Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

ObjectiveTo investigate the effects of rhizosphere organic acids secreted by the roots of Salvia miltiorrhiza on continuous cropping obstacles. MethodsThe mixed solution of organic acids in the rhizosphere of S. miltiorrhiza in continuous cropping and rotation cropping was added to the hairy roots subcultured for 21 days， and samples were collected on days 0， 2， 4， 6， 8， and 10. The changes of biomass， effective components， primary metabolites， secondary metabolites， antioxidant enzymes， and hormones in hairy roots of S. miltiorrhiza were observed and determined. ResultsCompared with the rotation cropping group and the blank control group， the simulation of organic acid secretion from the roots of S. miltiorrhiza had a significant inhibitory effect on the growth of hairy roots and decreased the content of effective components as well as total sugar and total protein in primary metabolites. Compared with the blank control group， the rotation cropping group and the continuous cropping group showed total sugar and total protein content decreases of 33.9% and 5.1%， respectively. On the other hand， the secretion of organic acids from S. miltiorrhiza roots significantly promoted the accumulation of total phenolic acids and total tanshinone， which showed increases of 14.6% and 1.6%， respectively， in continuous cropping group and rotation cropping group compared with the blank control group. ConclusionThe organic acid environment under continuous cropping significantly inhibited the growth of hairy roots and the accumulation of primary metabolites， while promoting the synthesis and accumulation of secondary metabolites of S. miltiorrhiza.

Objective:To investigate the safety and risk factors of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic lesions.Methods:Five thousand one hundred and sixty patients who underwent EUS-FNA in the Department of Endoscopy, Fudan University Shanghai Cancer Center from January 2012 to December 2022 were retrospectively reviewed. The incidence of adverse events was calculated, and independent risk factors were analyzed by univariate and logistic regression.Results:The incidences of postoperative pancreatitis, intraoperative bleeding and postoperative bleeding were 1.38% (68/4 930), 0.82% (42/5 143) and 0.78% (40/5 143) respectively. No perforation or death occurred. Age >60 years ( OR=0.581, 95% CI: 0.356-0.946, P=0.029), tumor located in the neck, body and tail ( OR=0.355, 95% CI: 0.194-0.652, P=0.001), lesion diameter of >20-40 mm ( OR=0.450, 95% CI: 0.227-0.893, P=0.023), and lesion diameter >40 mm ( OR=0.382, 95% CI: 0.168-0.869, P=0.022) were independent protective factors for postoperative pancreatitis. Transduodenal puncture ( OR=2.435, 95% CI: 1.319-4.496, P=0.005) was an independent risk factor for postoperative pancreatitis. Puncture for 3-4 pass ( OR=0.439,95% CI: 0.235-0.821, P=0.010), lesion diameter of >20-40 mm ( OR=0.154, 95% CI: 0.069-0.341, P<0.001), and lesion diameter >40 mm ( OR=0.326, 95% CI: 0.143-0.743, P=0.008) were independent protective factors for intraoperative bleeding. Fine-needle biopsy (FNB) needle ( OR=2.314, 95% CI: 1.189-4.502, P=0.014) was an independent risk factor for postoperative bleeding. Conclusion:EUS-FNA is a safe procedure with low incidence of adverse events. The occurrence of postoperative pancreatitis and intraoperative bleeding is mainly related to clinical characteristics of the lesion, while postoperative bleeding is related to the type of puncture needle.

Objective To observe the value of radiomics models and nomogram model based on two-dimensional ultrasound and automated breast volume scanning(ABVS)for predicting molecular types of breast cancer.Methods Data of 326 female patients of single breast cancer confirmed by pathology were analyzed retrospectively.The patients were randomly divided into training set(n=260)or validation set(n=66)at the ratio of 8∶2,and further divided into Luminal subgroup and non-Luminal subgroup.Radiomics features were extracted based on two-dimensional ultrasound of breast and ABVS imaging,then model2DUS,modelABVS and modelcombined radiomics were constructed,respectively.Univariate analysis and multivariate logistic regression analysis were used to screen independent factors for predicting molecular types of breast cancer,and nomogram model(modelnomogram)was constructed combined with independent factors and radiomics Radscores.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of each model for molecular type of breast cancer.Results The maximum diameter of tumor(OR=1.029)and the retraction phenomenon(OR=0.408)were both independent predictive factors for molecular type of breast cancer(both P＜0.05).The area under the curve(AUC)of model2DUS,modelABVS.modelcombined radiomics and modelnomogram for predicting molecular type of breast cancer in validation set was 0.67,0.75,0.84 and 0.83,respectively.No significant difference of AUC of modelcombined radiomics and modelnomogram was found(P＞0.05),which were both higher than AUC of model2DUs and modelABVS(all P＜0.05).Conclusion Combined radiomics model and nomogram model based on two-dimensional ultrasound and ABVS could effectively predict molecular type of breast cancer.

【Objective】 To explore the feasibility of en-bloc resection of bladder tumors by flexible cystoscope combined with laparoscopic instruments through urethra and to provide reference for the clinical application of this technique. 【Methods】 Self-designed and processed transurethral single-hole PORT and Olympus electronic cystoscope were used as observation mirror; Φ1.8 mm soft grasper, tissue scissors, electric hook, and ultrasonic scalpel were used as instruments; the porcine bladder was used as a model.The PORT was placed through the urethra, and the cystoscope was inserted to observe the inner wall of the bladder and the condition of the mucosa.After the lesion site was identified in the bladder cavity, the soft grasper was inserted to pull the mucosa to be removed, which was then fixed with tension at the target position to maintain a satisfactory feild of view.The surgeon held the cystoscope in the left hand, and operated the laparoscopic instruments into the bladder cavity through the PORT with the right hand.Observing with the cystoscope and lifting and pulling the mucosa with the grasper, the surgeon simulated the cutting and pushing actions to realize the en-bloc resection of the lesioned mucosa. 【Results】 The mucosa at 4 different locations were successfully resected on 2 in vitro porcine bladder models. 【Conclusion】 The in vitro experiments show that the combination of flexible electronic cystoscope and laparoscopic instruments achieves synergistic effects in en-bloc resection of bladder tumor by transurethral single-hole laparoscope without additional iatrogenic bladder injury caused by percutaneous bladder incision.This method is feasible in the treatment of bladder tumors, and has the potential of clinical application after further optimization.

Guizhi Mahuang Geban Tang derived from ZHANG Zhongjing's Treatise on Cold Damage is included in the Catalogue of Ancient Classic formulas （the second batch） issued by the National Administration of Traditional Chinese Medicine. By reviewing the ancient literature related to Guizhi Mahuang Geban Tang， this study analyzed the origin， medicinal composition， original plants and processing， dosage， decocting method， compatibility， effects， and indications of this formula. A total of 186 records of Guizhi Mahuang Geban Tang were obtained， involving 108 ancient books of traditional Chinese medicine. There are 6 synonyms of Guizhi Mahuang Geban Tang. This formula consists of Cinnamomi Ramulus， Paeoniae Radix Alba， Zingiberis Rhizoma Recens， Glycyrrhizae Radix et Rhizoma， Ephedrae Herba， Jujubae Fructus， and Armeniacae Semen Amarum， the original plants and processing of which are clear. With consideration to the dosage in modern clinical practice， it is recommended that the formula should be composed of 7.67 g Cinnamomi Ramulus， 4.60 g Paeoniae Radix Alba， 4.60 g Zingiberis Rhizoma Recens， 4.60 g Glycyrrhizae Radix et Rhizoma， 4.60 g Ephedrae Herba， 4.00 g Jujubae Fructus， and 2.60 g Armeniacae Semen Amarum. The decoction should be prepared by boiling Ephedrae Herba with 1 000 mL water for 15 min before the addition of other medicines， and the mixture was decocted to reach a volume of 360 mL， and 120 mL of the decoction should be taken warm once. Guizhi Mahuang Geban Tang is a combination of Guizhi Tang and Mahuang Tang， with the effects of dispersing wind cold and harmonizing nutrient-defense. The main diseases treated by this formula in the past dynasties have expanded compared with those in Treatise on Cold Damage. The traditional indications of this formula involve the diseases of greater Yang， reverting Yin， Yang brightness， and lesser Yin. In addition to common cold due to wind-cold， this formula can be used to treat headache， bitter mouth， dry throat， full abdomen， panting， heat invading blood chamber in women， skin itching， exanthema variolosum， syncope， and hardly perceivable pulse. In modern clinical practice， Guizhi Mahuang Geban Tang is used for treating pulmonary diseases such as upper respiratory tract infection， skin diseases （e.g.， urticaria， eczema， psoriasis， and neurodermatitis）， kidney failure， and diabetes complicated with pruritus.

This article explores the standardized management of colorectal polyps, including classification, treatment, follow-up, and preventive control. Corresponding treatment strategies, including endoscopic resection and surgical intervention, are employed for different types of polyps. Currently, there is debate over whether to choose endoscopic resection or surgical intervention for malignant polyps at pT1 stage. Drawing on the latest literature and guidelines, the article elaborates on polyp classification, treatment modalities, follow-up, and preventive measures. Standardized management of colorectal polyps is important for reducing the incidence of colorectal cancer and improving the cure rate of early-stage colorectal cancer.

Objective To evaluate the effectiveness and safety of ultrasound-guided microwave ablation technique in the treatment of benign thyroid nodules.Methods A total of 3985 nodules in 2913 patients with pathologically confirmed benign thyroid nodules during 2016-2023 were analyzed retrospectively.The one-time ablation success rate,incidence rate of postoperative complications and side effects were evaluated.For 1890 ablation nodules in 1449 patients with a median follow-up period of 12 months,the nodule volume re-duction rate (VRR),recurrence rate,re-ablation rate and technical effective ablation rate were evaluated in postoperative 1,3,6,12,24 months and more.Results The success rate of one-time ablation in all patients was 99.7％ (3972/3985),the technical effective ablation rate was 88.6％ (535/604),the recurrence rate was 3.1％ (59/1890) and the re-ablation rate was 0.7％ (13/1890).In the follow-up nodules,VRR in postopera-tive 1,3,6,12,24 months and more was (-17±430)％ (n=727),(48±152)％ (n=643),(72±38)％ (n=573),(83±20)％ (n=604),(88±18)％ (n=279),respectively.In all patients,the incidence rate of major complications was 2.57％,the incidence rate of minor complications was 2.06％,and the incidence of side effects was 3.09％.Conclusion Ultrasound-guided microwave ablation of thyroid nodules is an effective and safe method for the treatment of benign thyroid nodules.

This article explores the standardized management of colorectal polyps, including classification, treatment, follow-up, and preventive control. Corresponding treatment strategies, including endoscopic resection and surgical intervention, are employed for different types of polyps. Currently, there is debate over whether to choose endoscopic resection or surgical intervention for malignant polyps at pT1 stage. Drawing on the latest literature and guidelines, the article elaborates on polyp classification, treatment modalities, follow-up, and preventive measures. Standardized management of colorectal polyps is important for reducing the incidence of colorectal cancer and improving the cure rate of early-stage colorectal cancer.

Objective To explore device solutions for the Internet of Things(IoT)to enhance the efficiency of daytime operating rooms and process management in inpatient departments,and to address the issues of frequent and lengthy movements by anesthesiologists and circulating nurses.The study aims to evaluate the impact on surgical patients,determine the benefits of the proposed plan,reduce the duration of surgery for patients,and increase medical staff satisfaction.Methods A comparative experiment was conducted between operating rooms with the implementation of IoT device solutions and those without.Quantitative data recorded were empirically analyzed using the t test.Results The operating room utilizing the IoT solution experienced a reduction in the number and distance of movements by anesthesiologists and circulating nurses,as well as in the time required for surgical documentation,resulting in higher satisfaction levels.Conclusion The use of the IoT plan in the operating room can improve operational efficiency,reduce documentation time,and enhance the work efficiency of anesthesiologists and circulating nurses through real-time data-driven decision-making.