Objective To systematically evaluate the effectiveness and safety of calcium channel blockers (CCBs) and angiotensin-converting enzyme inhibitors (ACEIs) used alone v.s. used in combination on the reversion of left ventricular hypertrophy (LVH) in Chinese essential hypertension (EH) patients. Methods The following databases were searched, including, Cochrane Library (Issue 7, 2011), PubMed (1980 to 2011), EMbase (1990 to 2011), CBM (1978 to 2011), CNKI (1994 to 2011), VIP (1989 to 2011), and WanFang Data (1998 to 2011). The studies were screened, and the quality was evaluated according to predefined inclusion and exclusion criteria, and then Meta-analysis was conducted by using RevMan 5.1 software. Results A total of 10 studies involving 859 patients were included. The results of Meta-analysis showed that the CCBs plus ACEIs group (the combination group) was superior to the CCBs group in improving EH patients’ systolic pressure (SBP) (MD= –6.49, 95%CI –10.55 to –2.43), diastolic pressure (DBP) (MD= –4.48, 95%CI –6.76 to –2.21), left ventricular mass index (LVMI) (MD= –5.31, 95%CI –8.43 to –2.19), interventricular septal thickness (IVST) (MD= –1.33, 95%CI –2.00 to –0.66) and left ventricular posterior wall thickness (LVPWT) (MD= –0.87, 95%CI –1.41 to –0.33). In addition, compared with the ACEIs group, the combination group was greatly superior in decreasing LVMI (MD= –11.54, 95%CI –15.06 to –8.01), IVST (MD= –0.76, 95%CI –1.25 to –0.27) and LVPWT (MD= –0.80, 95%CI –1.01 to –0.59). But clinical effectiveness was similar between the combination group and the CCBs group or the ACEIs group in aspects of the left ventricular end diastolic diameter (LVEDD), fraction shortening (FS) and ejection fractions (EF) (Pgt;0.05). Conclusion The combination therapy of CCBs with ACEIs is superior to either the CCBs or the ACEIsmonothrepy in regression of left ventricular hypertrophy. Because of the low methodological quality and small sample, this conclusion needs to be proved by more high-quality, large-scale and multicenter randomized controlled trials in the future.
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.