Voxel-wise comparison of whole-brain anisotropy revealed widely distributed disintegration of white matter in mild Alzheimer disease (AD). The white matter shows a different pattern of degeneration from gray matter and may be an independent factor in the progress of AD.

Background: Triglyceride-glucose (TyG) index is a recently proposed surrogate indicator of insulin resistance. Previous studies evaluating the association between TyG index and hypertension risk in general adult population showed inconsistent results. We performed a meta-analysis to systematically evaluate this association.Methods: Observational studies, which evaluated the independent association between TyG index and hypertension in the general adult population, were identified by systematic search of PubMed, Embase, Web of Science, Wanfang data, and Chinese National Knowledge Infrastructure databases. A random-effect model, which incorporated the potential intra-study heterogeneity, was used for the meta-analysis.Results: Eight observational studies including 200,044 participants were included. Results showed that compared with those with the lowest category of TyG index, subjects with the highest category of TyG index were associated with higher odds of hypertension [adjusted risk ratio (RR): 1.53, 95% confidence interval (CI): 1.26–1.85, I2 = 54%, P < 0.001]. Sensitivity analysis by excluding one dataset at a time showed consistent result (adjusted RR: 1.44–1.62, P all < 0.001). Results of univariate meta-regression analysis showed that differences in sample size, mean age, male proportion, mean body mass index, and study quality score among the included studies did not have significant influence on the association between TyG index and hypertension (P values all > 0.10), suggesting that differences in these characteristics may not be the major source of heterogeneity. Subgroup analyses showed that study characteristics such as study design, participant ethnicity, age, or sex of the participants did not significantly affect the association (P for subgroup difference all >0.05).Conclusions: Higher TyG index may be associated with higher odds of hypertension in general adult population. Large-scale prospective cohort studies are needed to validate these findings, and further studies are needed to elucidate the potential pathophysiological mechanisms underlying the association between TyG index and hypertension.

BackgroundBrain metastases (BM) from hepatocellular carcinoma (HCC) are extremely rare and are associated with a poor prognosis. The aim of this study was to define clinical outcome and prognostic determinants in patients with BM from HCC.MethodsBetween January 1994 and December 2009, all patients with HCC and BM treated in Sun Yat-sen University Cancer Center were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possible prognostic factors.ResultsForty-one patients were diagnosed with BM from HCC, an incidence of 0.47%. The median age at diagnosis of BM was 48.5 years. Thirty-three patients (80.5%) developed extracranial metastases at diagnosis of BM, and 30 patients (73.2%) had hepatitis B. Intracranial hemorrhage occurred in 19 patients (46.3%). BM were treated primarily either with whole brain radiation therapy (WBRT; 5 patients), stereotactic radiosurgery (SRS; 7 patients), or surgical resection (6 patients). The cause of death was systemic disease in 17 patients and neurological disease in 23. Patients in a high RPA (recursive partitioning analysis) class, treated with conservatively and without lung metastases, tended to die from neurological disease. Median survival after the diagnosis of BM was 3 months (95% confidence interval: 2.2-3.8 months). In multivariate analysis, the presence of extracranial metastases, a low RPA class and aggressive treatment, were positively associated with improved survival.ConclusionsBM from HCC is rare and associated with an extremely poor prognosis. However, patients with a low RPA class may benefit from aggressive treatment. The clinical implication of extracranial metastases in HCC patients with BM needs further assessment.

Estrogen receptors (ERs) are critical regulators of breast cancer development. Identification of molecules that regulate the function of ERs may facilitate the development of more effective breast cancer treatment strategies. In this study, we showed that the forkhead transcription factor FOXK2 interacted with ERα, and inhibited ERα-regulated transcriptional activities by enhancing the ubiquitin-mediated degradation of ERα. This process involved the interaction between FOXK2 and BRCA1/BARD1, the E3 ubiquitin ligase of ERα. FOXK2 interacted with BARD1 and acted as a scaffold protein for BRCA1/BARD1 and ERα, leading to enhanced degradation of ERα, which eventually accounted for its decreased transcriptional activity. Consistent with these observations, overexpression of FOXK2 inhibited the transcriptional activity of ERα, decreased the transcription of ERα target genes, and suppressed the proliferation of ERα-positive breast cancer cells. In contract, knockdown of FOXK2 in MCF-7 cells promoted cell proliferation. However, when ERα was also knocked down, knockdown of FOXK2 had no effect on cell proliferation. These findings suggested that FOXK2 might act as a negative regulator of ERα, and its association with both ERα and BRCA1/BARD1 could lead to the down-regulation of ERα transcriptional activity, effectively regulating the function of ERα.

the outbreak of the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) that originated in Wuhan, Hubei province has spread rapidly across China. Many hospitals in Wuhan are the epicenter of the outbreak. The first 14 staff members who were infected with SARS-Cov-2 were from our department. All of them recovered. In such an urgent and unexpected situation, our department began immediate and effective prevention and control strategies to stop the spread of the epidemic in the department. We believe that clinical departments, especially those related to noninfectious diseases in geographic areas of high risk for virus transmission, should take appropriate management and control measures to improve safety during this epidemic. For this purpose, we summarize and share our experiences which should help medical staff prepare in advance for a similar situation. These include the characteristics of SARS-Cov-2 infection, principles of prevention and control of infection, management of infected patients, and epidemic prevention in the outpatient department, ward, operating room, and medical staff.At the end of December 2019, several cases of pneumonia in Wuhan, China caused by an unknown virus were reported to the World Health Organization (WHO). The novel virus was initially identified as a coronavirus on January 7, 2020, and named "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)" by WHO on February 11, 2020. The disease caused by SARS-CoV-2 is now known as coronavirus disease 2019 (COVID-19). According to the latest retrospective analysis, the median (range) incubation period of COVID-19 is 3 d, but incubation can be as long as 24 d. 1 The median age of patients is 47 yr, and adults are more susceptible than children and adolescents.There is no specific identifying symptom during the early stage of COVID-19 infection. Infected individuals may display weakness, cough, fever, or even no symptom, and yet they are already infectious. The accuracy of early diagnosis based on combined chest computed tomography and nucleic acid test can reach 97%. Expiratory dyspnea occurs in the late stages of infection, and respiratory distress syndrome, acute circulatory failure, or renal failure in severe cases. No specific effective therapeutic protocol in known. The current treatment methods are empiric based on symptoms, and consist of respiratory support (eg, oxygen, mechanical ventilation, or artificial lung technology), antibiotics, and antiviral drugs supplemented by immunoglobulin infusion. 1,2 The outbreak of COVID-19 in Wuhan occurred on the eve of the Chinese New Year (January 12, 2020). However, due to

Breast cancer that is accompanied by a high level of cyclin E expression usually exhibits poor prognosis and clinical outcome. Several factors are known to regulate the level of cyclin E during the cell cycle progression. The transcription factor DEC1 (also known as STRA13 and SHARP2) plays an important role in cell proliferation and apoptosis. Nevertheless, the mechanism of its role in cell proliferation is poorly understood. In this study, using the breast cancer cell lines MCF-7 and T47D, we showed that DEC1 could inhibit the cell cycle progression of breast cancer cells independently of its transcriptional activity. The cell cycle-dependent timing of DEC1 overexpression could affect the progression of the cell cycle through regulating the level of cyclin E protein. DEC1 stabilized cyclin E at the protein level by interacting with cyclin E. Overexpression of DEC1 repressed the interaction between cyclin E and its E3 ligase Fbw7α, consequently reducing the level of polyunbiquitinated cyclin E and increased the accumulation of non-ubiquitinated cyclin E. Furthermore, DEC1 also promoted the nuclear accumulation of Cdk2 and the formation of cyclin E/Cdk2 complex, as well as upregulating the activity of the cyclin E/Cdk2 complex, which inhibited the subsequent association of cyclin A with Cdk2. This had the effect of prolonging the S phase and suppressing the growth of breast cancers in a mouse xenograft model. These events probably constitute the essential steps in DEC1-regulated cell proliferation, thus opening up the possibility of a protein-based molecular strategy for eliminating cancer cells that manifest a high-level expression of cyclin E.

A fiber-tracking algorithm was used to extract fractional anisotropy of bilateral cingulum bundles in patients with probable Alzheimer's disease and normal aging controls. In addition, their hippocampal volumes were measured manually. Relative to normal controls, Alzheimer's disease patients showed a significant reduction of fractional anisotropy and hippocampal volumes. Significant correlation was observed between fractional anisotropy values and volumes of hippocampi and mini-mental state examination scores. This study suggests that lower anisotropy of cingulum bundles is associated with cognitive dysfunction and atrophy of the limbic system.

No abstract