Objective To explore the type of the rational digestive reconstruction after total gastrectomy for gastric malignancy.Metlhods Three types of digestive reconstruction were performed after total gastrectomy in 121 cases with gastric carcinoma.The operating time,morbidity and mortality,digestive tract symptoms,nutritional status in 1 year after operation were compared.Results There were no signifioant differences among the three procedures in operative morbidity and mortality,postoperative food intake,nutritional status,incidences of diarrhea and dumping syndrome.Roux-en-Y esophajejunostomy and P-type esophajejunostomy had an advantage d anti-esophageal reflux,and are obviously superior to Lahey + Braun anastomosis.Roux-en-Y esophajejunostomy was simpler with shorter operating time and less complication.Condusion Roux-en-Y esophajejunostomy and P-type esophajejunostomy could be recommended as suitable methods for digestive reconstruction after total gastrectomy.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.