Objective Jejunal interposition is an important option for restoring gastrointestinal continuity in patients with complex esophageal cancer in whom the stomach is unavailable for reconstruction due to previous gastrectomy, tumor involvement, failed gastric conduit, or other constraints. Although the jejunum offers a caliber similar to the esophagus, a rich blood supply, and preserved peristaltic function, anatomical variations in mesenteric length and vascular arcades render long-segment and high-level reconstruction susceptible to excessive tension, mesenteric torsion, venous congestion, and inadequate distal perfusion. This consensus aims to provide standardized recommendations for the application of jejunal interposition in this specific patient population. Methods This consensus was developed in accordance with the WHO Handbook for Guideline Development and Chinese national guideline development standards, with reference to the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), Reporting Items for Practice Guidelines in Healthcare (RIGHT), and Scientific, Transparent and Applicable Rankings (STAR) checklists. The project was registered on the international practice guidelines registry platform (PREPARE-2026CN1384). The working group systematically searched Chinese and English evidence addressing 12 clinical questions. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 system, with structured appraisal of risk of bias, inconsistency, indirectness, and imprecision. Recommendations were formulated through two rounds of Delphi surveys and a face-to-face consensus meeting, with an agreement threshold of ≥75%. Results The consensus generated 12 recommendations covering indications, selection between jejunum and colon, preoperative assessment, surgical approach and reconstruction route, pedicled jejunal interposition (PJI), supercharged pedicled jejunal interposition (SPJ), indocyanine green (ICG) perfusion assessment, perioperative nutrition, management of anastomotic leakage, long-term follow-up, and special treatment scenarios. Given that the available direct evidence is predominantly derived from single-center retrospective cohorts and case series, recommendations extrapolated from general esophagectomy or other gastrointestinal surgical evidence are deliberately phrased with caution. Conclusion Jejunal interposition is a safe and effective approach for digestive tract reconstruction in patients with complex esophageal cancer in whom the stomach is unavailable. This consensus emphasizes that clinical decision-making should be individualized based on the patient's prior treatment history, reconstruction height, vascular anatomy, technical availability, and institutional experience in the Chinese context.

Objective:To investigate the influencing factors of urinary system symptoms in urban and rural residents aged 35 years old and above in Anhui province.Methods:A total of 19 339 residents aged 35 years old and above were selected from 19 counties(districts)of 9 cities in Anhui Province by multi-stage stratified cluster random sampling method.Binary logistic regression was used to analyze the influencing factors of urinary system symptoms.Results:There were statistically significant differences among different gender,age,long-term residence,body mass index and education level in the other 3 symptoms except urinary secretions(P＜0.05).Binary logistic regression analysis model showed that with the increase of age,the risk of frequent urination/urgent urination/painful urination,eyelid or lower limb edema increased,OR values were all＞1.Body mass index≥24 kg/m2 was the risk factor of frequent urination/urgent urination/painful urination,eyelid or lower limb edema(P＜0.05).People who lived in rural areas for a long time had a lower risk of blood urination(OR=0.79,P＜0.05).The risk of urinary secretions decreased with the improvement of education level(P＜0.05).Diagnosed diabetes,use of analgesics(ibuprofen/butazon/indola,etc.),heavy dietary taste was(like to eat pickled/smoked/fried/spicy food),long-term heavy physical work(carrying heavy objects/digging/clearing snow/chopping wood,etc.),and sleep time＜8 h were the risk factors of these four urinary symptoms(P＜0.05).Long-term drinking was a risk factor for frequent urination/urgent urination/painful urination symptoms(OR=1.02,P＜0.05).Conclusion:Personal characteristics,diabetes mellitus,dietary habits,medication history and physical activity have a certain influence on the occurrence of urinary system symptoms.

Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.

Aim To detect the effect of Bio on impro-ving insulin resistance and explore its molecular mech-anism. Methods The HepG2 liver cells were derivat-ed by high concentration insulin to establish the insulin resistance cell model, and the cells were intervened by Bio. The glucose consumption was measured by glu-cose oxidase and peroxidase ( GOD-POD) assay. The expression of PPARγmRNA was detected by RT-PCR. The expression of PPARγ protein was detected by Western blot method. Results The glucose consump-tion was significantly decreased in the insulin resist-ance cells after incubated with 1 . 72 × 10 -5 mol · L-1 insulin ( P<0. 05 ) . 10 -5 ,10 -6 ,10 -7 mol · L-1 Bio increased the glucose consumption 135%,62%,39%separately in the insulin resistance cells. RT-PCR a-nalysis of PPARγ showed that Bio raised the PPARγmRNA. Western blot analysis displayed that the pro-tein of PPARγ with Bio was increased. Conclusion Bio can improve the insulin resistance of the HepG2 cells, and the molecular mechanism may be relevant with raising PPARγ expression.

OBJECTIVE: To discuss the role of carbon nanoparticles in the protection of parathyroid during thyroid carcinoma surgery. METHOD: Seventy-two patients with thyroid carcinoma who had initial surgery were randomly divided into two groups: carbon nanoparticles group and the control group. Emulsion of carbon nanoparticles was injected into the thyroid gland of carbon nanoparticles group patients. After thirty minutes,the excision of thyroid carcinoma and VI group neck dissection were performed in carbon nanoparticles group patients, the control group directly underwent operation. The black stained tissue in the dissection specimen of carbon nanoparticles group was separated. The number of total lymph node,metastasis lymph node and parathyroid gland in the tissure black stained or not in two groups were counted respectively. RESULTS: There were 312 lymph nodes in the black stained tissue of central compartment dissection specimen of carbon nanoparticles group. No parathyroid gland was found in the black stained tissue. Fifteen lymph nodes containing four parathyroid glands were found in the non black stained tissue in carbon nanoparticles group while there were 202 lymph nodes containing 13 parathyroid glands in the control group. There were statistical difference between the amount of lymph node in black stain tissue and the specimen of the control group. Parathyroid glands were not stained black,and no parathyroid gland was found in the black-stained tissue. CONCLUSION The carbon nanoparticles could be used to identify the lymph node and the parathyroid gland for protecting the parathyroid gland in thyroid surgery.
Carbon ; Carcinoma ; Coloring Agents ; Dissection ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Nanoparticles ; Neck Dissection ; Parathyroid Glands ; Thyroid Neoplasms ; pathology ; surgery

Objective To evaluate the efficacy and safety of nateglinide,a new antidiabetic agent,in the treatment of type 2 diabetes.Methods 276 patients with type 2 diabetes mellitus,in accordance with the table of random number method,were divided into the nateglinide group 138 cases,repaglinide group 138 cases.The nateglinide group was given 30 mg nateglinide,and repaglinide group was given 0.5 mg repaglinide,3 times a day,oral administration 15min before meal.12 weeks for one period of treatment.FBG,2h PBG,HbAlc and security index were detected before and after treatment.Results After treatment,FBG,2h PBG and HbAlc indexes in the two groups were lower than before treatment,the differences were statistically significant(all P ＜ 0.05).The differences were not significant compared between the two groups (all P ＞ 0.05).No serious adverse events occurred in two groups.Conclusion Nateglinide can effectively control fasting and postprandial blood sugar in patients with type 2 diabetes.It is safe and reliable and worthy clinical promotion.

ObjectiveTo investigate the expression of survivin,COX-2 and bcl-2 in non-Hodgkin lymphoma(NHL)and the significance and correlation between them.MethodsImmunohistochemistry MaxVision systems for survivin,COX-2 and bcl-2 were conducted on 44 NHL and 20 reactive lymphoid hyperplasia (RH).ResultsThe positive expression rates of survivin,COX-2,bcl-2 in NHL were 70.45 ％(31/44),68.18 ％ (30/44),63.64 ％ (28/44),respectively,and these in RH were 40.00 ％ (8/20),40.00 ％(8/20) and 20.00 ％ (4/20),respectively.There was positive correlation between the expression of COX-2 and survivin (r =0.306,P =0.043),survivin and bcl-2 protein (r =0.339,P =0.040) in NHL.ConclusionCOX-2,survivin,bcl-2 are highly expressed in NHL.To detect the expression of them has clinical value to diagnosis NHL and to estimate the malignant degree of lymphoma.There are a positive correlations between the expression of COX-2 and survivin protein,and between the expression of survivin and bcl-2 protein,which indicates that they may play a synergistic role in the occurrence and development of NHL.

This study investigated the anti-HSV-2 effect of alumen through in vitro and in vivo experiments. Viable cell counting was employed to assess the toxicity of alumen on Vero cells. The inhibition rate of HSV-2 was defined as the cytopathic effect (CPE) of the cells infected with the virus. Alumen suppositories of different concentrations were vaginally applied to the guinea pigs which were then infected with HSV-2 via a vaginal route. The clinical symptoms were observed and the local virus titer calculated. The results showed that alumen had an in vitro anti-HSV-2 effect by means of antiviral duplication, direct killing of the virus, and antiviral adsorption. Alumen suppositories of different concentrations could reduce or completely inhibit HSV-2 infection in guinea pigs. It was concluded that alumen had an in vitro anti-HSV-2 effect through multiple approaches and it could suppress in vivo vaginal HSV-2 infection of guinea pig to some extent.

This study investigated the anti-HSV-2 effect of alumen through in vitro and in vivo experiments.Viable cell counting was employed to assess the toxicity of alumen on Vero cells.The inhibition rate of HSV-2 was defined as the cytopathic effect (CPE) of the cells infected with the virus.Alumen suppositories of different concentrations were vaginally applied to the guinea pigs which were then infected with HSV-2 via a vaginal route.The clinical symptoms were observed and the local virus titer calculated.The results showed that alumen had an in vitro anti-HSV-2 effect by means of antiviral duplication,direct killing of the virus,and antiviral adsorption.Alumen suppositories of different concentrations could reduce or completely inhibit HSV-2 infection in guinea pigs.It was concluded that alumen had an in vitro anti-HSV-2 effect through multiple approaches and it could suppress in vivo vaginal HSV-2 infection of guinea pig to some extent.