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 evaluate the clinical value of 3D reconstruction in the single utility-port thoracoscopic segmentectomy of early stage NSCLC by propensity score matching (PSM). Methods We retrospectively analyzed clinical data of 150 early stage NSCLC patients undergoing single utility-port thoracoscopic segmentectomy. The patients were divided into reconstruction group (n=58) and non-reconstruction group (n=92) according to 3D reconstruction. PSM was performed on two groups to compare perioperative outcomes. Results Procedures were successfully completed on all patients, without perioperative death. In each group, 43 patients were successfully matched after PSM on the basis of 8 confounding factors, age, gender, smoking status, BMI, maximum tumor diameter on CT, tumor location, % FEV1 and type of planned segmentectomy. After PSM, in complex segmentectomy, the patients in the reconstruction group had shorter operation time (155.77±30.17 vs. 212.94±66.49min, P < 0.001) and less blood loss (46.00±25.94 vs. 88.79±68.36ml, P=0.002), compared with the non- reconstruction group. Conclusion Preoperative 3D reconstruction could help improve the efficiency of single utility-port thoracoscopic surgery for complex segmentectomy and reduce intraoperative bleeding.

Objective To explore the clinical efficacy of indwelling suture in preventing re-adhesion of fallopian tube after fallopian tube recanalization(FTR). Methods Screen 93 patients with fallopian tube obstruction and FTR indications of prospective, the patients without other interference factors of infertility, they were randomized with random sampling into two groups (treatment group 50 and control group 43)and treated by FTR,then the treatment group with indwelling sutures in fallopian tube for 3 days, the control group were infused lipiodol into the tube and with a intrauterine cavity perfusion in 3 days. The two groups received followed up examination at 2,6 months after operation ( a treatment was repeated with the case of re-obstruction) . Follow-up for 12 months to appraise the pregnancy rate and the influence of pregnancy competence of tube with indwelling suture(6 months after operation, to collect and compare the pregnancy rate and ectopic pregnancy rate of patent tube in two groups). Results The tubal patency rate were 89.8%(53/59),89.5%(51/57)of treatment group at 2,6 months after operation and the control group were75.9%(44/58),75.0%(39/52), there was a significant difference between the two groups(2 m:χ2=4.027, P<0.05;6 m:χ2=3.958,P<0.05). One year after operation,the pregnancy rate of treatment group was 43.2%(16/37) , the control group was 20.6%(7/34) ,there was a significant difference(χ2=4.152,P<0.05). Six
months after operation, the pregnancy rate and ectopic pregnancy rate of patent tube in treatment group were 21.6%(11/51),2/11, the control group were15.4%(6/39),1/6, there was no significant difference between them(pregnancy rate:χ2=0.552,P>0.05). Conclusions The indwelling suture of fallopian tube can prevent re-adhesion better after FTR, then improve the long-term recanalization rate and the pregnancy rate. There is no change on the pregnancy competence of fallopian tube.

Objective To observe the efficacy of multifactor intensive nursing intervention on chronic heart failure patients with outside hospital treatment,including self-management ability and related clinical indicators.Methods By application of prospective study,a total of 215 patients with chronic heart failure discharged from hospital were randomized into the usual care group (105 cases) and the intensive nursing intervention group (1 10 cases).Patients were followed up for 12 months,and 205 patients completed the follow-up.The usual care group only received conventional outpatient follow-up,the intensive intervention group patients received telephone counseling,more detailed clinical follow-up and regular health education.The intervention effect was compared between two groups.Results Compared with the usual care group,the passing rate of sodium/water limit and daily monitoring of weight was higher in the intensive intervention group.Left ventricular ejection fraction and six-minute walking test were better in the intensive intervention group,while the level of NT-pro-BNP was lower in the intensive intervention group.Compared with the usual care group,re-hospitalization rate and incidence of cardiovascular events were lower in the intensive intervention group.Conclusions Multifactor intensive nursing intervention is helpful on improving self-management ability,alleviate cardiac function,reduce re-hospitalization rate and incidence of cardiovascular events for chronic heart failure patients.