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 risk factors of invasive fungal disease after haploid hematopoietic stem cell transplantation in children with acute leukemia.Methods:Four hundred and two children (median age 10 years) with acute leukemia, undergoing haplo-HSCT at this institutute from January 2016 to December 2020,were analyzed retrospectively according to the diagnosis criteria of IFD. The basic information and preoperative indicators of the children were collected, including gender, age, primary disease, remission status of primary disease, and previous IFD history. Postoperative indicators were collected, including long-term granulocyte deficiency time, high-dose glucocorticoids, using CD25 monoclonal antibody, acute and chronic graft-versus-host disease. Count data are expressed as example (%), and comparisons between groups are made using the continuously multifactorial corrected Chi-square test or Fisher exact probability method. Logistic regression model was used to analyze the risk factors of IFD after haplo-HSCT in children.Results:Among 402 cases, 250 were male and 152 were female. The median age at transplantation was 10 years, and the age range was 9 months to 17 years 7 months. Before transplantation, 390 cases achieved complete remission of the primary disease, 9 cases had partial remission, and 3 cases had no remission. The implantation time of neutrophils ranged from +10 to 24 days, with a median time of 12 days. IFD occurred in 17 cases (4.2%), of which 3 cases (0.7%) were proven IFD and 14 cases (3.5%) were probable IFD. IFD occurred from 13 to 275 days after transplantation, with a median time of 30 days. The lungs were the most common site of infection (88.2%,15/17). The multivariate Logistic regression analysis showed that age >10 years old ( P=0.046, odds ratio =3.05, 95% confidence interval: 1.02~9.13), the use of high-dose corticosteroids ( P=0.005, odds ratio =7.72, 95% confidence interval: 1.85~32.20) were risk factors for IFD after haplo-HSCT in children. Conclusions:IFD is an important complication after haplo-HSCT in children with acute leukemia. Age >10 years and the use of high-dose corticosteroid are risk factors for IFD after haplo-HSCT in children with acute leukemia.

Objective To evaluate the diagnostic value of high frequency ultrasound in sebaceous gland carcinoma of eyelid (SC).Methods The ultrasonic characteristic for 11 cases with eyelid SC were respectively analyzed by using 13 MHz high frequency ultrasound and 22 MHz ultra-high frequency ultrasound.Results Through 13 MHz high frequency ultrasound,in 7 patients who exhibited Pagetoid invasion the lid shin thickness of tumor side displays no significant alteration in a comparison with normal side.Furthermore,the color Doppler flow imaging (CDFI) evealed a branch-like blood flow surrounding the masses in all cases,but the blood flow of seven patients with Pagetoid invasion had no difference compared with the healthy side.On 22 MHz ultra-high frequency ultrasound examination,slit-like low echo was found in 9 ;transition zone of tumor infiltration can be identified in 9 ; the echo of tumors with Pagetoid invasion was lower than the healthy side and the skin thickness of tumors with Pagetoid invasion was thicker (0.6 ±0.1) mm than the healthy side.CDFI revealed that mesh-basket like blood flow was rich in all patients,the small branch blood vessels arrived at subcutaneous,and vasa vasorum were found in some patients.The region with Pagetoid invasion was rich in blood flow.The sonography findings on 13 MHz and 22 MHz high frequency ultrasound examination were compared with chisquare test.There were significant differences on homogeneous echo,slit-like low echo,transition zone of tumor infiltration,infiltration skin thickness,blood distribution,central blood vessels,vasa vasorum,blood flow in the region with Pagetoid invasion (x2 =12.571,15.231,15.231,4.701,22.000,15.231,4.899,10.267,P＜0.05).Conclusions Slit-like low echo in the mass is a main finding of eyelid sebaceous gland cercinoma on the 22 MHz ultra-high frequency ultrasound.The ultra-high frequency ultrasound can accurately reveal the skin depth infiltrated by the eyelid sebaceous gland cercinoma and this method can provide solid guidance for clinical treatment strategies.

OBJECTIVE: To observe the changes of endothelium-dependent dilation (EDD) of patients with congestive heart failure (CHF) before and after Kanli Decoction treatment. METHODS: Thirty-five CHF patients were treated with Kanli Decoction. We used color Doppler ultrasound to monitor the flow-mediated dilation (FMD), pulsatile index (PI), resistance index (RI), baseline blood flow (BF), ejection fraction (EF) before and after the treatment. RESULTS: FMD after treatment (9.26+/-3.19) were obviously higher than that before the treatment (7.06+/-2.58) (P<0.05), but BF, PI and RI were not improved. CONCLUSION: Applying color Doppler ultrasound into observation on EDD of patients suffering from CHF and treated by the Kanli Decoction shows that the CHF could be treated by traditional Chinese medicine.