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 effects of behavior, pathology, the serum IL-17, IL-23 level, and the expressing of RORγt, IL-17 and IL-23 mRNA in nasal tissues of experimental allergic rhinitis rats after the scoparone treatment. METHODS The animal model were divided into 4 groups: normal control group(group NC), allergic rhinitis group(group AR), artemolactone group(group Sco) and dexamethasone group(group Dxm). The symptom score, HE staining of the nasal mucosa, IL-17 and IL-23 level in serum measured by ELISA, the RORγt, IL-17 and IL-23 mRNA level detected by RTPCR. RESULTS Symptoms and inflammatory pathology were relieved in the experimental group after scoparone treatment. The serum levels of the IL-17, IL-23 in group Sco and group Dxm were little higher than that in group NC. The levels of RORγt, IL-17 and IL-23 mRNA in group AR were significantly higher than that in the other three groups. The levels of RORγt, IL-17 and IL-23 mRNA in group Sco and group Dxm were little higher than that in the group NC. CONCLUSION Sco could significantly inhibited or eliminated the allergy symptoms of AR in rats, and could reduce the severity and inflammatory response of diseases.

BACKGROUND: The silk fibroin/type II collagen composite scaffold has been prepared by low-temperature bio-3D printing technology in the previous study and the scaffold has good mechanical properties. Studies have shown that mechanical stimulation is beneficial to bone remodeling, and gradient loading strain is beneficial to the activation of osteoblasts and osteoclasts. OBJECTIVE: To co-culture silk fibroin/type II collagen composite scaffolds with chondrocytes under compression loading, to observe the proliferation of cells, and to observe the preliminary repair effect of silk fibroin/type II collagen composite scaffold on cartilage defects. METHODS: The silk fibroin/type II collagen composite scaffold was prepared by low-temperature 3D printing to detect the porosity of the scaffold. The passage 3 mouse chondrocytes ADTC-5 were inoculated on the silk fibroin/type II collagen composite scaffold and cultured under static culture and mechanical load respectively. (1) Static culture: blank scaffold was set as control, and cell proliferation was detected by MTT assay at 1, 3, 5, 7, 10, 14 days of inoculation. (2) Culture under mechanical load: blank scaffold was set as control. At 1 day after inoculation, 0％, 1％, 5％, 10％, 15％, 20％ compressive strains were applied to the cell-scaffold complex, and continued to load for 3 days. Cell proliferation was detected by MTT assay, and the distribution, adhesion and morphology of the cells on the scaffold were observed by scanning electron microscopy and hematoxylin-eosin staining. A cartilage defect of 3.5 mm in diameter was made in the bilateral knee joint of New Zealand rabbits. The silk fibroin/type II collagen composite scaffold was implanted onto the left side, and no material was implanted onto the right side. The repair site was observed at 8 weeks after surgery. RESULTS AND CONCLUSION: (1) The porosity of the scaffold was (89.3±3.26)％, which was conducive to cell attachment. (2) After 5 days of static culture, the chondrocytes proliferated well on the surface of the composite scaffold. Under 0％, 1％, 5％, 10％, 15％, 20％ compressive strains, the cell proliferation on the scaffold first increased and then decreased, wherein the cell proliferation was highest under 10％ compressive strain, and lowest under 20％ compressive strain. (4) Under the scanning electron microscopy, the chondrocytes in the 0％ load group were distributed in the surface of the scaffold with irregularities, the cell morphology was obvious, and the cell protrusions were fully extended. There were few or no chondrocytes on the contact surface of the 10％ load group, and more cells distributed on the lateral and internal surfaces of the first layer, but the cell morphology was flat with obvious protrusions. (5) Hematoxylin-eosin staining showed that the chondrocytes in the 0％ load group were concentrated on the surface of the scaffold, and there were almost no cells in the pores, while the chondrocytes in the 10％ load group were distributed in the scaffold pores. (6) There was still a circular defect model with no scaffold implantation, and no obvious repair appeared; similar hyaline cartilage appeared in the defect after scaffold implantation, but there was no adhesion to the surrounding defected cartilage, and the new hyaline cartilage was independent. Overall, the adsorption, proliferation and growth of chondrocytes on the silk fibroin-type II collagen scaffolds is better when the compressive strain is 10％, and the composite scaffold can be used as a repair material for cartilage defects.

RORγt, an immune cell-specific isoform of RORγ( retinoic acid receptor-related orphan nuclear receptor gam-ma) , is a key transcription factor for the development of Th 17 cells both in human and mouse .RORγt is required for the induction of IL-17 transcription and for the manifestation of Th 17-dependent autoimmune diseases in mice .RORγt natural ligands are retinoic acid . RORγt is closely implicated in the pathology of numerous autoimmune diseases , infectious diseases and cancer .With the further re-searches about the role of RORγt, we will clarify the mechanism of RORγt in autoimmune diseases , which will provide new ideas to di-agnose and treat autoimmune diseases .

OBJECTIVE: To observe changes of serum Th1/Th2 cytokines and IgE of rats with experimental allergic rhinitis (AR) treating with Scoparone (20 ml/kg, the concentration is 168 mg/L). METHOD: Forty male SD rats were randomly divided into 4 groups : group NC, group AR, group Sco, group Dxm. The rats were sensitized with OVA and were then treated with Scoparone, during the treatment, the behaviors were observed and the change in nasal mucosa were recorded. The level of serum cytokines IFN-gamma, IL-4, IL-5 and IgE were determined by ELISA. RESULTS: The behavior scores of group Sco were significantly lower than those of group AR, the difference was statistically significant (P < 0.01). Comparing to group Dxm and group NC respectively, the difference was not statistically significant (P > 0.05). The nasal inflammation of group Sco was significantly less than that of group AR. The level of serum IFN-gamma of group Sco was significantly higher than that of group AR, while the levels of serum IgE, IL4, IL-5 of group Sco were significantly lower (P < 0.01). There were no significantly difference between group Sco and group NC, group Dxm, the difference was not statistically significant (P > 0.05). CONCLUSION Scoparone is highly effective in treating allergic rhinitis by regulating the expression of Th1/Th2 cytokines and IgE.
Animals ; Coumarins ; pharmacology ; Disease Models, Animal ; Immunoglobulin E ; blood ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Interleukin-5 ; blood ; Male ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; drug therapy ; Th1-Th2 Balance ; drug effects

OBJECTIVE: To observe the suppressive effects of immunostimulatory DNA sequences (ISS) in conjunction with dermato phalloides farinae allergen (Df) on nasal cavity inflammation in rats of experimental allergic rhinitis (AR). METHOD: Thirty-two rats were divided into 4 groups: group ISS(A), group ISS+ Df (B), group Df (C) and group normal saline (D). Rats in groups A,B and C were sensitized and challenged with Df. Blood samples were obtained every week for six weeks, Df specific IgE was measured by ELISA. The nasal mucosa were studied pathologically. The levels of serum interferon gamma (IFN-gamma), IL-12, IL-4 and IL-5 were determined by ELISA. RESULT: The serum level of sIgE in group B was significantly lower than that in group C in six weeks, but that in group A was not significantly different to that in group C. The mean levels of serum IFN-gamma and IL-12 in A, B group were significantly higher than in C group (P < 0.01). But IL-4 and IL-5 level was much lower (P < 0.01). CONCLUSION ISS+ Df have inhibited effectiveness on allergic nasal cavity inflammation in rats and its action time is 6 weeks.
Adjuvants, Immunologic ; Allergens ; Animals ; Base Sequence ; DNA ; immunology ; Immunization ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Interleukin-5 ; blood ; Male ; Pyroglyphidae ; immunology ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic, Perennial ; immunology ; therapy

Objective:To observe the effects of sera Th1/Th2-typed cytokines in patients allergic rhinitis (AR) who were treated with kebimin decoction(KD),and to study the therapeutic mechanism of KD in AR.Methods:60 patients of AR were randomly divided into two groups (treating group,TG and control group,CG). Patients in TG were treated with KD,while those in CG were treated with Xinfang Rhinitis Capsule before and after treatment,the levels of serum Th1-typed cytokines IFN-?、IL-2、IL-12 and Th2-typed cytokines IL-4、IL-5、IL-10 were determined by enzyme-linked immune sorbent assay (ELISA); and compared with 30 healthy controls.Results:The levels of serum Th2-typed cytokines IL-4、IL-5、IL-10 were higher and the levels of Th1-typed cytokines IFN-?、IL-2、IL-12 were lower in AR than that in healthy control ( P 05).Conclusion:Kebimin decoction is highly effective in treating allergic rhinitis by regulating the levels of Th1、Th2-typed cytokines,correcting the imbalance Th1/Th2-typed cytokines network.