-140-3p,and the downstream target gene of miR-140-3p was HMGB1.The dual-luciferase reporter gene,RIP and pull-down assays confirmed the direct binding between miR-140-3p and HMGB1.The Western blot experiment found overexpression of miR-140-3p resulted in the HMGB1 expression decrease in DU145 and PC3 cells.Silencing circZNF652 expression resulted in the decrease of HMGB1 protein levels in the DU145 and PC3 cells,while inhibiting miR-140-3p could reverse this decrease.Conclusion Overexpression of circZNF652 could promote the progression and me-tastasis of PCa by regulating the miR-140-3p/HMGB1 axis.

Objective:To analyze the clinical characteristics of 18 patients with Brucella melitensis infection (abbreviated as brucellosis) in Xinjiang Uygur Autonomous Region (abbreviated as Xinjiang). Methods:A retrospective analysis was conducted on the medical records of 18 patients diagnosed with Brucella melitensis infection by blood culture at the First Affiliated Hospital of Shihezi University from March 2023 to March 2024, including general information, epidemiological characteristics, clinical manifestations, laboratory test results, etc. Results:Among the 18 patients with sheep brucellosis, 14 patients were aged 45-59 years old and 13 patients were male, with 13 cases having a clear history of contact with cattle and sheep. The main clinical manifestations were fever (18 cases), bone and joint pain (5 cases), and fatigue (5 cases). Laboratory test results confirmed all 18 cases as Brucella melitensis infection (AMOS-PCR), with one case originating from cattle. Laboratory tests showed that 12 patients had elevated lactate dehydrogenase (LDH) levels. Correlation analysis revealed, there was a positive association between aspartate aminotransferase (AST) and LDH ( r = 0.84, P < 0.001); a positive correlation between the number of affected systems and the percentage of neutrophils (N%, r = 0.73, P = 0.001); a positive correlation between the duration of medication and the number of affected systems ( r = 0.82, P < 0.001) and N% ( r = 0.75, P = 0.001); and a negative correlation between treatment duration and lymphocyte percentage (LYM%, r =-0.76, P = 0.001). Conclusions:The main source of Brucella melitensis infection in Xinjiang is sheep, and contact with cattle can also cause Brucella melitensis infection. Brucella melitensis patients are more common in middle-aged males. The clinical manifestations are diverse and atypical; N% and LYM% are correlated with the number of affected systems.

Objective:To analyze the clinical characteristics of 18 patients with Brucella melitensis infection (abbreviated as brucellosis) in Xinjiang Uygur Autonomous Region (abbreviated as Xinjiang). Methods:A retrospective analysis was conducted on the medical records of 18 patients diagnosed with Brucella melitensis infection by blood culture at the First Affiliated Hospital of Shihezi University from March 2023 to March 2024, including general information, epidemiological characteristics, clinical manifestations, laboratory test results, etc. Results:Among the 18 patients with sheep brucellosis, 14 patients were aged 45-59 years old and 13 patients were male, with 13 cases having a clear history of contact with cattle and sheep. The main clinical manifestations were fever (18 cases), bone and joint pain (5 cases), and fatigue (5 cases). Laboratory test results confirmed all 18 cases as Brucella melitensis infection (AMOS-PCR), with one case originating from cattle. Laboratory tests showed that 12 patients had elevated lactate dehydrogenase (LDH) levels. Correlation analysis revealed, there was a positive association between aspartate aminotransferase (AST) and LDH ( r = 0.84, P < 0.001); a positive correlation between the number of affected systems and the percentage of neutrophils (N%, r = 0.73, P = 0.001); a positive correlation between the duration of medication and the number of affected systems ( r = 0.82, P < 0.001) and N% ( r = 0.75, P = 0.001); and a negative correlation between treatment duration and lymphocyte percentage (LYM%, r =-0.76, P = 0.001). Conclusions:The main source of Brucella melitensis infection in Xinjiang is sheep, and contact with cattle can also cause Brucella melitensis infection. Brucella melitensis patients are more common in middle-aged males. The clinical manifestations are diverse and atypical; N% and LYM% are correlated with the number of affected systems.

With the rapid advancements in pancreatic cancer diagnosis and treatment research,the Chinese Society of Clinical Oncology(CSCO)has released two editions of pancreatic cancer diagnosis and treatment guidelines in 2022 and 2024.The present article systematic-ally compares the differences between the two editions in terms of diagnostic stratification,treatment pathways,and supportive manage-ment.By integrating insights from cutting-edge international research,the scientific rationale and clinical value of the underlying guideline revisions are explored.Clinicians are encouraged to adopt the new guidelines to dynamically assess the biological characteristics and treat-ment tolerance of patients,thereby formulating personalized diagnosis and treatment plans that ultimately lead to the synergistic enhance-ment of both survival benefits and quality of life for patients.

The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

Objective To investigate the current status of off-label drug use(OLDU)management in tertiary hospitals of Guizhou province and to provide baseline evidence for developing a unified administration regulation for OLDU in Guizhou province.Methods In line with the relevant policies and regulations,a questionnaire including basic information about the person filling out the form,basic information about the hospitals,and information about OLDU was developed.The questionnaire was sent to 84 tertiary hospitals in Guizhou province through the Wenjuanxing.Results A total of 84 questionnaires were distributed and recovered,with a response rate of 100.00%.Of the 84 hospitals,77 had OLDU,of which 68(88.31%)had established a management system for OLDU.Among the 77 hospitals with OLDU,65(84.42%),42(54.55%),58(75.32%),36(46.75%),15(19.48%),and 21(27.27%)hospitals respectively,required approval from the Committee on Drug Administration and Pharmacotherapy before OLDU,restricted the qualifications of doctors prescribing OLDU,required informed consent from patients or their families before OLDU,recorded the matters and reasons in the medical records of patients treated with OLDU,followed up patients in their files and evaluated the reasonableness of the OLDU,and carried out special reviews for OLDU.Only 30(38.96%)hospitals have set up a catalogue of OLDUs,and 58(75.32%)hospitals have urgent needs to set up a unified provincial catalogue of OLDUs.Conclusion The pharmacy administration level of OLDU in tertiary hospitals of Guizhou province is relatively low,so there is an urgent need to establish a unified OLDU management system and medication catalog.