Viral hepatitis is an important cause of liver cirrhosis and liver cancer， which has become a major public health problem in the world. Traditional Chinese medicine has unique advantages in treating viral hepatitis， which can inhibit virus replication and enhance immunity. It can effectively prevent liver fibrosis and canceration， improving liver function and symptoms significantly with definite clinical curative effects， a high level of safety， and seldom drug resistance. In addition， it reduces the side effects of western medicine， achieving the effect of synergy and attenuation while reducing the recurrence rate of patients after drug withdrawal. Attention has been paid to the research on the treatment of viral hepatitis with traditional Chinese medicine， and great progress has been made in experimental research and clinical practice. In this paper， the research progress of traditional Chinese medicine in the treatment of viral hepatitis at home and abroad in recent five years was systematically reviewed. Modern research has confirmed that traditional Chinese medicine can play a role in the treatment of viral hepatitis by directly or indirectly inhibiting the virus， anti-inflammatory， anti-fibrosis， anti-oxidation， regulating immunity， regulating autophagy， and other signal pathways. In clinics， traditional Chinese medicine compound or combined with western medicine is often adopted to ameliorate the clinical symptoms of patients such as fatigue and loss of appetite， improve the immune mechanism of the body， enhance the antiviral ability， shorten the treatment course of patients and improve their quality of life. The research provides a reference for pharmacological research， clinical research， and new drug development for viral hepatitis.

Objective:To study the diagnostic value of artificial intelligence B-ultrasound image computer-aided diagnosis system (hereinafter referred to as intelligent ultrasound system) in adult goiter.Methods:In June 2022 and March 2023, two phases of thyroid disease survey were carried out in 4 cities in Anhui Province. One village was selected in each city, and 250 adults were selected as survey subjects in each village. Adult bilateral thyroid area was scanned by both intelligent ultrasound system and conventional ultrasound scanning equipment, and the effectiveness of intelligent ultrasound system in the diagnosis of goiter was analyzed based on the results of conventional ultrasound examination. Receiver operating characteristic (ROC) curve was drawn, and Kappa test was used to analyze the consistency between intelligent ultrasound system and conventional ultrasound examination in the diagnosis of goiter. At the same time, Spearman correlation analysis and Bland-Altman method were used to evaluate the consistency of the two methods in measuring thyroid volume.Results:After screening and removing outliers and missing values, a total of 910 adults were included, including 253 males (27.80%) and 657 females (72.20%). The age was (45.92 ± 10.20) years old, ranging from 18 to 60 years old. The sensitivity, specificity, and accuracy of the intelligent ultrasound system for diagnosing adult goiter were 80.00%, 99.67%, and 99.56%, respectively. The area under the ROC curve (AUC) was 0.996, which was consistent with the results of conventional ultrasound examination for diagnosing goiter ( κ = 0.67, P < 0.001). After controlling for variables such as gender, thyroid function, and thyroid nodules, the intelligent ultrasound system showed good consistency with conventional ultrasound examination in the diagnosis of goiter in females, adults with thyroid dysfunction, and adults without thyroid nodules ( κ = 0.66, 0.80, 0.80, P < 0.001). The consistency in the diagnosis of goiter in adults with thyroid nodules was moderate ( κ = 0.56, P < 0.001). Spearman correlation analysis showed a highly positive correlation between the measurement results of adult thyroid volume by intelligent ultrasound system and conventional ultrasound examination ( r = 0.88, P < 0.001). The Bland-Altman method results showed that only 4.62% (42/910) of points in adults were outside the 95% consistency limit, indicating good consistency between intelligent ultrasound system and conventional ultrasound examination in measuring thyroid volume (< 5%). The proportion of points outside the 95% consistency limit in males, adults with thyroid dysfunction, and adults with thyroid nodules was 6.72% (17/253), 5.83% (12/206), and 6.45% (12/186), respectively. Conclusions:The intelligent ultrasound system has certain diagnostic value for adult goiter and has good consistency with conventional ultrasound examination for thyroid volume measurement. However, the accuracy of diagnosis for males and adults with thyroid nodules still needs to be improved.

Objective The objective of this study was to explore the key genes regulating the metastasis of breast cancer,de-termine the effects of DLX2 on proliferation,migration,invasion,and apoptosis of breast cancer cells,and explore the role and mecha-nism of DLX2 in regulating the characteristics of breast cancer stem cells.Methods A DLX2 gene knockdown breast cancer MCF7 cell line was constructed.The cell viability was detected in breast cancer cells by CCK-8 assay,apoptosis was detected in breast canc-er cells by flow cytometry,cell migration and invasive abilities were detected by Transwell assay,the expression of SOX4 protein was detected by immunofluorescence(IF)in breast cancer cells and xenografts,the expression of CD44 and ALDH1 protein was detected in breast cancer cells and xenografts by Western blot,apoptosis was detected in xenografts by TUNEL assay,and the malignancy degree of tumor tissues was assessed by HE staining.Results After knocking down DLX2,the cell viability decreased(P＜0.001),apoptosis increased(P＜0.001),and cell migration and invasion abilities decreased in breast cancer cells(P＜0.05).The results of IF showed that the expression of SOX4 was inhibited.The results of Western blot showed a decrease in the expression of CD44 and ALDH1 pro-teins in breast cancer cells,which are cellular stemness markers(P＜0.05).In the Balb/c nude mouse breast cancer transplantation tumor model,the volume of xenografts in the sh-DLX2 group was significantly smaller than that in the model group(P＜0.001),the xenografts grew slowly,and the volume and weight of xenografts were also lower than those of the model group(P＜0.05).Apoptosis in the sh-DLX2 group was higher than that in the model group,and the expression of SOX4,CD44 and ALDH1 was consistent with the cellular level,all of which were inhibited(P＜0.05).Conclusion DLX2 inhibits proliferation,migration and invasion of breast cancer cells,promotes apoptosis of breast cancer cells,and regulates the characteristics of breast cancer stem cells through SOX4.

Objective:To study the effect of iodine excess on antioxidant capacity and blood lipid in adult.Methods:A survey was conducted in areas with different iodine nutrition levels in Shandong and Shanxi provinces to collect fasting morning urine and venous blood samples of adults. Urinary iodine, serum levels of superoxide dismutase(SOD), malondialdehyde (MDA), total cholesterol (TCHO), triglyceride (TG), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were determined. According to the median urinary iodine of the population in the investigated village, they were divided into appropriate iodine group (100-299 μg/L) and iodine excess group (≥300 μg/L) . Multiple linear regression was used to analyze the effects of iodine nutrition and other factors on oxidative stress indexes and blood lipids. Partial correlation analysis was used to analyze the relationship between iodine nutrition and oxidative stress indexes and blood lipids.Results:A total of 1 049 subjects were included, including 471 in the appropriate iodine group and 578 in the iodine excess group. The median (quartile) urinary iodine of the appropriate iodine group and the iodine excess group was 228.70 (157.02, 341.49) and 558.73 (298.06, 985.06) μg/L, respectively. The serum SOD level of the appropriate iodine group and the iodine excess group was 12.60 (10.83, 14.10) and 11.29 (9.18, 13.10) U/ml, respectively, and the difference between the groups was statistically significant ( U = 92 697.50, P < 0.001). There were statistically significant differences in serum TG, HDL-C and apoB levels between the appropriate iodine group and the iodine excess group ( U = 108 879.50, 96 613.50, 99 050.50, P < 0.05). The results of multiple linear regression showed that after excluding age, gender and body mass index (BMI), there was a negative correlation between iodine nutrition and serum SOD and HDL-C levels [standard regression coefficient ( β) = - 0.196, - 0.294, P < 0.001]. Partial correlation analysis showed that there was a negative correlation between iodine nutrition and serum SOD and HDL-C levels [correlation coefficient ( r) = - 0.16, - 0.09, P < 0.05]. Conclusion:Excessive iodine intake affects oxidative stress and lipid metabolism in human body.

Objective:To systematically evaluate the relationship between growth and thyroid volume (Tvol).Methods:Chinese and English papers were searched in CNKI, Wanfang Data, VIP Database, PubMed, EMbase, Springerlink, Medline database, articles on the correlation between Tvol and growth in children published from the establishment of these databases to October 2021 were collected. Meta-analysis was conducted with R language 4.0. I2 and Q test were used for heterogeneity test. According to the heterogeneity test results, the fixed effect model or random effect model was selected, and sensitivity analysis was conducted. Egger's method was used to test publication bias. Results:A total of 17 papers were incorporated in this study, including 11 Chinese papers and 6 English papers. The correlation between body surface area (BSA) and Tvol was the strongest[estimated effect value ( COR) = 0.44, 95% confidence interval ( CI): 0.39 - 0.50], followed by weight ( COR = 0.39), height ( COR = 0.37) and age ( COR = 0.29). Sensitivity analysis showed that the estimated effects COR were all within 95% CI of the total effects after deleting any paper, which indicated that the results of Meta-analysis were reliable. Egger's method result showed P > 0.05, indicating that there was no obvious publication bias in this study. Conclusion:Age, height, weight and BSA all have effects on Tvol, among which BSA has the greatest effect.

The controversy over the ultrasonic testing of thyroid volume (TVOL) in children exists in some aspects, mainly focusing on the measurement errors caused by different testing personnel, instruments and techniques. Moreover, with the development of children growth higher than before, the influence of physiological factors on TVOL and relevant correction methods should be paid attention. This paper reviews domestic and foreign literatures. Firstly, through describing the TVOL reference values of international recommended, foreign country and China, we clarify the differences between them, and analyze the current situation and characteristics of each. Secondly, by studying the ultrasonic testing methods and physiological factors which affect TVOL, this paper analyzes the importance of various factors, discusses the availability of several measurement methods and compares several TVOL correction methods. Some suggestions are put forward for further improving the reference value of TVOL of children in China.

Objective To observe prolactin (PRL) and estradiol (E2) levels in lactating women in different iodine nutrition areas.Methods According to the recent national water-borne high iodine area survey and the monitoring results of iodine deficiency disorders,the following places were selected,including Nankang,Xinggang and Yingpan towns of Beihai City,Guangxi (water iodine ≤ 10 μg/L,low iodine areas),Yangcheng Township and Jiajiazhuang Township of Fenyang City,Shanxi (water iodine 50-100 μg/L,adaptive iodine areas),Pingyao County and Jicun Town of Fenyang City,Shanxi (water iodine ≥300 μg/L,high iodine areas),and urinary and blood samples were collected in lactating women (n =100,97,123) from the three regions.The urinary iodine concentration was tested by arsenic cerium catalytic spectrophotometry.Serum levels of PRL and E2 were determined by chemiluminescence immunoassay.Results The urinary iodine medians of lactating women were 51.42,283.62,842.31 μg/L,respectively,in the three regions,the difference between the regions was statistically significant (x2 =241.09,P ＜ 0.05);the iodine levels of lactating women in low iodine areas,adaptive iodine areas and high iodine areas were in the state of iodine deficiency (＜ 100 μg/L),sufficient or adequate (200-299 μg/L) and iodine excess status (≥ 300 μg/L),respectively.Serum PRL and E2 levels of lactating women in the three types of areas were 38.81,20.98,16.41 μg/L and 29.57,43.70,45.51 ng/L,respectively.The differences between the regions were statistically significant (x2 =41.54,24.03,P ＜ 0.05).Conclusion With the increase of iodine nutrition level,PRL in lactating women has presented a gradually decreasing trend,E2 is increased.

Objective To understand the effects of different water iodine level on iodine nutrition and thyroid function in pregnant women,and provide a reference for prevention and treatment of iodine deficiency disorders in the future.Methods According to the background material of water iodine in provinces given non-iodized salt,the administrative villages with water iodine content ＜ 10,10-49,50-99,100-299 and ≥ 300 μg/L were selected as survey sites in Shandong,Shanxi,Hebei,Henan,Jiangsu and Anhui provinces.Urine,blood,drinking water and salt samples were collected from pregnant women at the site of investigation,and urinary iodine,serum iodine,thyroid function and antibody index,water iodine,and salt iodine were measured;thyroid volume was also examined.Results A total of 575 pregnant women were investigated.The medians urinary iodine of pregnant women with water iodine ＜ 10,10-49,50-99,100-299 and ≥300 μg/L groups were 175.55,180.90,139.70,330.15 and 817.70 μg/L,respectively,and the differences were statistically significant in different water iodine groups (H =152.593,P ＜ 0.01).The levels of serum iodine and free thyroxine (FT4) were significantly different among pregnant women in different water iodine groups (H =82.843,F =3.070,P ＜ 0.01 or ＜ 0.05).However,there was no significant difference in serum thyroid stimulating hormone (TSH) levels (H =1.774,P ＞ 0.05).And with the increase of water iodine levels,the abnormal rate of TSH showed the phenomenon of middle low and both ends high ("U" type,x2 =16.729,P ＜ 0.01).There were no significant differences in the positive rates of serum thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),any antibody and double antibodies in pregnant women among different water iodine groups (P ＞ 0.05).And there was a statistically significant difference in the detection rate of subclinical hypothyroidism (x2 =11.869,P ＜ 0.05).The rates of goiter in pregnant women among different water iodine groups were less than 5％.The difference in detection rates of thyroid nodules was statistically significant (x2 =13.591,P ＜ 0.05),and the rate was the highest in water iodine ≥300 μg/L group (21.33％,16/75).Conclusions In water iodine ≥300 μg/L group,urinary iodine level of pregnant women is in the level of iodine excess,and serum iodine level,FT4 level,thyroid nodules detection rate are higher.The abnormal rate of serum TSH and the detection rate of hypothyroidism show a "U" curve that increases at iodine deficiency and iodine excess.

Objective To assess iodine nutrition and thyroid function in children and pregnant women before and after iodized salt concentration decline,and investigate the appropriate concentration of iodized salt.Methods Cluster sampling was carried out,study areas in Shandong and Gansu provinces were selected according to the coverage rate of iodized salt which was more than 95％ and the levels of iodine and fluoride in drinking water which were less than or equal to 10 μg/L and 1 mg/L,respectively in 2012 and 2014.Before (2012) and after (2014) iodized salt concentration decline:children and pregnant women were selected;salt,drinking water and urinary samples were collected;the iodine content of salt,the iodine and fluoride content of drinking water,and urinary iodine were tested.B ultrasound was used to examine the thyroid volume and the total goiter rate (TGR) was calculated in children.The blood sample was collected to test thyrotropin (TSH) and thyroglobulin (Tg) in the 2 groups of subjects.Results Before iodized salt concentration decline,the children median urinary iodine (MUI) concentrations of Shandong and Gansu provinces were 291.4 and 321.9 μg/L,which at the over appropriate and overdose levels,respectively.MUI of Shandong and Gansu provinces were 220.5 and 274.7 μg/L in pregnant women,which were at adequate and over appropriate levels.After iodized salt concentration decline,MUI of Shandong and Gansu provinces were 199.8 and 178.2 μg/L in children,and were 178.6 and 159.2 μg/L in pregnant women,which were all at adequate levels.Children's TGR declined from 7.95％ (7/88) to 5.88％ (7/119) in Shandong Province,children's TGR rose to 5.77％ (6/104) from 2.06％ (2/97) in Gansu Province,there was no statistical differences (x2 =0.34,1.81,P ＞ 0.05).Before and after iodized salt concentration decline,there were no differences statistically in TSH levels of children and pregnant women in Shandong and Gansu provinces (Z =-1.08,-0.83,-1.30,-0.80,P ＞ 0.05).Mter iodized salt concentration decline,the Tg levels were significantly lower than that before intervention in children and pregnant women in Shandong Province (Z =-10.78,-7.04,P ＜0.01);the Tg level was increased than that before intervention in pregnant women group in Gansu Province (Z =-2.78,P ＜ 0.01).Conclusion After iodized salt concentration declined,iodine nutrition and thyroid function status of Shandong Province are reasonable,but the indicators of Gansu Province have a trend of iodine deficiency,monitoring needs to be strengthened,and iodized salt content needs to be adjusted in time.