Chiari malformation type I is a common developmental anomaly of the craniovertebral junction, most notably characterized by downward herniation of the cerebellar tonsils through the foramen magnum. Traditionally, Chiari malformation type I etiology has been attributed to congenital hypoplasia of the osseous posterior cranial fossa, resulting in a mismatch between volume of intracranial contents and available cranial space. However, with advanced imaging technologies and molecular genetic research, this classical understanding has been increasingly challenged. In recent years, a range of alternative pathogenic theories have emerged, including brain tissue overgrowth, atlantoaxial instability, tethered cord syndrome, idiopathic intracranial hypertension, and dysfunction of the myodural bridge complex; these theories offer novel perspectives from different anatomical and physiological dimensions, complementing or contesting the traditional view. Notably, some of these hypotheses have led to the development of innovative treatment strategies. Nevertheless, these emerging theories remain controversial and lack comprehensive validation. This review gives a systematic overview on the existing etiological hypotheses of Chiari malformation type I, elucidating its multifactorial pathogenesis and highlighting the distinct clinical phenotypes associated with each theory, aiming to provide a theoretical foundation for developing personalized treatment approaches in clinical management of Chiari malformation type I.

The menopausal age is one of the important menopausal factors, and women of different menopausal ages have different risks of diabetes. This study reviewed the evidence from prospective studies on the association between the age at natural menopause and diabetes risk, both domestically and internationally, and presented its research design and main findings. Advanced menopause, especially premature and early menopause, will increase the risk of diabetes in postmenopausal women. The research on the influence of delayed menopause on the incidence of diabetes is still insufficient. Many factors may modify the association between menopausal age and the risk of diabetes.

The menopausal age is one of the important menopausal factors, and women of different menopausal ages have different risks of diabetes. This study reviewed the evidence from prospective studies on the association between the age at natural menopause and diabetes risk, both domestically and internationally, and presented its research design and main findings. Advanced menopause, especially premature and early menopause, will increase the risk of diabetes in postmenopausal women. The research on the influence of delayed menopause on the incidence of diabetes is still insufficient. Many factors may modify the association between menopausal age and the risk of diabetes.

Chiari malformation type I is a common developmental anomaly of the craniovertebral junction, most notably characterized by downward herniation of the cerebellar tonsils through the foramen magnum. Traditionally, Chiari malformation type I etiology has been attributed to congenital hypoplasia of the osseous posterior cranial fossa, resulting in a mismatch between volume of intracranial contents and available cranial space. However, with advanced imaging technologies and molecular genetic research, this classical understanding has been increasingly challenged. In recent years, a range of alternative pathogenic theories have emerged, including brain tissue overgrowth, atlantoaxial instability, tethered cord syndrome, idiopathic intracranial hypertension, and dysfunction of the myodural bridge complex; these theories offer novel perspectives from different anatomical and physiological dimensions, complementing or contesting the traditional view. Notably, some of these hypotheses have led to the development of innovative treatment strategies. Nevertheless, these emerging theories remain controversial and lack comprehensive validation. This review gives a systematic overview on the existing etiological hypotheses of Chiari malformation type I, elucidating its multifactorial pathogenesis and highlighting the distinct clinical phenotypes associated with each theory, aiming to provide a theoretical foundation for developing personalized treatment approaches in clinical management of Chiari malformation type I.

Objective:To investigate plasma levels of fibrinopeptide A(FPA)and platelet alpha-granule membrane glycoprotein 140(GMP-140), and to analyze the changes of coagulation activity in elderly patients with primary microvascular angina(PMVA).Methods:In this prospective case-control study, a total of 45 elderly patients(aged 60-80 years, 27 males and 18 females)admitted to our hospital from Jan.2019 to Dec.2020 were diagnosed as PMVA(as microvascular angina group)by clinical symptoms, electrocardiogram, dynamic electrocardiogram and coronary angiography.Forty-three age-and sex-matched elderly subjects who took a medical check-up and had no primary microvascular angina were included as the control group.Plasma levels of FPA, GMP-140 and high-sensitivity C-reactive protein were determined.The levels of systolic blood pressure, diastolic blood pressure, platelet, fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein, uric acid, renal function and liver function were detected.Results:The FPA level was higher in the PMVA group than in the control group[(430.32±364.05)μg/L vs.(263.73± 118.29)μg/L, t=2.913, P<0.01]. There was no difference in GMP-140 level between the PMVA group and the control group[(5.78±3.92)μg/L vs.(6.95±1.91)μg/L, t=-1.790, P>0.05]. The high-sensitivity C-reactive protein level was higher in the PMVA group than in the control group[(3.33±5.70)mg/L vs.(0.81±0.86)mg/L, t=2.927, P<0.01]. Conclusions:Compared with the control group, the FPA level is significantly increased with elevated coagulation activity in patients with primary microvascular angina.The increased inflammatory state in the PMVA group might promote the occurrence and development of microvascular angina, but whether the inflammatory state promotes the enhancement of coagulation activity needs further study to confirm.

Objective:To explore the associations between perceived built environment attributes and adults’ leisure-time physical activity in four cities of China.Methods:Multistage cluster random sampling method was used to select adults aged 25 to 64 in Hangzhou, Suzhou, Chengdu, and Qingdao. Data were collected from June 2017 to July 2018. The perception of the urban built environment was assessed by the neighborhood environment walkability scale-abbreviated (NEWS-A), and the physical activity was assessed by the International Physical Activity Questionnaire. Generalized linear mixed models were used to explore the relationship between the perceived built environment and leisure-time physical activities.Results:A total of 3 789 participants were included in the analysis. After adjusting for potential confounders, better access to public services ( OR=1.34, 95% CI: 1.02-1.75) and higher aesthetic quality ( OR=1.37, 95% CI: 1.09-1.73) were positively associated with the possibility of engaging in leisure-time physical activity in the past week. Similarly, these two attributes were positively associated with leisure-time walking. Higher scores on the perception of street connectivity were positively associated with leisure-time walking [ exp( β)=1.09, 95% CI: 1.00-1.19]. Higher residential density [ exp( β)=1.000 4, 95% CI:1.000 0-1.000 8], better access to physical activity destinations[ exp( β)=1.09, 95% CI: 1.00-1.19], and better aesthetics [ exp( β)=1.11, 95% CI:1.00-1.22] were associated with higher leisure-time physical activity. Similarly, these three attributes were positively associated with the possibility of meeting the WHO recommendations. Conclusion:Changing some urban built environment attributes may increase leisure-time physical activity.

Objective:To investigate epidemic status of avian influenza virus (AIV) in live poultry market (LPM) and evaluate its potential public health threat and develop control measures in Nanchang city.Methods:Forty-seven LPM in 10 counties/districts of Nanchang city were selected as surveillance sites by using cluster random sampling. Poultry swabs and environmental samples were obtained from LPM. Real time RT-PCR was used for AIV typing and subtyping. Excel 2016, SPSS 24.0 and Prism Version 7 (GraphPad) software were used for statistical analysis.Results:Total of 9 248 poultry swabs and environmental samples were collected. 1 525 specimens(16.49%) were positive for AIV. H7 and H9 were the dominant subtypes, and H9 positive rate was highest (17.44%). Sewage (21.46%) and throat swabs (20.46%) had higher positive rates than the other types of samples. Chicken and duck were dominant hosts for AIV, the corresponding positive rates were 22.80% and 13.95%. The positive rates of Honggutan district, Anyi county and Xinjian district were 25.52%, 24.31% and 22.35%, which were higher than that of the other counties/districts. Each county/district had its unique subtype composition of AIV.Conclusions:The coexistence of H7, H9 and other subtypes of AIV in LMP was identified in Nanchang city. Continuing active surveillance and comprehensive control measures should be taken to reduce the potential risk of human infection.

Objective To observe the effects of stromal cell-derived-factor-1(SDF-1) on the function of endotheli?al progenitor cells(EPCs)of peripheral blood in patients with diabetes, and to discuss the effects of PI3K/AKT signaling path?way on the role of SDF-1 in EPCs. Methods The peripheral blood samples (30 mL) were collected in 10 diabetes patients (DM group) and 10 healthy controls (HC group). (1) The 100μg/L SDF-1 was added in intervention group. EGM-2MV was added in non-intervention group. The Boyden chamber and in vitro angiogenesis kit were used to analyze the migration and in vitro angiogenesis of EPCs. (2) Cultured EPCs were divided into blank control group, 1μg/L SDF-1 group, 10μg/L SDF-1 group, 100μg/L SDF-1 group, pure AMD3100 group and 100μg/L SDF-1+AMD3100 group. AKT protein expression lev?els of endothelial progenitor cells were detected by Western blot assay in each group. Results (1) Without intervention with SDF-1, EPCs’migration and angiogenesis ability were lower in DM group than those in HC group. After intervention with SDF-1, the migration and angiogenesis ability were enhanced in two groups, but the increased level was higher in DM group than that of HC group. (2) Under the same concentration, AKT protein expression level was significantly lower in DM group than that in HC group (P<0.01). AKT protein expression levels were increased with the increased levels of SDF-1 in DM group and HC group (P<0.05). AKT protein expression was significantly lower in 100μg/L SDF-1+AMD3100 group than that of 100μg/L SDF-1 group (P<0.05). Conclusion SDF-1 can increase the chemotactic migration and angiogenesis ability of EPCs in peripheral blood, especially for patients with diabetes. The effects of SDF-1 on EPCs were related to the PI3K/AKT signaling pathway.

Objective To investigate the relationship of parity and other reproduction-associated factors with metabolic syndrome(MS) in middle-aged and elderly women in Nanchang community.Methods Female permanent residents over 40 years old were sampled for a routine examination and a questionnaire survey covering basic information,5 894 subjects were enrolled and identified as effective cases.MS was diagnosed according to the standard of China Diabetes Society in 2004.Factors including age,education,profession,marital status,parity,child-bearing history of macrosomia,breastfeeding,menarche age,and menopausal age were analyzed in order to find their relationship with MS.The univariate logistic analysis was followed by binary logistic regression analysis if P＜0.05,and OR value and confidence interval were calculated.Results Univariate logistic regression analysis showed that age,education,profession,parity,breastfeeding,and menopausal age were influencing factors of MS (all P ＜ 0.05).There was no correlation to marital status,miscarriage history,child-bearing history of macrosomia,menarche age with MS(all P＞0.05).Binary Logistic regression analysis showed that the risk of MS increased with age:OR =1.51 (95 ％ CI 0.98-2.32) during 50-59 years,OR =2.10 (95 ％ CI 1.34-3.30) during 60-69 years,and OR =2.63 (95 ％ CI 1.61-4.31) in cases aged over 70 years,as compared to the group aged 40-49 years.The risk in non-manual workers increased about 34 percent OR =1.33 (95 ％ CI 1.04-1.70),compared with manual workers.The risk of MS increased with parity,being OR =1.46 (95％ CI 1.14-1.88),OR =1.78 (95％ CI 1.30-2.43),and OR =1.84 (95％ CI 1.24-2.72),with 2,3,and 4 child-bearings respectively as compared to cases with only one childbearing.The risk of MS was reduced with advancing menopausal age being about 6 percent reduction with each increased year of menopausal age(OR =0.94,95％ CI 0.90-0.99).There was no difference between education,breastfeeding and MS(P＞005).Conclusion Multiple parity,earlier menopausal age,less manual work,and aging seem to be the risk factors of MS in women.