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 observe the clinical efficacy of acupuncture based on "status-target coherence" theory combined with Kegel exercises for vaginal laxity syndrome (VLS). METHODS: Sixty-six patients with VLS were randomized into an observation group (33 cases, 2 cases dropped out, 1 case was discontinued) and a control group (33 cases, 5 cases dropped out). The observation group was treated with acupuncture combined with Kegel exercises, acupuncture was applied to bilateral Ciliao (BL32), Zhongliao (BL33), Sanyinjiao (SP6), etc. The control group was treated with Kegel exercises. Both acupuncture and Kegel exercises were performed once every other day, three times a week for 12 weeks. Before and after treatment, the vaginal laxity questionnaire (VLQ) score, pelvic floor muscle strength (vaginal resting pressure, vaginal systolic pressure, vaginal contraction duration), degree of vaginal laxity and sexual satisfaction questionnaire (SSQ) grade were observed in both groups. RESULTS: After treatment, the VLQ score, vaginal resting pressure, vaginal systolic pressure, vaginal contraction duration in the observation group were elevated compared with those before treatment (P<0.05), and SSQ grade was improved (P<0.05); and the above indexes in the observation group were better than those in the control group (P<0.05). There were no significant difference before and after treatment in the degree of vaginal laxity in the two groups (P>0.05). CONCLUSION Acupuncture based on "status-target coherence" theory combined with Kegel exercises can effectively enhance the strength of pelvic floor muscles, improve the symptoms of vaginal laxity, and improve the satisfaction of sexual life, and its therapeutic effect is better than Kegel exercises alone.
Humans ; Female ; Adult ; Vagina/physiopathology* ; Acupuncture Therapy ; Exercise Therapy ; Young Adult ; Middle Aged ; Treatment Outcome ; Acupuncture Points ; Combined Modality Therapy ; Vaginal Diseases/therapy*

OBJECTIVE To analyze the incidence of infectious diseases in a certain department from 2015 to 2022,to provide scientific basis for formulating health and epidemic prevention measures.METHODS Descriptive epide-miological methods were used to analyze the incidence of infectious diseases.RESULTS Over the eight-year period,a total of 3,635 cases of 35 types of infectious diseases were reported.The top five diseases in terms of incidence were chickenpox,influenza,tuberculosis,viral hepatitis and acute febrile respiratory diseases.From the perspec-tive of transmission routes,respiratory infectious diseases were the most common,followed by blood-borne and sexually transmitted diseases,and gastrointestinal infectious diseases.Regarding time distribution,the high-est number of cases occurred in the first quarter,with the least in the third quarter.From the perspective of popu-lation distribution,soldiers have the highest incidence of the disease,followed by military officers,with age of on-set ranging from 17 to 25 years old.CONCLUSIONS Respiratory infectious diseases are the primary cause of the epidemic,with an obvious seasonal distribution characteristics,and sexually transmitted diseases show a slow growth trend.It is imperative to strengthen monitoring,early warning and timely disposal of respiratory infectious diseases;meanwhile health education and intervention for risk factors related to sexually transmitted diseases should be strengthened.

OBJECTIVE To analyze the incidence of infectious diseases in a certain department from 2015 to 2022,to provide scientific basis for formulating health and epidemic prevention measures.METHODS Descriptive epide-miological methods were used to analyze the incidence of infectious diseases.RESULTS Over the eight-year period,a total of 3,635 cases of 35 types of infectious diseases were reported.The top five diseases in terms of incidence were chickenpox,influenza,tuberculosis,viral hepatitis and acute febrile respiratory diseases.From the perspec-tive of transmission routes,respiratory infectious diseases were the most common,followed by blood-borne and sexually transmitted diseases,and gastrointestinal infectious diseases.Regarding time distribution,the high-est number of cases occurred in the first quarter,with the least in the third quarter.From the perspective of popu-lation distribution,soldiers have the highest incidence of the disease,followed by military officers,with age of on-set ranging from 17 to 25 years old.CONCLUSIONS Respiratory infectious diseases are the primary cause of the epidemic,with an obvious seasonal distribution characteristics,and sexually transmitted diseases show a slow growth trend.It is imperative to strengthen monitoring,early warning and timely disposal of respiratory infectious diseases;meanwhile health education and intervention for risk factors related to sexually transmitted diseases should be strengthened.

Objective:To explore the correlation between high cholinergic pathway signaling and cognitive function in patients with Parkinson disease(PD) accompanied with sleep disorder.Methods:PD patients admitted from 2017 to 2022 were divided into PD with sleep disorder group (PD-SD group) ( n=56) and PD without sleep disorder group (PD-NSD group) ( n=41) according to the Parkinson's disease sleep scale (PDSS) score. All participants underwent magnetic resonance imaging examination.All patients were evaluated by the PDSS, Hoehn-Yahr (H-Y), Montreal cognitive assessment scale (MoCA), and cholinergic pathways hyper intensities scale (CHIPS). The difference of cognitive function between the two groups and the correlation between CHIPS and cognitive function were analyzed.Independent sample t-test, Spearman correlation analysis, and binary Logistic regression analysis were performed on the data by SPSS 26.0 statistical software. Results:(1)The MoCA score of the PD-SD group (22.00 (5.00)) was lower than that of the PD-NSD group (26.00 (5.00)) ( Z=-3.830, P<0.05). The total and all aspects scores of CHIPS in PD-SD group were higher than those in PD-NSD group(the total score of the low external capsule: 12.00(8.00), 0(8.00), the total score of the high external capsule: 12.00(2.00), 6.00(9.00), the total score of the radial crown: 8.00(0), 4.00(4.00), the total score of the centrum semiovale: 3.00(4.00), 0(2.00), the total score of the right side: 16.00(9.00), 5.00(10.00), the total score of the left side: 17.00(6.00), 7.00(9.00), the total score of CHIPS: 32.00(14.00), 14.00(20.00))( Z=-5.081, -5.873, -4.933, -3.211, -5.562, -6.232, -5.995, all P<0.05). (2)The correlation analysis between the score of CHIPS and cognitive function in the PD-SD group showed that, the total score of the low external capsule ( r=-0.286), the total score of the centrum semiovale ( r=-0.307), the total score of the right side ( r=-0.376), the total score of the left side ( r=-0.284) and the total score of CHIPS ( r=-0.349) were negatively correlated with MoCA(all P<0.05). (3)Binary Logistic regression analysis showed that white matter lesions in centrum semiovale, low inner capsule, right and left leukodystrophy were not influence factors for cognitive impairment (all P>0.05). Conclusion:PD patients with sleep disorders have lower cognitive function scores, higher CHIPS scores, and significant changes in white matter lesions compared to those without sleep disorders. In PD patients with sleep disorders, the higher the CHIPS score, the lower the cognitive function score, and the more significant the rate of cognitive impairment occurrence and development.

Objective To explore the pulmonary ultrasound manifestations of pediatric infectious pneumonia and its combined diagnostic value with serum amyloid protein A(SAA)/hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT).Methods A tatol of 107 children with infectious pneumonia admitted to the 903rd Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from January 2019 to June 2023 were selected as the research group,and 50 healthy children who underwent physical examinations during the same period were selected as the control group.Both groups of children underwent lung ultrasound examination to analyze the ultrasound manifestations of children with infectious pneumonia,compare SAA/hs-CRP and PCT,and analyze the diagnostic value of lung ultrasound combined with SAA/hs-CRP and PCT detection for pediatric infectious pneumonia.Results Among 107 children with infectious pneumonia,104 were diagnosed positive by lung ultrasound,with a positive rate of 97.20％.The lung ultrasound score,SAA/hs-CRP,and PCT of the study group were higher than those of the control group(P＜0.05).The lung ultrasound score,SAA/hs-CRP,and PCT in children with severe infectious pneumonia were higher than those in mild cases(P＜0.05).The diagnostic efficacy of lung ultrasound combined with SAA/hs-CRP and PCT detection for pediatric infectious pneumonia is superior to that of individual detection,with a curve area of 0.923,sensitivity and specificity of 92.30％and 87.98％,respectively.The lung ultrasound score is positively correlated with SAA/hs-CRP and PCT(P＜0.05).Conclusion Pulmonary ultrasound can display the characteristics of pulmonary lesions in children with infectious pneumonia.The ultrasound manifestations of children are mostly abnormal pleural lines,increased B-lines,and pulmonary consolidation.Combined detection with SAA/hs-CRP and PCT can further improve the diagnostic efficiency of pediatric infectious pneumonia.

Objective:To explore the influence of temperament between parenting style and externalizing problem behaviors in school-age children.Methods:In October 2017, a stratified cluster sampling method was used to conduct a questionnaire survey among 380 school-age children in Aruhorqin Banner, Chifeng City, Inner Mongolia Autonomous Region. All the school-age children were assessed by the Achenbach child behavior checklist, parenting style scale, and middle childhood temperament questionnaire.Mediation models were established by the PROCESS macro program of SPSS, and the mediating effect was tested by the Bootstrap method.Results:The scores of various scales for school-age children were as follows: father's authoritative parenting style(3.77±1.11), father's authoritarian parenting style(1.55±0.68), father's indulgent parenting style(1.25±0.57), mother's authoritative parenting style(3.86±1.16), mother's authoritarian parenting style(1.64±0.73), mother's indulgent parenting style(1.25±0.61), activity level(2.42±0.71), attention dispersion(3.78±0.81), externalization problem behaviors 3.0(4.0).For school-age children, the scores of externalization problem behaviors were negatively correlated with the scores of authoritative parenting style( r=-0.15, -0.11, both P<0.05), and positively correlated with authoritarian and indulgent parenting style ( r=0.17-0.33, all P<0.05). The scores of externalization problem behaviors were positively correlated with eight temperament dimensions, such as adaptability, emotional essence, reaction threshold, attention dispersion, persistence, rhythmicity, activity level and reaction intensity( r=0.17-0.42, all P<0.05). After controlling for age and gender, attention dispersion played a masking effect on the influence of authoritative parenting style on children's externalizing problem behaviors, with the indirect effect accounting for 21.05%(|0.04/-0.19|) and 26.67%(|0.04/-0.15|) of the direct effect respectively. Attention dispersion partially mediated the impact of father's authoritarian parenting style on children's externalization problem behaviors, with the mediating effect accounting for 10.71%(0.03/0.28) of the total effect. Response intensity partially mediated the impact of authoritarian parenting style on children's externalizing problem behaviors, with the mediating effect accounting for 25.00%(0.07/0.28) and 27.58%(0.08/0.29) of the total effect respectively. Conclusion:Temperament plays a mediating role between parenting styles and externalizing problem behaviors among school-age children. A nurturing environment suitable for children's temperament should be created to prevent the occurrence of externalizing problem behaviors among school-age children.

Objective To investigate the clinical and practical value of transvaginal endoscopic technology by using traditional hysteroscope in the diagnosis and treatment of intrauterine lesions in asexual women of childbearing age.Methods A retrospective analysis was conducted on 98 cases of hysteroscopic surgery in asexual women of childbearing age admitted from January 2005 to May 2024.Transvaginal endoscopic technology was applied for hysteroscopic examination and/or treatment by using traditional hysteroscope.Results A total of 62 cases underwent electrocautery after cervical dilation with a dilation rod,including 43 cases of endometrial polyps,15 cases of submucosal fibroids,and 4 cases of cervical polyps.The remaining 36 cases underwent endometrial biopsy or curettage by using a microscope,and all obtained endometrial biopsy pathology.One case of hymen laceration about 0.3 cm in length was sutured with 5-0 absorbable suture for one stitch.For the remaining cases,the hymen remained intact.Conclusion Using transvaginal endoscopic technology with traditional hysteroscope can complete hysteroscopic examination or surgical treatment without damaging the hymen,which is suitable for asexual women of childbearing age.

Objective To investigate the clinical and practical value of transvaginal endoscopic technology by using traditional hysteroscope in the diagnosis and treatment of intrauterine lesions in asexual women of childbearing age.Methods A retrospective analysis was conducted on 98 cases of hysteroscopic surgery in asexual women of childbearing age admitted from January 2005 to May 2024.Transvaginal endoscopic technology was applied for hysteroscopic examination and/or treatment by using traditional hysteroscope.Results A total of 62 cases underwent electrocautery after cervical dilation with a dilation rod,including 43 cases of endometrial polyps,15 cases of submucosal fibroids,and 4 cases of cervical polyps.The remaining 36 cases underwent endometrial biopsy or curettage by using a microscope,and all obtained endometrial biopsy pathology.One case of hymen laceration about 0.3 cm in length was sutured with 5-0 absorbable suture for one stitch.For the remaining cases,the hymen remained intact.Conclusion Using transvaginal endoscopic technology with traditional hysteroscope can complete hysteroscopic examination or surgical treatment without damaging the hymen,which is suitable for asexual women of childbearing age.

Humans ; Asthma/drug therapy* ; Biological Therapy