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 value of echocardiography in assessing right ventricular function of primary light-chain amyloidosis(AL)-cardiac amyloidosis(CA)patients.Methods A total of 25 patients biopsy diagnosed as AL-CA,who were admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2021,were enrolled in this study as amyloidosis group.And 25 heathy volunteers were set as control group.The routine right ventricular morphology and functional parameters were acquired by standard echocardiography.Right ventricular global longitudinal strain(RVGLS)and right ventricular free wall longitudinal strain(RVfwLS)were obtained by two-dimensional speckle tracking imagine.Tricuspid annular plane systolic excursion(TAPSE)/pulmonary artery systolic pressure(PASP),RVGLS/PASP,RVfwLS/PASP ratio were calculated as the noninvasively parameters of right ventricular-pulmonary artery coupling.Results ①Compared with control group,patients in amyloidosis group showed significantly larger right heart size,and significantly thicker right ventricular free wall[(7.16±1.84)mm vs.(3.76±0.66)mm],the difference was statistically significant(P<0.001).②Compared with control group,RVGLS[(17.43±2.45)%vs.(23.22±3.73)%]and RVfwLS[(18.44±2.10)%vs.(22.62±3.64)%]were significantly impaired in amyloidosis group,the difference was statistically significant(P<0.001).The ratios of TAPSE/PASP,RVGLS/PASP,RVfwLS/PASP were found to be lower in amyloidosis group,the difference was statistically significant(P<0.001).③TAPSE/PASP showed mild correlations with N-terminal brain natriuretic peptide precursor(NT-proBNP),highly sensitive T cardiac troponin(hs-TNT)(r=0.45 and 0.40)there were statistically significant(P<0.05).Conclusion Echocardiography can effectively evaluate the right heart function impairment in AL-CA patients,providing valuable information for a deeper understanding of the pathological and physiological mechanisms of the disease.

p70 ribosomal protein S6 kinase (p70S6K), an important member of AGC family, is a kind of multifunctional Ser/Thr kinases, which plays an important role in mTOR signaling cascade. The p70 ribosomal protein S6 kinase is closely associated with diverse cellular processes such as protein synthesis, mRNA processing, glucose homeostasis, cell growth and apoptosis. Recent studies have highlighted the important role of S6K in cancer, which arose interests of scientific researchers for the design and discovery of anti-cancer agents. Herein, the mechanisms of S6K and available inhibitors are reviewed.

Objective To investigate the clinical characteristics,prevention and treatment strategy of de novo hepatitis B virus (HBV)infection after pediatric living liver transplantation.Methods In total,106 pediatric recipients undergoing living liver transplantation in Organ Transplantation Center of Affiliated Beijing Friendship Hospital of Capital Medical University and Organ Transplantation Center of Tianjin First Center Hospital from July 2010 to July 2014 were enrolled in this study.All surgeries were performed by the same surgical team.According to preoperative test outcomes of donor HBV serological markers,all recipients were divided into the positive (n =45)and negative (n =61)antibody to hepatitis B core antigen (anti-HBc)donor liver groups (positive group and negative group),and the prevalence of de novo HBV infection was compared between two groups.The risk factors of de novo HBV infection in the positive group were analyzed to elucidate the clinical characteristics of de novo HBV infection in affected children.Results The incidences of de novo HBV infection in positive and negative group were 18% (8 /45 )and 2% (1 /61 )respectively.The risk factors of de novo HBV infection in recipients with positive anti-HBc were negative anti-HBs before transplantation and absence of antiviral therapy post-transplantation in recipients (both in P <0.05 ).The median interval between time of onset and time of liver transplantation was 12 months (8-48 months).Seven cases were treated with lamivudine and the remaining two cases were left untreated.All nine recipients survived.Conclusions Application of positive anti-HBc donor liver have a risk of HBV infection in recipients after pediatric liver transplantation.Absence of postoperative nucleoside analogue therapy and negative anti-HBs before transplantation acts as risk factors of de novo HBV infection in the recipients with positive anti-HBc donor liver.After liver transplantation,nucleoside analogue therapy is recommended for the pediatric recipients with positive anti-HBc donor liver to prevent the incidence of de novo HBV infection.Besides,hepatitis B vaccine should be administered prior to liver transplantation.

The general system of clinical engineering professional certification in Germany was introduced from the aspects of history, certification authority, requirement of certification, skills and knowledge points, methods of implementation and so on. Through comparative study, some suggestions were proposed to promote clinical engineering staff technology level assessment and certification, which might provide some references for the further improvement of clinical engineering certification system in China.