The nuclear receptor hepatocyte nuclear factor 4alpha(HNF4α)plays a critical role in the regulation of metabolic homeostasis,including glucose homeostasis.Sulfotransferases(SULTs)catalyze the transfer of a sulfate group from 3-phosphoadenosine 5-phosphosulfate(PAPS)to an acceptor molecule.Sulfonation plays an essential role in regulating the chemical and functional homeostasis of endogenous and exogenous molecules.Among SULTs,the cholesterol sulfotransferase 2B1b(SULT2B1b)preferentially catalyzes the sulfoconjugation of cholesterol and oxysterols to form cholesterol sulfate and oxysterol sulfates.Hepatic gluconeogenesis represents a critical component of energy metabolism.Although there have been reviews on the regulation of glucose homeostasis by HNF4α,the interplay between HNF4α and SULT2B1b in hepatic glucose homeostasis remains scattered.In this review,we intend to provide an overview on how HNF4α functionally cross-talks with SULT2B1b to regulate hepatic glucose homeostasis and whether the HNF4α-SULT2B1b axis represents a novel therapeutic target for the management of metabolic liver disease and metabolic syndrome.

Objective To analyze the voice acoustic characteristics in Parkinson's disease(PD)patients,and to study the correlation between voice features and the severity of disease.Methods A total of 83 patients with PD were selected from the Dongguan Songshan Lake Central Hospital from January 2021 to January 2022 as the experi-mental group,and 87 healthy subjects were enrolled as the control group.All the PD patients were tested with Uni-fied Parkinson's Disease Rating Scale(UPDRS).The vioce samples of all subjects were collected and acoustic char-acteristic were analyzed using speech processing software.The acoustic parameters of two groups were compared ac-cording to sex,and the correlation between vioce features and the severity of disease was analyzed.Results A total of 3 720 speech samples were collected,including 1 895 for PD and 1 825 for the controls.The maximum fundamen-tal frequency,fundamental frequency range and fundamental frequency period change rate were lower than the con-trol group,and the amplitude disturbance was higher than the control group,the differences were statistically signif-icant(P＜0.05).There was a negative correlation between UPDRS-Ⅲ score and the rate of fundamental frequency period change in female patients with PD(r=-0.617,P＜0.05).Conclusion The changes in acoustic parameters are mainly manifested as the decrease in the maximum fundamental frequency,range of fundamental frequency and the change rate of fundamental frequency period,and the increase in the the amplitude disturbance.The rate of fun-damental frequency period change may be used as an indicator to evaluate the severity in female patients with PD.

Objective To investigate the prevalence, accessory gene regulator (agr) and staphylococcal cassette chromosome mec (SCCmec, only for methicillin resistantS. aureus, MRSA) types of theS. aureus strains carrying toxic shock syndrome toxin-1 (tst) and/or panton-valentine leukocidin (pvl) genes.Methods Nine hundred and sixteen isolates ofS. aureus were collected from seven hospitals in Shanghai and Zhejiang Province and subjected to detection oftst,pvl,mecA andmecC genes by polymerase chain reaction (PCR). Theagr and SCCmec (only for MRSA) types were determined in thetst orpvl gene positive isolates.Results Of the 916 isolates, 208 carriedtst gene (22.7%), 35 harboredpvl gene (3.8%), and 665 weremecA positive (MRSA). No isolate was mecC positive. Out of the 665 MRSA isolates, 198 hosted thetst gene (29.8%). The most commonagr and SCCmec types were agr 2 (97.0%) and SCCmec II (94.4%), respectively. For thepvl gene, only 14 isolates were positive (2.1%). Theagr 1 (85.7%), SCCmecIII (42.9%) and SCCmec IVa (28.6%) were the most commonagr type and SCCmec type. In the 251 methicillin-sensitiveS. aureus (MSSA) isolates, 10 carriedtst gene (4.0%) and 21 carriedpvl gene (8.4%). The prevalence oftst gene in MRSA was higher than that in MSSA, while the prevalence ofpvlgene was just the opposite. However, the prevalence ofpvlgene in MRSA isolates from Zhejiang Province was higher than that in the MRSA isolates from Shanghai (P<0.05).Conclusions The prevalence oftst gene in MRSA is signiifcantly higher than that in MSSA. The prevalence ofpvlgene is low in theS. aureus isolates studied. However, clinicians should pay close attention to these strains due to the implication of PVL toxin in some
severeS. aureus infections.

Objective:To explore functional brain region changes and their correlation with behavioral variables based on amplitude of low-frequency fluctuation (ALFF) analysis using resting-state functional MRI (rs-fMRI) in patients with spinocerebellar ataxia type 3 (SCA3).Methods:In this prospective study, patients with SCA3 and healthy controls (HC) were recruited by Southwest Hospital, Army Medical University from May 2017 to March 2022. All subjects completed the scale for assessment and rating of ataxia (SARA), the international cooperative ataxia rating scale-posture and gait (ICARS-p&g), the rapid verbal retrieval (RVR) and Montreal cognitive assessment (MoCA). Meanwhile, the subjects underwent structural MRI and rs-fMRI scans. The MRI data were processed by DPABI software based on MATLAB. The normalized ALFF values of the two groups were compared using two-sample t-test, and the changes of ALFF values in the brain regions of SCA3 and HC groups were analyzed with the t-test of partial correlation coefficient. Spearman correlation analysis was used to evaluate the relationship between the ALFF values of abnormal brain area and the score of neurobehavioral scale in SCA3. Results:Compared with HC group, ALFF significantly increased in the left cerebellum (Crus1, Crus2, 4_5, 6, 7b, 8, 9), right cerebelum_9, left fusiform gyrus and vermis_8; while ALFF significantly decreased in the vermis_4_5 in patients with SCA3. Correlation analysis showed that ALFF values in the left cerebellar_8 were negatively correlated with RVR scores ( r=-0.293, P=0.035), ALFF values in the left cerebellar_9 were negatively correlated with MoCA scores ( r=-0.324, P=0.019), ALFF values in the right cerebellar_9 were negatively correlated with RVR scores ( r=-0.401, P=0.003) in the SCA3 patients. ALFF in the vermis_8 was positively correlated with SARA scores ( r=0.308, P=0.026) and ICARS-p&g scores ( r=0.313, P=0.024) in the SCA3 patients. Conclusion:There are significant changes in ALFF values in the cerebellum and left fusiform gyrus in patients with SCA3, and the changes of ALFF values are closely related with communication, cognitive and movement disorders.

Objective:Telemedicine,as an information-based tool,is widely recognized as an effective solution for compensating for the imbalanced allocation of medical resources in China.This study specifi-cally aimed to analyze the impact of telemedicine functions on the operational efficiency of public hospi-tals,with a particular focus on their heterogeneous effects on hospitals of different levels.Methods:A cross-sectional research design was used based on the 2022 Health Informatization Statistical Survey data,and 8 944 public hospitals were used as research objects to analyze the impact of telemedicine on hospital revenues and business capacity.Multivariate linear model,propensity score matching(PSM),and grouped regression methods were employed to evaluate the impact of telemedicine on hospital revenues,number of consultations,and the number of discharges.Results:The descriptive results showed that telemedicine was available in 35.51％of public hospitals.The analysis also demonstrated that various factors,such as hospital level,academic category,area of the hospital,administrational level and num-ber of beds all had a significant influence on the operation of the hospital.Moreover,the regression re-sults showed that opening telemedicine could increase hospital revenues by 0.140(P＜0.01),hospital consultations by 0.136(P＜0.01),and the number of discharges by 0.316(P＜0.01).After correc-ting for endogeneity using the propensity score matching,the results showed that the effect of opening telemedicine on hospital revenues,consultations,and the number of discharges was 0.191(P＜0.01),0.216(P＜0.01),and 0.353(P＜0.01),respectively.Further heterogeneity analysis was conducted to explore the differential effects of telemedicine on hospitals of different levels.Grouped regression showed that telemedicine had a positive impact on the income of secondary hospitals,with a coefficient of 0.088(P＜0.05),and it had a more significant positive impact on hospital consultations in secondary hospitals,with a coefficient of 0.127(P＜0.01).An even greater impact on the number of discharges in primary hospitals,with a coefficient of 1.203(P＜0.01).Telemedicine,on the other hand,did not have a significant positive impact on the overall revenue and operational capacity of tertiary hospitals.Conclusion:Telemedicine had a significant promoting effect on hospital revenues,hospital consultations and the number of discharges,and this effect was differentiated between hospitals of different levels.Through the construction of telemedicine,primary hospitals were able to significantly improve their business capacity and revenue,which played a positive role in improving the operation of primary public hospitals.

Objective:To evaluate the effect of preoperative cognitive training on postoperative neurocognitive function in elderly patients undergoing coronary artery bypass grafting (CABG) and/or valve surgery.Methods:Seventy-four elderly patients of either sex, of American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ, aged 60-90 yr, with body mass index of 19-28 kg/m 2, scheduled for elective CABG or valve surgery under general anesthesia, were divided into 2 groups ( n=37 each) using a computer-generated random number table method: cognitive training group (group CT) and control group (group C). Group CT was instructed to complete a cognitive training once 1 h per day for 5 consecutive days prior to surgery. Group C did not receive any cognitive training before surgery, and routine nursing was performed. At the 7th day after surgery, the patients′ neurocognitive function was evaluated by the Montreal Cognitive Assessment Scale(MoCA), the Postoperative Quality Recovery Scale (PQRS) was used to assess the patients′ recovery status, and the postoperative complications and morality in both groups were recorded. The patients were assessed using the Geriatric Depression Scale, MoCA and PQRS at the 1st month and 3rd month after operation. Results:The MoCA scores were significantly higher at the 7th day, 1st month and 3rd month postoperatively than in group C ( P<0.05). There was no significant difference in the postoperative case fatality rate and incidence of complications between the two groups ( P>0.05). Significant difference was observed in PQRS scores between the two groups at the 7th day after surgery ( P<0.05), but there were no significant differences in the PQRS scores and Geriatric Depression Scale scores between the two groups at the 1st month and 3rd month after operation ( P>0.05). Conclusions:The cognitive training can improve postoperative neurocognitive function in elderly patients undergoing CABG and/or valve surgery.

Purpose: Radiation-induced dermatitis (RD) is a common side-effect of therapeutic ionizing radiation that can severely affect patient quality of life. This study aimed to develop a risk prediction model for the occurrence of RD in patients with cervical carcinoma undergoing chemoradiotherapy using electronic medical records (EMRs). Methods: Using EMRs, the clinical data of patients who underwent simultaneous radiotherapy and chemotherapy at a tertiary cancer hospital between 2017 and 2022 were retrospectively collected, and the patients were divided into two groups: a training group and a validation group. A predictive model was constructed to predict the development of RD in patients who underwent concurrent radiotherapy and chemotherapy for cervical cancer. Finally, the model's efficacy was validated using a receiver operating characteristic curve. Results: The incidence of radiation dermatitis was 89.5% (560/626) in the entire cohort, 88.6% (388/438) in the training group, and 91.5% (172/188) in the experimental group. The nomogram was established based on the following factors: age, the days between the beginning and conclusion of radiotherapy, the serum albumin after chemoradiotherapy, the use of single or multiple drugs for concurrent chemotherapy, and the total dose of afterloading radiotherapy. Internal and external verification indicated that the model had good discriminatory ability. Overall, the model achieved an area under the receiver operating characteristic curve of .66. Conclusions The risk of RD in patients with cervical carcinoma undergoing chemoradiotherapy is high. A risk prediction model can be developed for RD in cervical carcinoma patients undergoing chemoradiotherapy, based on over 5 years of EMR data from a tertiary cancer hospital.

Objective:To investigate the relationship between urinary polycyclic aromatic hydrocarbons(PAHs) metabolites and pulmonary function in community population.Methods:A total of 4 812 participants were recruited from two communities in Wuhan city from April to May 2011 and two communities in Zhuhai city in May 2012. Information of demographic characteristics and life style was collected by semi-structural questionnaire. Physical examination was performed and pulmonary function was measured. Morning urine was also collected. The concentration of 12 urinary PAHs metabolites was tested and classified into four types by chemical structure, including hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene and hydroxypyrene. The level of pulmonary function in different group of urinary PAHs metabolites was compared by using covariance analysis. The association of the urinary PAHs metabolites and pulmonary function was analyzed by using generalized linear model, and the interaction of different population characteristics and life style on the association was analyzed.Results:The age of participants was(51.99±13.64) years old, and 67.66% ( n=2 565) of the population were women. The M ( P25, P75) of concentration of total urinary PAHs metabolites was 5.72 (3.91,8.72) μg/mmol Cr. After controlling for variables including age, gender, city, Waist-to-Hip Ratio, smoking status, drinking situation, physical activity, cooking meals at home or not, kitchen ventilation and exposure to dust as confounding factors, generalized linear model showed that each 1-unit increase in log-transformed levels of hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene, hydroxypyrene and total PAHs was associated with 26.83 (95% CI: -48.18, -5.48) , 21.86 (95% CI: -40.49, -3.23), 26.18(95% CI: -48.27, -4.09), 34.95 (95% CI: -55.95, -13.94), and 35.23 (95% CI: -58.93, -11.54) ml reduction of FVC and 29.36 (95% CI: -47.23, -11.48), 20.79 (95% CI: -36.39, -5.19), 22.65 (95% CI: -41.15, -4.15), 31.44(95% CI: -49.03, -13.85), and 33.20 (95% CI: -53.04, -13.36) ml reduction of FEV 1 respectively (all P values<0.05). Compared to non-alcohol users and participants with home cooking, the association was more evident in alcohol users and participants without home cooking( P for interaction<0.05). Conclusion:The exposure to PAHs was associated with decreased pulmonary function, and the association was more evident in alcohol users and participants without home cooking.

Objective:To investigate the relationship between urinary polycyclic aromatic hydrocarbons(PAHs) metabolites and pulmonary function in community population.Methods:A total of 4 812 participants were recruited from two communities in Wuhan city from April to May 2011 and two communities in Zhuhai city in May 2012. Information of demographic characteristics and life style was collected by semi-structural questionnaire. Physical examination was performed and pulmonary function was measured. Morning urine was also collected. The concentration of 12 urinary PAHs metabolites was tested and classified into four types by chemical structure, including hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene and hydroxypyrene. The level of pulmonary function in different group of urinary PAHs metabolites was compared by using covariance analysis. The association of the urinary PAHs metabolites and pulmonary function was analyzed by using generalized linear model, and the interaction of different population characteristics and life style on the association was analyzed.Results:The age of participants was(51.99±13.64) years old, and 67.66% ( n=2 565) of the population were women. The M ( P25, P75) of concentration of total urinary PAHs metabolites was 5.72 (3.91,8.72) μg/mmol Cr. After controlling for variables including age, gender, city, Waist-to-Hip Ratio, smoking status, drinking situation, physical activity, cooking meals at home or not, kitchen ventilation and exposure to dust as confounding factors, generalized linear model showed that each 1-unit increase in log-transformed levels of hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene, hydroxypyrene and total PAHs was associated with 26.83 (95% CI: -48.18, -5.48) , 21.86 (95% CI: -40.49, -3.23), 26.18(95% CI: -48.27, -4.09), 34.95 (95% CI: -55.95, -13.94), and 35.23 (95% CI: -58.93, -11.54) ml reduction of FVC and 29.36 (95% CI: -47.23, -11.48), 20.79 (95% CI: -36.39, -5.19), 22.65 (95% CI: -41.15, -4.15), 31.44(95% CI: -49.03, -13.85), and 33.20 (95% CI: -53.04, -13.36) ml reduction of FEV 1 respectively (all P values<0.05). Compared to non-alcohol users and participants with home cooking, the association was more evident in alcohol users and participants without home cooking( P for interaction<0.05). Conclusion:The exposure to PAHs was associated with decreased pulmonary function, and the association was more evident in alcohol users and participants without home cooking.