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 explore the effect of Wilms′ tumor 1-associated protein(WTAP) on tissue collagen deposition in pulmonary fibrosis caused by bleomycin. Methods : 60 mice were randomly divided into four groups: control group(Control group), Bleomycin-induced pulmonary fibrosis group(BLM group), pulmonary fibrosis lentivirus empty vector control group(BLM+LV-NC group), pulmonary fibrosis WTAP lentivirus group virus group(BLM+LV-WTAP group). Experimental pulmonary fibrosis mouse model was established by subcutaneous injection of bleomycin(35 mg/kg) into the abdomen, twice a week for a total of 8 times. After modeling, Western Blot was used to detect the protein expression of fibrosis-related markers α-smooth muscle actin(α-SMA), type I collagen(Collagen Ⅰ), fibronectin(Fibronectin), and WTAP protein. Masson staining and Sirius Red staining were used to detect collagen deposition. RT-qPCR was used to detect WTAP mRNA expression, WTAP lentivirus infection effect, and Collagen Ⅰ mRNA expression. Results: Compared with the Control group, the expression of pulmonary fibrosis markers α-SMA(P<0.001), Collagen Ⅰ(P<0.001), and Fibronectin(P<0.01) protein in the BLM group all increased. Masson staining(P<0.001) and Sirius Red staining(P<0.001) confirmed that significant collagen deposition occurred in the lung tissue of the BLM group. In addition, the expression of WTAP protein in the lung tissue of the BLM group increased(P<0.01). Compared with the Control group, the expression of WTAP mRNA in the BLM group increased(P<0.001). Compared with the BLM+LV-NC group, the expression of WTAP mRNA in the tissues of the BLM+LV-WTAP group decreased(P<0.001), proving that virus infection is effective. After infection with WTAP lentivirus, collagen fiber deposition decreased(P<0.001), Collagen Ⅰ mRNA(P<0.001) level decreased, and protein(P<0.001) expression decreased in the BLM+LV-WTAP group. Conclusion Knocking down of WTAP can reduce collagen deposition in bleomycin-induced pulmonary fibrosis tissue in mice and improve experimental pulmonary fibrosis.

Objective: To investigate the effect of sirtuin 2(SIRT2) on the proliferation and migration of cardiac fibroblasts(CFs)in C57BL/6 mice under angiotensin II(Ang Ⅱ) stimulation. Methods : The hearts were taken from 1 to 2 days C57BL/6 milk mice. After cutting and digesting, CFs were extracted by different adhesion centrifugation. After CFs attachment, the cells were cultured under control medium and Ang Ⅱ(100 nmol/L) medium and treated using OE-SIRT2 plasmid to overexpression the SIRT2 gene. RT-qPCR was used to detect mRNA expression of SIRT2 proliferating cell nuclear antigen(PCNA), periostin(POSTN)and type Ⅰ collagen procollagen A1(Col1A1), Western blot assay was used to measure the protein expression levels of SIRT2, PCNA, POSTN and Col1A1, CCK-8 assay and EdU assay were used to evaluate CFs proliferation rate, Transwell experiment was used to assess CFs migration activity. Results: Compared with control group, Ang Ⅱ stimulation led to down-regulation of SIRT2 expression in CFs, increased collagen expression, and promoted CFs proliferation and migration. The expression of SIRT2 was up regulated in CFs treated with OE-SIRT2 plasmid under Ang Ⅱ stimulation, Col1A1, POSTN and PCNA expression was down regulated, and CFs proliferation and migration ability decreased. Conclusion Overexpression of SIRT2 can inhibit the proliferation and migration of CFs under Ang Ⅱ stimulation, indicating that SIRT2 may be a key regulatory point in the onset and progression of cardiac fibrosis.

Early,complete,and sustained reperfusion of the culprit vessel is critical for success-ful rescue and long-term prognostic improvement in patients with acute ST-segment elevation myocar-dial infarction(STEMI).This report described a patient with STEMI initially presenting with chest pain and found to have three-vessel coronary artery disease during angiography.Rapid identification of the culprit vessel and intraoperative adjustment of the rescue strategy successfully rescued the patient's life and improved prognosis despite of recurrent ventricular fibrillation and electrical storm.

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 t he p otential mechanism of Tibetan medicine Wuwei shexiang pills in the treatment of “Grum bu ”disease（i.e. rheumatoid arthritis ）. METHODS ：Referring to Sibu Yidian ，Drug Standard of the Ministry of Public Health（Tibetan Medicine ），Jingzhubencao，the constituent ，dose and flavor of Wuwei shexiang pills were collected ；vector structure model was built. From the aspects of six tastes ，three tastes after digestion and seventeen effects ，the properties of the formulation were analyzed ；the“formulation-drug property-disease ”network for the treatment of “Grum bu ”disease was constructed by using Gephi 0.9.2 complex network software. The effective components of Wuwei shexiang pills were screened by using the pharmacology analysis platform of TCM system and the database of organic small molecule biological activity. The target proteins corresponding to the active components were predicted by using BATMAN-TCM network pharmacology research platform ； the target proteins of “Grum bu ”disease were searched by ETCM database. On the basis of screening the common targets of the two，David 6.8 bioinformatics resource database was adopted to conduct gene ontology （GO） analysis and KEGG pathway enrichment analysis ；the network of Wuwei shexiang pills- “Grum bu ”- target-pathway was constructed by using Cytoscape 3.7.0 software，and the network topology analysis was carried out to screen the core targets. Using Glide score as evaluation index ， Maestro Version 11.1.011 software was used for molecular docking of above core targets with effective components of Wuwei shexiang pills. RESULTS & CONCLUSIONS ：Wuwei shexiang pills contains myrobalan ，Aconitum pendulum ，Aucklandia lappa ， Acorus calamus and artificial moschus ，and the highest dosage was myrobalan. The six tastes of this formulation were mainly bitter and sweet ；the three tastes after digestion were mainly bitter ；the seventeen effects were mainly blunt ，cool and heavy ，which were mainly used to treat twenty characteristics such as acute ，hot and light. In “formulation-property-disease”network，higher values of edge weight between seventeen effects and twenty characteristics were cooling effect-heat ， blunt effect-sharpness ， heavy effect-light，dilute effect-odor （edge weight values ≥430），etc. A total of 2 306 potential targets of effective components of Wuwei shexiang pills ，211 targets related to “Grum bu ”disease，32 common targets and 29 corresponding effective components were obtained. The results of GO analysis showed that 52 relative results were predicted ，the common targets mainly located in the extracellular area ，nucleus and other parts ，mainly including biological processes and molecular functions such as immune response，inflammatory response ，cytokine activity. The results of KEGG enrichment were significant in 31 pathways（P＜0.05）， involving TNF signaling pathway ，cancer pathway and other signaling pathways. There were 94 active components ，targets and pathway nodes in the network of Wuwei shexiang pills- “Grum bu ”-target-pathway，and 460 edges；TNF，FAS，IL6，IL10， FASLG，PTGS2 and IL 1B were the core targets of the network ， connected with effective components such as quinic acid ， thymol，dehydroepiandrosterone，norcaxone by Van Der Waals force ，hydrogen bond and hydrophobic interaction ，Pi-cation bond and other bonds ，so as to play a role in the treatment of “Grum bu ”disease.

Objective To study the impact of rehabilitation training combined with low molecular heparin calcium on functional recovery and venous thrombosis of postoperative period of hip fracture in the elderly.Methods 86 elderly patients with hip fracture surgery were divided into the control group(43 cases)and observation group (43 cases)according to random number table method.The control group was given low molecular heparin calcium, and the observation group was given rehabilitation training combined with low molecular heparin calcium.After four weeks,the hip functional recovery and venous thrombosis occurrence were observed in the two groups.The levels of blood rheology indicators such as blood high shear viscosity,shear viscosity,low shear viscosity,erythrocyte aggrega-tion index and coagulant function index of thrombin time and D -dimer were detected.Results The scores of hip joint pain,joint function,joint mobility,deformity and Harris score in the observation group were higher than those in the control group,the differences were statistically significant(t =3.713,3.224,3.345,1.861 and 8.087,all P <0.05).The incidence rate of venous thrombosis in the observation group was 6.89%,which was lower than 23.26%in the control group,the difference was statistically significant (χ2 =4.440,P =0.035).After 4 weeks treatment,the levels of the whole blood high shear viscosity,shear viscosity,low shear viscosity and erythrocyte aggregation index in the observation group were lower than those in the control group,the differences were statistically significant (t =2.092,2.590,1.716 and 2.590,all P <0.05).After treatment,the level of D -dimer in the observation group was lower than that in the control group,and the prothrombin time in the observation group was higher than that in the con-trol group,the differences were statistical significance(t =7.510 and 2.151,all P <0.05).Conclusion The rehabil-itation training combined with low molecular heparin calcium can promote hip joint function recovery of postoperative period of hip fracture in the elderly,reduce the incidence of venous thrombosis,improve blood rheology and blood coagulation function indicators.

Objective To study the protein binding rate of glaucocalyxin A in plasma of rat. Methods The plasma balance dialysis was used. An HPLC for the quantitative determination of glaucocalyxin A was presented and used to calculate the protein binding rate in plasma of rat. Results There were protein binding rate results of 74.46%, 77.87%, and 75.29% at three various concentrations 20, 10, and 1 ?g/ mL of glaucocalyxin A in plasma of rat. Conclusion The HPLC method used to determine glaucocalyxin A is simple, rapid, and sensitive with good specificity, precision and accuracy, and glaucocalyxin A has medium capacities in protein binding rate in plasma of rat.

Objective To study the benzofuran compounds from roots and rhizomes of Ligularia caloxantha, which is a folk medicine used in the Naxi Nationality in Yunnan Province. Methods Compounds were separated and purified by silica gel and Sephadex LH-20 column chromatography. Their structures were elucidated by physicochemical properties and spectral analysis. Results Eighit compounds are isolated from ethanolic extracts of the roots and rhizomes. They were identified as euparin (Ⅰ), 6-methoxy-euparin (Ⅱ), 4, 5-dimethoxy-2-hydroxybenzaldehyde (Ⅲ), 2-acetyl-5, 6-dimethyoxybenzofuran (Ⅳ), 4-hydroxyacetophenone (Ⅴ), 2-isopropenyl-5, 6-dimethoxy-2, 3-hydrocumaran (Ⅵ), 8?-hydroxy-7(11)-eremophilen-12, 8?-olide (Ⅶ), lupeol (Ⅷ). Conclusion All the eight compounds were obtained from L. caloxantha for the first time as benzofurans. Compounds Ⅰ and Ⅱ are two major ones with insecticide and insect food refusal-induced activities. That is the relative reason of L. caloxantha used for folk anti-insect.