Volume 105 · Issue 39 · 2025

On July 15, 2025, the updated 2025 Clinical Practice Guideline for the Management of Primary Aldosteronism (PA) was released on the American Society of Endocrinology Annual Meeting. This guideline was spearheaded by the Endocrine Society and co-endorsed by 6 international academic organizations. Compared with the 2016 version, the new guideline has made significant updates in screening, diagnosis, classification and treatment. The new guideline recommends expanding the screening scope, conducting aldosterone-renin ratio screening for all patients with hypertension, without the need for strict drug elimination; it simplifies the diagnostic process, reducing the four diagnostic tests to three aldosterone suppression tests; it adopts a probability stratification strategy, allowing high-probability patients to skip the aldosterone suppression test and directly proceed to the classification assessment; at the same time, it optimizes the classification method, further clarifying the exemption conditions for adrenal venous sampling. In terms of treatment, unilateral lesions are recommended for surgery, while for bilateral or those with surgical contraindications, lifelong use of mineralocorticoid receptor antagonists is suggested, and the recovery of renin levels is used as a monitoring indicator of the efficacy. The new guideline focuses on "population-wide screening-precise classification-individualized intervention", aiming to reduce the risk of PA-related complications through early identification and targeted intervention. This article provides an interpretation of the core recommendations outlined in the 2025 guideline, presents a point-by-point comparison highlighting differences from the 2016 edition, and aims to deliver rapid and accurate, evidence-based information.

Pilon fractures are comminuted fractures of the distal tibial articular surface caused by high-energy axial loading, typically resulting from falls from height, motor vehicle accidents, or sports injuries. The patients with Pilon fractures are often associated with articular cartilage damage, metaphyseal comminution, and severe soft tissue injury, which can lead to poor long-term prognosis. Pilon fractures are among the most challenging types of fractures to treat. At present, there are still some controversies regarding the treatment of Pilon fractures. This article aims to explore hot-topic issues in the treatment of Pilon fractures, including early and staged treatment strategies, management of fibular fractures, selection of surgical approaches, reduction techniques, and choice of internal fixation devices, and summarize the updates in treatment concepts, aiming to provide reference for the clinical diagnosis and treatment of Pilon fractures.

Ankle arthritis is mainly secondary to trauma and is often associated with varus deformity. Patients with ankle arthritis are generally younger than those with hip and knee osteoarthritis, making its clinical management a growing focus in foot and ankle surgery. Current evidence demonstrates that supramalleolar osteotomy can effectively correct varus deformity, enhance postoperative functional outcomes, and even reverse the radiographic stage of arthritis in selected cases. This article provides a comprehensive analysis of critical issues in managing varus ankle arthritis, including three-dimensional deformity assessment, compensatory mechanisms of hindfoot and subtalar joint alignment, management of concomitant subchondral cysts, and optimization of lower limb mechanical axis, aiming to guide clinicians in the rational selection of surgical procedures and improving prognosis. With advancements in medical imaging, computer technology, biomechanical research, and materials science, supramalleolar osteotomy is expected to become a safer, more effective, and more widely applicable core ankle-preserving treatment for varus ankle osteoarthritis.

The objective of this review was to summarize the latest research progress in the past five years on changes in central nervous system (CNS) function in patients with chronic lateral ankle instability (CLAI). Previous studies suggested that alterations in CNS function might be a potential factor contributing to CAI-related impairments. In recent years, with advancements in research techniques, it has been discovered that ankle disfunction in CAI patients may be associated with abnormalities in CNS function, such as changes in neuromuscular control and sensory-pain mechanisms. Based on the current understanding of CNS functional changes in CAI patients, various treatment approaches targeting the CNS functions have emerged. These interventions aim to improve neurological function in such patients, providing more precise and effective conservative treatment options for individuals with CAI.

Posterior malleolar fractures, as a complex and controversial subtype of ankle fractures, remain a research hotspot and challenge in the field of orthopedics. Given the unique anatomical structure and complex biomechanical characteristics of the posterior malleolus, there is ongoing debate regarding its injury mechanisms and optimal treatment strategies, which often leads to significant variations in clinical outcomes. In recent years, numerous scholars have conducted in-depth research on various aspects of posterior malleolar fractures, including the injury mechanisms, classification, surgical approaches, and internal fixation options, leading to the development of new perspectives. This article, synthesizing current research advances, shares insights on several key controversies and hot topics concerning posterior malleolar fractures, aiming to provide valuable references for their clinical management. It is believed that with in-depth research in biomechanics, continuous advancements in imaging technology, and the widespread adoption of minimally invasive concepts, studies on the injury mechanisms, classification evolution, and surgical approaches for posterior malleolar fractures will achieve greater progress, along with more refined preoperative planning.

Maternal and infant mortality rates are important indicators for evaluating the level of healthcare services in a country or a region. Due to physiological and internal environmental changes, women during pregnancy and the puerperium are at an increased risk of developing cerebral venous thrombosis (CVT). CVT occurring during pregnancy and the puerperium poses significant risks to both maternal and neonatal health. However, due to its hidden onset, non-specific clinical signs, and symptoms that overlap with normal perinatal changes, many clinicians lack adequate awareness and attention of it. To address this issue, the Expert Committee of the National Health Commission′s Million Disability Reduction Project, together with the Cerebral Venous Disease Group of the Chinese Stroke Association and the Stroke Prevention and Control Professional Committee of the Chinese Preventive Medicine Association, convened leading experts from relevant fields across China to developed the "Guidelines for the management of cerebral venous thrombosis during pregnancy and the puerperium (2025 edition)" using the Delphi method on the basis of the latest domestic and international progress. These guidelines encompass eight aspects: epidemiology, pathogenesis and risk factors, clinical presentation, diagnosis and differential diagnosis, treatment, pregnancy and lactation, prevention strategies, and management of future pregnancies of CVT during pregnancy and postpartum period. A total of 49 recommendations are provided, aiming to establish a standardized and China-specific management framework for CVT during pregnancy and puerperium, and promote homogenized development of prevention and treatment capabilities across medical institutions at all levels.

To analyze the trends in fasting blood glucose (FBG) levels among patients and health examinees at Zhongshan Hospital, Fudan University from 2005 to 2024.

A retrospective analysis was conducted using the laboratory information system database of Zhongshan Hospital, Fudan University from November 9, 2005, to December 31, 2024. Individuals with FBG test records were included, and a fixed cohort with consecutive annual FBG measurements was selected. The Mann-Kendall trend test and Theil-Sen slope estimator were employed to analyze the changing trends of FBG levels and their abnormal rates (FBG≥7 mmol/L) in the overall population, fixed cohort, as well as different age subgroups and gender-specific subgroups.

The general population comprised 4 523 490 individuals (2 561 242 males and 1 962 248 females), with the age [M (Q₁, Q₃)] of 53 (39, 64) years. The fixed cohort consisted of 4 280 individuals (2 426 males and 1 854 females), with a median age of 47 (35, 57) years (at enrollment in 2008). From 2005 to 2024, in the overall population, FBG levels increased from 4.8 (4.3, 5.4) mmol/L to 5.4 (4.9, 6.3) mmol/L (P=0.015), and the prevalence of abnormal FBG rose from 6.9% (95%CI: 6.8%-7.1%) to 16.1% (95%CI: 16.0%-16.2%, P<0.001). Among the fixed cohort, FBG levels increased from 4.8 (4.3, 5.4) mmol/L to 5.5 (5.0, 6.4) mmol/L (P<0.001), and the prevalence of abnormal FBG rose from 6.0% (95%CI: 5.3%-6.8%) to 18.0% (95%CI: 16.8%-19.1%, P<0.001). From 2008 to 2024, in the overall population, FBG levels remained stable in both males and females aged 20-39 years (Theil-Sen slopes of 0.018 and 0.011, respectively, both P>0.05); FBG levels in males aged 40-59 years increased slowly (Theil-Sen slope of 0.023, P=0.018); FBG levels in both males and females aged 60-79 years increased significantly (Theil-Sen slopes of 0.039 and 0.022, respectively, both P<0.05); and the most pronounced increases were observed in males and females aged≥80 years (Theil-Sen slopes of 0.042 and 0.026, respectively, both P<0.05). Among the fixed cohort, FBG levels in both males and females aged 40-59 years increased significantly (Theil-Sen slopes of 0.062 and 0.052, respectively, both P<0.001).

From 2005 to 2024, among the patients and individuals undergoing physical examinations at Zhongshan Hospital, Fudan University, both the overall population and the fixed cohort exhibited an upward trend in FBG levels and their abnormality rates. In the overall population, the FBG levels and abnormality rates remained relatively stable among individuals aged 20-39 years. For males aged 40-59 years, FBG levels showed a gradual increase, with a more pronounced rise starting from the age of 60, and the most significant elevation in FBG levels was observed in those aged 80 years and above.

To investigate the correlation between preoperative tibial tubercle-trochlear groove distance (TT-TG) and postoperative tibiofemoral prosthesis divergence angle (DA) in mobile-bearing unicompartmental knee arthroplasty (MB-UKA) for knee osteoarthritis, and to assess the clinical effect of DA on functional outcomes.

This retrospective study included the consecutive patients undergoing MB-UKA at the Third Hospital of Hebei Medical University from January to December 2023. Postoperative DA was measured using 30° patellar axial radiographs. The linear relationship between postoperative DA and preoperative TT-TG was clarified based on their correlation, and a regression equation was established. Based on regression analysis, a DA threshold of 12° corresponded to a preoperative TT-TG of 16 mm. The patients were divided into groups according to DA or TT-TG: DA≥12° and<12° group or TT-TG≥16 mm and<16 mm group. The Hospital for Special Surgery (HSS) knee score and Feller patella score before and after surgery were recorded to assess knee function and perform intergroup comparisons.

A total of 156 cases were enrolled in this study, including 30 males and 126 females with a mean age of (66.29±5.42) years. Over a mean follow-up of (13.3±2.7) months, no bearing dislocations occurred. At the final postoperative follow-up, the median HSS knee score [M(Q₁,Q₃)] significantly improved from 55 (50, 60) preoperatively to 86 (82, 92) points, and the median Feller patella score increased from 17 (15, 20) to 22 (21, 24) points, with both differences being statistically significant (both P<0.05). The mean postoperative DA was 10.03°±4.71°. The DA≥12° group exhibited inferior Feller scores when compared to DA<12° group [21 (20, 23) vs 23 (21, 24) points, P=0.001], but there was no statistically significant difference in the improvement of Feller scores between the two groups (P=0.119). There was no statistically significant difference in postoperative HSS scores or the improvement of HSS scores compared to preoperative values between the two groups (both P>0.05). Preoperative TT-TG values were significantly higher in the DA≥12° subgroup than that in DA<12° group [12.7 (11.3, 15.3) vs 10.7 (8.3, 13.6)mm, P<0.001]. Patients with a preoperative TT-TG≥16 mm demonstrated greater DA than those with a TT-TG<16 mm (12.50°±4.70° vs 9.65°±4.61°, P=0.009); no statistically significant differences were found between the two groups in terms of HSS scores, Feller scores, or their postoperative improvements compared to preoperative values (all P>0.05).

DA demonstrates a significant association with preoperative TT-TG, emphasizing the necessity of TT-TG evaluation during MB-UKA preoperative planning, particularly for cases with TT-TG>16 mm. Furthermore, DA critically influences postoperative clinical outcomes, with DA<12° being associated with favorable early functional recovery.

To investigate the effect of soft-tissue referenced tibial tunnel positioning based on the distal fold of the posterior capsule and the posterior compartment on the"killer turn"effect in posterior cruciate ligament (PCL) reconstruction.

A retrospective analysis was conducted on the clinical data of 40 patients with PCL injury who underwent reconstruction surgery in the Department of Joint Surgery, the Third Hospital of Hebei Medical University, from July 2023 to October 2024. All patients underwent PCL reconstruction by the same surgical team. The distal fold of the posterior capsule and the posterior septum were set as reference landmarks at the tibial side. MRI was used to measure the soft-tissue and bony"killer turn"angles of 20 patients immediately postoperatively and at 6 months after the surgery, to assess the impact of soft-tissue referenced positioning and remnant-preserving PCL reconstruction on the"killer turn"effect and its dynamic changes. Graft diameters of these 20 patients were measured on MRI immediately postoperatively and at 6 months and were compared. The graft and remnant morphology and the status of the posterior capsule were evaluated too. The knee stability and functional scores [Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score] were assessed in the other 20 patients with 1 year of follow-up. A 30-year-old male volunteer underwent CT scanning and reconstruction to create a three-dimensional finite element model of the knee joint. Two models were established based on whether the PCL remnant was preserved or not: a soft-tissue referenced non-remnant-preserving PCL reconstruction model and a remnant-preserving PCL reconstruction model. A posterior drawer test was simulated to compare the stress conditions of the grafts in the two models.

A total of 40 eligible patients [including 27 males and 13 females, aged (37.2±14.9) years] were included in this study. The imaging data of these patients were included. Immediately postoperatively, the soft-tissue"killer turn"angle was 104.70°±7.95°, and the bony"killer turn"angle was 91.39°±10.21° (P<0.001). At 6 months postoperatively, the soft-tissue"killer turn"angle was 108.13°±12.01°, was comparable with the immediate postoperative value (P=0.107); and the graft diameter did not change significantly at 6 months postoperatively when compared with the immediate postoperative period [[(7.58±0.57) mm] vs (7.65±0.56) mm, P=0.167]. Ultrasound at 6 months postoperatively showed intact graft morphology and the distal fold structure of the posterior capsule. At 1 year postoperatively, the Lysholm score, Tegner activity score and IKDC score all improved significantly when compared to the preoperative values (all P<0.05). In the finite element analysis, the remnant-preserving model exhibited lower graft tension, interaction force with the tibial plateau, and frictional force compared to the non-remnant-preserving model.

The soft-tissue referenced tibial tunnel positioning based on the distal fold of the posterior capsule and the posterior compartment for remnant-preserving PCL reconstruction can effectively reduce the"killer turn"effect, minimize graft-bone friction, and prevent graft wear and thinning.

To analyze the clinical characteristics and factors influencing survival time in patients with chronic myeloid leukemia myeloid blast-phase (CML-MBP).

The patients with CML-MBP treated at Henan Cancer Hospital from September 2009 to July 2024 were retrospectively enrolled. The patients were stratified into two groups based on different treatment regimens: the combination group [the patients receiving tyrosine kinase inhibitors (TKI) combined with an acute myeloid leukemia-type regimen following CML-MBP diagnosis] and the monotherapy group (the patients receiving TKI monotherapy). With follow-up extending from CML-MBP diagnosis until October 16, 2024, clinical characteristics were compared between groups. Potential factors influencing survival time were analyzed using Cox regression models.

A total of 141 patients were enrolled: 107 in the combination group [64 males and 43 females, aged M (Q₁, Q₃), 43 (32, 52) years] and 34 in the monotherapy group [19 males and 15 females, aged 51 (45, 61) years]. The median follow-up duration was 6.5 (2.5, 15.1) months. About 90.1% (127/141) of the patients had a history of chronic/accelerated phase. During CML-MBP, 78.7% (111/141) of the patients had received TKI therapy. Extramedullary blast phase occurred in 18.4% (26/141) of the patients, with 5.0% (7/141) presenting as isolated extramedullary myeloid blast phase. Additional chromosomal abnormalities were detected in 57.4% (81/141) of the patients, of whom 63.0% (51/81) exhibited complex chromosomal karyotypes. Abelson murine leukemia viral oncogene homolog 1 (ABL1) kinase domain mutations were identified in 58.0% (65/112) of the patients, with the T315I mutation being the most common. The patients in the combination group were younger at diagnosis than those in the monotherapy group. The proportions of complex chromosomal abnormalities [63.6% (68/107) vs 38.2% (13/34)] and treatment with third-generation TKI following blast phase [43.0% (46/107) vs 14.7% (5/34)] were higher than those in the monotherapy group. The proportions of the patients with white blood cell count [14.1 (4.3, 48.9)×10⁹/L vs 50.1 (11.5, 149.0)×10⁹/L], serum lactate dehydrogenase level [510 (297, 930) vs 900 (535, 1 898) U/L], and treatment with imatinib following blast phase [8.4% (9/107) vs 20.5% (7/34)] were all lower than those in the monotherapy group (all P<0.05). Among 104 and 28 evaluable patients who completed efficacy evaluation in the combination group and monotherapy group, respectively, the major molecular response (MMR) rate was higher in the combination group [16.3% (17/104) vs 3.6% (1/28), P=0.049]. The 1-year survival rate did not differ significantly between the groups (37.8% vs 32.4%, P=0.101). Multivariate Cox regression analysis showed that isolated extramedullary myeloid blast phase (HR=0.211, 95%CI: 0.064-0.704), achievement of major hematologic response (MHR) (HR=0.184, 95%CI: 0.102-0.330), and/or deep molecular response (DMR) (HR=0.119, 95%CI: 0.028-0.504) were identified as independent protective factors for survival.

Most patients with CML-MBP have a history of chronic or accelerated phase disease and TKI therapy, frequently accompanied with complex chromosomal karyotypes and the T315I mutation. While patients receiving TKI combination therapy demonstrate higher rates of MMR, their overall survival remains poorer. Isolated extramedullary acute myeloid blast phase, and the achievement of MHR and/or DMR through treatment are beneficial for the survival of patients with CML-MBP.

To establish a permanent cerebral ischemia mouse model with electrode implantation and explore the efficacy of deep brain stimulation (DBS) in the cerebellar interposed nucleus on improving its neurological and motor dysfunction.

A total of 33 male C57BL/6 mice aged 8-9 weeks were selected and a permanent middle cerebral artery occlusion (MCAO) model was established by using thread embolism. The mice were divided into the control group (MCAO) and the DBS group (MCAO+DBS), according to the random number table method. Subsequently, DBS electrodes were implanted into the cerebellar interposed nucleus. After a 1-week recovery period, the DBS group underwent 3 weeks of selective cerebellar interposed nucleus DBS treatment, while the control group only had electrodes implanted without DBS treatment. The stimulation parameters were set as follows: pulse width, 60 μs; current intensity, 30 μA; frequency, 30 Hz. The neurological and motor functions of the model was assessed by conducting the 5-point scale, open-field and cylinder tests. The differences in neurological function and motor function were compared between the two groups after 0, 14, and 21 days with or without continuous electrical stimulation.

The success rates of the MCAO was 69.7% (23/33), with 11 in the control group and 12 in the DBS group, while the success rate of MCAO model electrode implantation was 87.0% (20/23).The scores measured on the 5-point scale in the DBS group were significantly lower than those in the control group after 21 days of DBS stimulation [M(Q₁, Q₃), 0(0,1)vs 2(1,2), P<0.01]. In the cylinder test, the hemiplegia score of the electrical stimulation group was significantly lower than that of the control group at the same period after 21 days of DBS stimulation [0.18(0.14,0.20)vs 0.40(0.35,0.51), P<0.001]. In the open field test, the total distance and average speed of the mice in the DBS group were both higher than those in the control group (all P<0.05).

DBS in the cerebellar interposed nucleus can improve the recovery of neurological and motor functions in mouse models of ischemic stroke.

A retrospective analysis of clinical data (treatment group) is conducted on the patients of newly diagnosed acute promyelocytic leukemia(APL) who received Venetoclax for increased white blood cells in Linyi People′s Hospital from January to December 2024. The patients who received traditional chemotherapy drugs to reduce white blood cells from January 2020 to January 2024 were categorized as the control group. Both groups were followed up to January 1st, 2025. Comparisons were made between groups on white blood cell count reduction time, coagulation recovery, blood transfusion (the infusion volume of platelets, plasma, etc.), courses needed for complete molecular remission (CMR), length of hospital stay, and total cost. A total of 50 patients were included, with 10 patients in the treatment group [4 males and 6 females, aged 19-56 (35±14) years], and 40 patients in the control group [21 males and 19 females, aged 14-76 (45±15) years]. The follow-up time [M (Q₁, Q₃) ] was 34.9 (10.6, 46.3) months. No statistically significant difference exists between groups in terms of gender, age, white blood cells at diagnosis of APL, disease prognosis stratification, bone marrow promyelocyte proportion, coagulation function indicators, etc (all P>0.05). Compare to the control group, the treatment group exhibited earlier leukocytes reduction [3.0 (2.7, 3.2) vs 4.0 (3.0, 6.0) d] and coagulation recovery [4.5 (1.7, 8.0) vs 7.0 (6.0, 10.0) d], shorter hospital stay [21 (19, 27) vs 28 (25, 29) d], fewer courses for CMR [2.0 (1.8, 2.0) vs 2.5 (2.0, 3.0) times], less need for platelet transfusion (2.5 (1.7, 4.0) vs 4.0 (3.0, 6.0) times], plasma transfusion volumn [100 (0, 250) vs 575 (0, 1 230) ml], and lower cost [2.9 (2.5, 3.8) vs 4.6 (3.5, 6.5) ten thousand yuan] (all P<0.05). The efficacy of Venaclera in reducing the elevation of white blood cells during induction therapy for acute promyelocytic leukemia is still acceptable.

A 42-year-old female was seen in Zhongshan Hospital affiliated to Dalian University on April 26, 2025 for "pain in the right lower abdomen for 1 week and melena for 2 days". Lower abdominal pelvic CT showed the possibility of local ileocecal intussusception. Total abdominal CT showed that the local intestinal wall was slightly thickened, and there were many small lymph nodes around it, and local ileocecal intussusception was possible. Colonoscopy showed that the ileocecal bulge was to be examined, and there was no erosion, bleeding, ulcer and new organisms in the remaining large intestinal mucosa. Laparoscopic right hemicolectomy was performed on 27 Apr 2025 under emergency general anesthesia. Intraoperative observations: a small amount of exudate in the pelvic cavity, obvious edema of the cecum with thickening of the intestinal wall, the range is about 6 cm ×5 cm, and the appendix is sleeved inward from the root into the cecum about 2 cm. Postoperative pathology revealed highly aggressive B-cell lymphoma of the cecum, consistent with diffuse large B-cell lymphoma (GCB subtype). After operation, the patient was treated regularly with decitabine + rituximab + cyclophosphamide + pirarubicin + vincristine for 4 cycles in the hematology department. The patient was followed up until August 1, 2025. The patient had no symptoms of digestive tract discomfort, no abnormalities and no signs of tumor recurrence were found on abdominal physical examination.

In recent years, with the development of imaging technology and its application in community and clinical cohort studies, there has been a deeper understanding of the mechanism of formation and clinical significance of enlarged perivascular spaces (EPVS). Circulatory disorders of the lymphoid system, immune mechanisms, blood-brain barrier disruption, and brain atrophy synergistically contribute to EPVS. EPVS (CSO-EPVS) in the center of the semi-oval may reflect amyloid beta (A β) deposition and are associated with Alzheimer's disease (AD) -related cognitive impairment. EPVS in the basal ganglia region (BG-EPVS) are associated with the onset of vascular cognitive impairment, but their association with cognitive function is influenced by other cerebral small vessel disease (CSVD) pathologies. The relationship between hippocampal EPVS (H-EPVS) and hippocampal atrophy and cognitive function is currently unclear. Special morphological EPVS are associated with a decrease in information processing speed. However, the understanding of the pathophysiological mechanisms of EPVS is still lacking, and the different pathological mechanisms of EPVS in different brain regions and how they affect cognitive function in diseases are still controversial.

Helicobacter pylori (Hp) Infection, as the primary pathogenic factor of gastric cancer, can play a central driving role in the Correa cascade through epigenetic regulation, especially DNA methylation modification. Based on this, this paper integrates the multi-dimensional evidence of pathogen microbiology, epigenomics and translational medicine, and systematically reviews the pathogen and host cellsHpApplication and research progress of associated DNA methylation in the mechanism and clinical transformation of gastric carcinoma. On the one hand, the article outlinesHpThe internal mechanism of fine regulation of gene expression and enhancement of environmental adaptation through self-DNA methylation; On the other hand, it expoundsHpInfection can induce abnormal DNA methylation in host cells, which in turn promotes malignant transformation. In this paper, the research status of DNA methylation markers related to gastric cancer was further discussed, in order to provide new ideas and basis for early diagnosis and prognosis of gastric cancer.

Acute pancreatitis (AP) is a common acute abdomen in clinic. During the course of the disease, there is intestinal dysfunction, which is manifested by the destruction of intestinal mucosal barrier and disorder of intestinal function. Early diagnosis of intestinal dysfunction in AP patients and individualized comprehensive treatment for patients are the key to improve prognosis and reduce mortality. In this paper, various factors of intestinal mucosal barrier destruction in AP patients are described in detail, with emphasis on mechanical barrier, chemical barrier, immune barrier and biological barrier; At the same time, the clinical evaluation of AP combined with intestinal dysfunction by detecting biomarkers and gastrointestinal function scoring tools was reviewed. This article also focuses on the clinical treatment measures of AP patients with intestinal dysfunction, focusing on the treatment of intestinal microorganisms and their metabolites metabolites short chain fatty acids (SCFA) for intestinal dysfunction; Finally, this paper summarizes the deficiencies in the assessment and treatment of AP with intestinal dysfunction and the expectations for the future.