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.

OBJECTIVETo investigate the anti-oxidative stress and anti-fibrotic mechanisms of adiponectin by examining effects on oxidative stress levels and expression of fibrosis-related signaling factors, including transforming growth factor-beta 1 (TGFb1), collagen I (COL-1), and the adenosine monophosphate-activated protein kinase (AMPK) pathway by using an in vitro HSC-T6 cultured cell system.

METHODSActivated HSC-T6 cells were pre-treated with 1.0 mug/mL adiponectin for 0, 30, 60 and 120 min, or left untreated to serve as controls, and both groups were then exposed to 5 mumol/L H2O2; a portion of the adiponectin-treated oxidative stress-induced cells were treated with an AMPK inhibitor (Compound C). The effects on mRNA levels of TGFb1. and COL-1 were analyzed by real-time PCR, in the levels of secreted TGF-b1 and COL-1 were detected by enzyme-linked immunosorbent assay of supernatants, and in the phosphoAMPK and AMPK protein expressions were detected by Western blotting.

RESULTSCompared to the H2O2 group without adiponectin pre-treatment, the H2O2 group with adiponectin pre-treatment showed significantly increased activity of superoxide dismutase (SOD), decreased content of malondialdehyde (MDA), and decreased gene and protein expressions of TGF-b1 and COL-1 (P less than 0.05). Moreover, inhibition of the AMPK pathway inhibited these adiponectin-mediated effects. The H2O2 group with adiponectin pre-treatment also showed increased levels of phospho-AMPK protein expression, with the maximum effect detected after 120 min of the adiponectin pre-treatment (P less than 0.01).

CONCLUSIONInhibition of oxidative stress is one of the mechanisms of the anti-fibrotic effects of adiponectin. Adiponectin can attenuate oxidative stress levels, resulting in down-regulation of TGFb1 and COL-1 expression through activation of the AMPK pathway.

AMP-Activated Protein Kinases ; Adiponectin ; Cell Line ; Collagen Type I ; Down-Regulation ; Hepatic Stellate Cells ; Humans ; Hydrogen Peroxide ; Oxidative Stress ; RNA, Messenger ; Signal Transduction ; Transforming Growth Factor beta1

Objective To construct and identify norepinephrine ( NE) complete antigen for the preparation of high sensitive and specific anti-NE monoclonal antibody .Methods Glutaraldehyde ( GA) and 1-Ethyl-3-(3-Dimethylaminopropyl ) carbodiimide ( EDC) were used to cross-link NE with carrier pro-teins (BSA, OVA) for NE complete antigen preparation under conditions of pH 4.5 or pH9.0.Three assays including UV scanning , SDS-PAGE and FeCl3 color reaction were performed for identification of NE com-plete antigen.Serum antibody titers were evaluated in mice model induced by intraperitoneal immunization with NE complete antigen .Results NE complete antigens were successfully prepared as indicated by the three identification assays .The coupling ratio was significantly increased in a time-depended manner under the condition of pH9.0 in comparison to that in the condition of pH 4.5.Indirect ELISA results showed that , when coating antigens and serum antibodies were prepared with the same cross -linking method , the serum antibody titers were significantly higher than those with different methods .Conclusion Anti-NE antibodies were successfully prepared by immunizing mice with NE complete antigens .

OBJECTIVEAccording to the organizational structure and management system of the hospital medical engineering support, integrate medical engineering support workflow to ensure the medical engineering data effectively, accurately and comprehensively collected and kept in electronic archives.

METHODSAnalyse workflow of the medical, equipment support work and record all work processes by the portable electronic document. Using XML middleware technology and SQL Server database, complete process management, data calculation, submission, storage and other functions.

RESULTSThe practical application shows that the medical equipment support information system optimizes the existing work process, standardized and digital, automatic and efficient orderly and controllable.

CONCLUSIONSThe medical equipment support information system based on portable electronic document can effectively optimize and improve hospital medical engineering support work, improve performance, reduce costs, and provide full and accurate digital data

Automatic Data Processing ; methods ; Hospital Information Systems ; Software Design

BACKGROUND: Similar to other prosthesis, metal-metal prosthesis would produce plenty of wear particles and metal ions, mainly presented as cobalt (Co~(2+)) and chromium (Cr~(3+)), which can lead to osteolysis, eventually, result in aseptic loosening. OBJECTIVE: To observe the effect of Co~(2+) and Cr~(3+) ions on the cells viability and expression of RANK in rats m0nocyte-macrophage cells (RAW264.7) in vitro. METHODS: Monocyte-macrophage cells (RAW264.7) were cultured in vitro, and then the cells were exposed to Co~(2+) and Cr~(3+) ions. The cell viability was assured by MTT test and the level of RANK Mrna was detected by semi-quantitative RT-PCR at different times. RESULTS AND CONCLUSION: Compared to the control group, MTT test demonstrated that Co~(2+) and Cr~(3+)ions could decrease the cell activity of monocyte-macrophage cells obviously. When the cells were exposed to Co~(2+) Cr~(3+) ions, compared to the control group, the Mrna expression of RANK of the metal ions group was increased at 12 hours (P < 0.05), reached its peak level at 24 hours (P < 0.05), and decreased at 48 hours than that of 24 hours (P < 0.05). The results revealed that metal ions have a cytotoxic effect on monocyte-macrophage cells, stimulate the expression of RANK, and have the potential of facilitating monocyte-macrophages cells transform into osteoclast-like cells.

The medical diagnostic photographic X-ray machine is a kind of widely used image examination equipment in hospital,and the images produced is of great significance to patients and doctors as an important clinical diagnostic warranty.This paper introduces a quality inspection technology aiming at medical diagnostic X-ray machine in large-scale hospitals.This technology is based on a multipurpose X-ray survey-meter and several performance phantoms.It can survey important parameters and evaluate image quality of X-ray equipments,and is especially fit to clinical engineers to carry out daily quality control.

In recent years,the mode of the support and service of medical engineering in hospitals is always a focus in the community of clinic engineering. Based on the characteristics of the medical engineering support and service in hospital,we propose a creative,digitalized medical engineering support system,and introduce the workflow of the support system as well as its fundamental parts and characteristics.