Objective To investigate the expression of T helper type 17 cells (Th17) and cell‐related cytokines ,including interleukin (IL)‐21 ,IL‐22 ,IL‐23 in the peripheral blood of different clinical stages of patients with acute hepatitis B (AHB) .Methods Ten cases of AHB patients were enrolled .The frequency of Th17 cells in the three clinical stages (i .e .acute phase ,convalescent phase and resolved phase) were detected by flow cytometry . IL‐21 , IL‐22 and IL‐23 were measured by enzyme‐linked immunosorbent assay (ELISA) .Control group was composed of ten healthy subjects .The comparison between the two groups was done by t test and the differences among multiple groups were compared by one way ANOVA .Pearson correlation analysis was used for correlation analysis .Results The frequency of Th17 in healthy controls was (0 .68 ± 0 .29)% ,while those in acute phase ,convalescent phase and resolved phase of AHB patients were (18 .22 ± 4 .13)% , (3 .14 ± 1 .90 )% and (3 .31 ± 0 .95 )% , The differences between the two groups were significant (t= 13 .405 ,4 .047 and 8 .342 , respectively ;all P< 0 .01) .The levels of IL‐21 ,IL‐22 and IL‐23 in healthy controls were (42 .00 ± 6 .95) ,(315 .89 ± 96 .16) and (11 .95 ± 6 .95) ng/L ,respectively .Those in acute phase of AHB patients were (575 .39 ± 47 .01) ,(648 .44 ± 47 .12) and (38 .29 ± 4 .68) ng/L ,respectively ,those in convalescent phase were (366 .50 ± 33 .74) ,(405 .04 ± 47 .12) and (25 .10 ± 4 .69) ng/L ,respectively ,while those in resolved phase of AHB patients were (46 .62 ± 8 .28) ,(365 .94 ± 45 .62) and (15 .29 ± 4 .69) ng/L , respectively .Compared with healthy controls ,t values of the levels of IL‐21 in three different phases of AHB patients were 35 .497 ,29 .792 and 1 .354 with P value of <0 .01 ,<0 .01 and 0 .193 ,respectively ;those of IL‐22 were 9 .820 ,2 .632 and 1 .487 with P value of < 0 .01 ,0 .021 and 0 .161 ,respectively ;those of IL‐23 were 9 .944 ,4 .961 and 1 .260 with P values of <0 .01 ,<0 .01 and 0 .226 ,respectively . After comparison of IL‐21 ,IL‐22 and IL‐23 among three different phase of AHB ,F values were 622 .784 , 107 .772 and 60 .743 with all P values less than 0 .01 ,respectively .The levels of IL‐21 ,IL‐22 and IL‐23 were all positively correlated with the serum ALT level in acute phase (r= 0 .655 ,0 .666 and 0 .673 , respectively ;all P<0 .05) .Correlation analysis demonstrated that the frequency of Th17 was positively correlated with the levels of IL‐21 , IL‐22 and IL‐23 in acute phase ( r= 0 .879 ,0 .866 and 0 .879 , respectively ;all P<0 .01) .The frequency of Th17 was positively correlated with the level of IL‐21 in the resolved phase . No correlations between the remaining groups were confirmed . Conclusion The expressions of Th17 and cell‐related cytokines ,including IL‐21 ,IL‐22 and IL‐23 decline with the recovery of A HB .

Objective To investigate the function of the hypothalamic-pituitary-adrenal (HPA) axis in postmenopausal women with type 2 diabetes and visceral obesity. Methods Subjects were divided into three groups:control group(group C),type 2 diabetes mellitus with non-obesity group (group DM) and type 2 diabetes mellitus with visceral obesity group (group DM + OB). General clinical characteristics, morning blood cortisol concentrations and 24 h urine free cortisol of three groups were compared. Serum cortisol levels were also compared after 0.25 mg dexamethasone suppression test and followed by oral intake of 25 mg cortisone acetate. Results (1) There were no significant differences in basal cortisol levels, but after inhibition with dexamethasone the group DM + OB showed significantly higher cortisol level than that in the control group (P < 0.01). (2) Conversion of oral cortisone to plasma cortisol differed significantly between the group C (lower) and group DM + OB (P < 0.05). (3) Plasma LH and FSH concerntrations were significantly lower in group DM + OB compared with group C (P < 0.01). Conclusion In the postmenopausal women with type 2 diabetes mellitus, the negative feedback mechanism and hepatic 11β-HSD-1 activity were impaired, especially in those with visceral obesity.

Forty women with polycystic ovary syndrome( PCOS) were enrolled. Basal plasma and urine cortisol, pituitary hormones, homeostasis model assessment for insulin resistance, and plasma cortisol in 0. 25 mg dexamethasone inhibition test were determined. In over-weight or obese PCOS patients, cortisol levels before and after inhibition test were increased (P<0. 05 or P<0. 01 ). The results suggest that the feed-back regulation of glucocorticoids to hypothalamas-pituitary is impaired and the change in hypothalamic-pituitary-adrenal axis is associated with insulin resistance.

Objective To investigate the clinical utility of keyhole craniotomy for Cholesteatmas in the cerebello-pontine angle region presenting as Trigeminal neuralgia by using keyhole craniotomy. Methods Clinical data of 35 pa-tients with Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia was analyzed retrospec-tively. All patients received suboccipital retrosigmoid keyhole craniotomy. Thirty cases who received conventional craniot-omy group were served as control group. A comparative analysis was conducted to assess the difference between these two groups in microsurgical methods, effects and complications. Results All patients were confirmed with MR diagnosis. In keyhole group, all patients had no pain symptoms of trigeminal neuralgia after surgical operation. The symptoms disap-peared immediately in 33 cases and gradually disappeared in 2 cases within one month following keyhole craniotomy. The tumors were totally removed in 25 cases and almost completely in 10 cases. The surgical duration was shorten in key-hole group than in conventional group (126±48 vs. 216±66 min;t=2.536, P<0.05). The amount of bleeding was smaller in keyhole group than in conventional group (91.3±52.2 vs. 186.3±65.4 mL;t=2.163, P<0.05). Postoperative neurologi-cal function was assessed in House-Brackmann. In keyhole group, there were 32 cases in class Ⅰ and 3 in grade Ⅱ. Two patients had hearing loss which was improved gradually in three months. In conventional group, there were 25 cases in class Ⅰ and 5 in grade Ⅱ (χ2=4.158, P<0.05). Postoperative hearing evaluation (AAO-HNS) revealed that there were 33 cases in grade A , and 2 in grade B in the keyhole group, whereas there were 27 cases in grade A and 3 in grade B in the conventional group(χ2=5.167, P<0.05). There were no relapse of tumors and death during 3 month to 5 years follow-up. Conclusions The suboccipital retrosigmoid keyhole craniotomy is a valid choice for Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia.

Objective To investigate the dynamic changes in the frequencies ofTh17 (CD3+CD8-IL-17+) and regulatory T cells (Treg,CD4+CD25+CD127low) and Th17/Treg ratio in the peripheral blood in patients with acute hepatitis B (AHB),as well as their association with the outcome of AHB.Methods A total of 10 AHB patients were enrolled as observation group,and according to the outcome of AHB,these patients were further divided into acute stage group,early recovery group,and full recovery group.Another 10 healthy subjects who underwent physical examination were enrolled as control group.Flow cytometry was used to measure the frequencies of Th17 and Treg in peripheral blood,and the Th17/Treg ratio was calculated.An automatic biochemical analyzer was used to measure liver function parameters,and RT-PCR was used to measure HBV DNA.An one-way analysis of variance was used for comparison between groups,and the t-test was used for comparison between any two groups.Results Compared with the control group,the acute stage group showed significant increases in the frequencies of Th1 7 and Treg (18.22％±4.13％/6.46％±2.46％ vs 0.68％±0.29％/1.62％±0.18％,P ＜ 0.01) and the Th1 7/Treg ratio (3.37±1.73 vs 0.42±0.20,P ＜ 0.01).Compared with the acute stage group,the early recovery group showed a significant reduction in the frequency of Th 17 (3.14％± 1.90％,P ＜ 0.01),a significant increase in the frequency of Treg (11.73 ％± 1.76％,P ＜ 0.01),and a significant reduction in the Th17/Treg ratio (0.27±0.19,P ＜ 0.01).Compared with the early recovery group,the full recovery group showed a slight increase in the frequency of Th17 (3.31±0.95,P =0.888),a significant reduction in the frequency of Treg (6.83％±1.85％,P ＜ 0.01),but which was significantly higher than that in the control group (P ＜ 0.01),and a slight increase in the Th17/Treg ratio (0.52±0.21,P ＜ 0.05),which showed no significant difference between this group and the control group (P =0.286).In the acute stage ofAHB,HBsAg and HBeAg levels were positively correlated with Th17/Treg ratio (r =0.639,P ＜ 0.05;r =0.633,P ＜ 0.05).Conclusion The dynamic changes in the frequencies of Th17 and Treg and the Th1 7/Treg ratio may be associated with the outcome of AHB.

Background: To examine the influences of psychosocial work conditions on mental health risk and intention to leave the public sector among workers of public health agencies in Taiwan. Methods: We surveyed 492 public health workers in March 2022 during the COVID-19 pandemic. Information on job demands, job control, workplace justice, experiences of workplace violence and its type and origin, and mental health status (assessed by the 5-item Brief Symptom Rating Scale, BSRS-5) was obtained. Of them, 192 participated in a follow-up survey conducted in May 2023 that assessed mental health status, employment changes, and intention to leave. Results: In the initial survey, 32.93% of participants reported poor mental health status, defined by having a score of BSRS-5 ≧ 10, and 48.17% experienced some form of workplace violence over the past year. Notably, high psychosocial job demands (OR = 3.64, 95% CI = 1.93–6.87), low workplace justice (OR = 2.58, 95% CI = 1.45–4.58), and workplace violence (OR = 2.38, 95% CI = 1.51–3.77) were significantly associated with increased risk of mental disorders. Among those who participated in the follow-up survey, 22.40% had persistent poor mental health, and 30.73% considered leaving or have left the public sector. Longitudinal analyses indicated that job demands predicted persistent mental disorders and intention to leave the public sector, and the experience of workplace violence added additional mental health risks. Conclusion The public health workforce is crucial for effective and resilient public health systems. Our findings that public health workers were at high mental health risk and had a high intention to leave the job warrant attention and policy interventions.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.