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 application effect of a wearable visual field meter based on extended reality (XR) glasses for patients with macular disease.Methods:A self-controlled study was conducted.A total of 41 consecutive patients (41 eyes) with macular disease were recruited at Renmin Hospital of Wuhan University from October 2022 to October 2024.All patients underwent 10-2 center visual field test using a self-developed wearable visual field meter (XRVF), and the results were compared with those obtained using a traditional Humphrey field analyzer (HFA).The comparison parameters included mean retinal sensitivity (MS), false positive rate (FPR), false negative rate (FNR), and testing duration.A subject satisfaction questionnaire was administered.This study followed the Declaration of Helsinki.The study protocol was approved by the Medical Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2024-K263), and all subjects signed the informed consent form.Results:The retinal sensitivity of patients measured by HFA was (23.24±3.71)dB, which was higher than (22.01±3.45)dB by XRVF, showing a statistically significant difference ( t=4.924, P=0.036).The FPR measured by HFA and XRVF were (2.39±2.51)% and (2.59±3.29)%, respectively, and the FNR were (3.49±6.05)% and (3.74±5.38)%, respectively, showing no statistically significant difference ( t=-3.624, P=0.948; t=-1.241, P=0.519).The median test duration for HFA and XRVF was 6.15 (5.78, 6.65) and 5.98 (5.71, 6.69)minutes, respectively, without statistically significant difference ( Z=-1.987, P=0.953).92.6% of the subjects thought the device was comfortable, simple and practical. Conclusions:The XRVF has good consistency with the HFA, can effectively and reliably evaluate the visual field function of patients with macular disease, and is easily accepted by patients.

Objective:To evaluate the application effect of a wearable visual field meter based on extended reality (XR) glasses for patients with macular disease.Methods:A self-controlled study was conducted.A total of 41 consecutive patients (41 eyes) with macular disease were recruited at Renmin Hospital of Wuhan University from October 2022 to October 2024.All patients underwent 10-2 center visual field test using a self-developed wearable visual field meter (XRVF), and the results were compared with those obtained using a traditional Humphrey field analyzer (HFA).The comparison parameters included mean retinal sensitivity (MS), false positive rate (FPR), false negative rate (FNR), and testing duration.A subject satisfaction questionnaire was administered.This study followed the Declaration of Helsinki.The study protocol was approved by the Medical Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2024-K263), and all subjects signed the informed consent form.Results:The retinal sensitivity of patients measured by HFA was (23.24±3.71)dB, which was higher than (22.01±3.45)dB by XRVF, showing a statistically significant difference ( t=4.924, P=0.036).The FPR measured by HFA and XRVF were (2.39±2.51)% and (2.59±3.29)%, respectively, and the FNR were (3.49±6.05)% and (3.74±5.38)%, respectively, showing no statistically significant difference ( t=-3.624, P=0.948; t=-1.241, P=0.519).The median test duration for HFA and XRVF was 6.15 (5.78, 6.65) and 5.98 (5.71, 6.69)minutes, respectively, without statistically significant difference ( Z=-1.987, P=0.953).92.6% of the subjects thought the device was comfortable, simple and practical. Conclusions:The XRVF has good consistency with the HFA, can effectively and reliably evaluate the visual field function of patients with macular disease, and is easily accepted by patients.

Objective To retrospectively analyze the importance of preoperative ultrasound and D-dimer determination for patients with traumatic fractures so as to evaluate the value of vascular color Doppler ultrasound in diagnosing of vein thrombosis and the correlation between D-dimer level and lower extremity vein thrombosis. Methods The study involved 1000 in-patients with multiple traumatic fractures, femoral fractures, tibial fractures or tibiofibular fractures admitted from March 2008 to April 2009 who were prepared for open reduction surgery. There were 568 males and 432 females, at age range of 20-90 years ( average 54.8 years). Vein D-dimer was examined in the morning on the second day after admission. Vascular color Doppler ultrasound was performed on the lower extremity one day before operation (after the swelling faded away, about 4-10 days after fracture). Results The vascular color Doppler ultrasound on the lower extremity showed vein thrombosis of the lower extremity in 64 patients (6.4%) including 26 patients with iliac- femoral vein thrombosis, 10 with popliteal-tibial vein thrombosis and 28 with gastrocnemius or soleus muscle vein thrombosis. On the second day after operation, out of 736 patients (73.6%) with D-dimer above normal (324 μg/L), 56 patients (7.6%) developed thrombosis afterwards;of 264 patients (26.4%) with normal D-dimer, eight patients (3.03%) developed thrombsis. Incidence of thrombosis in patients with D-dimer above 650 μg/L was higher than that in patients with D-dimer below 650 μg/L (P＜0. 01). Conclusions Preoperative lower extremity vein Doppler ultrasound in traumatic fracture patients can lower the risk of fatal lung thrombosis caused by existing deep vein thrombosis.D-dimer above normal level indicates tendency of thorombosis. However, normal D-dimer still have the possibility to develop thrombosis, which deserves attention.

Purpose:To study the effect of NVB in the treatment of advanced non small cell lung cancer (NSCLC).Methods:In 39 cases advanced stage, primary chemotherapy patients account for 30 cases and 9 were recurrent diseases.Results:CR 2 cases PR 20 cases NC 13 cases and PD 4 cases, total response rate 56.4%. The majory toxicity was bone marrow suppression.Conclusions:Combined chemotherapy including NVB has better curative effect for advanced NSCLC.