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Abstract Background Stroke and thromboembolism in nonvalvular atrial fibrillation (NVAF) primarily arise from thrombi or sludge in the left atrial appendage (LAA). Comprehensive insight into the characteristics of these formations is essential for effective risk assessment and management. Methods We conducted a single-center retrospective observational of 176 consecutive NVAF patients with confirmed atrial/appendage thrombus or sludge determined by a pre-ablation transesophageal echocardiogram (TEE) from December 2017 to April 2019. We obtained clinical and echocardiographic characteristics, including left atrial appendage emptying velocity (LAAeV) and filling velocity (LAAfV). Data analysis focused on identifying the morphology and location of thrombus or sludge. Patients were divided into the solid thrombus and sludge groups, and the correlation between clinical and echocardiographic variables and thrombotic status was analyzed. Results Morphological classification: In total, thrombi were identified in 78 patients, including 71 (40.3%) mass and 7 (4.0%) lamellar, while sludge was noted in 98 (55.7%). Location classification: 92.3% (72/78) of patients had thrombus confined to the LAA; 3.8% (3/78) had both LA and LAA involvement; 2.7% (2/78) had LA, LAA and RAA extended into the RA, the remained 1.2%(1/78) was isolated to RAA. 98.0% (96/98) of patients had sludge confined to the LAA; the remaining 2.0% (2/98) were present in the atrial septal aneurysm, which protrusion of interatrial septum into the RA. The thrombus and sludge groups showed low LAAeV (19.43 ± 9.59 cm/s) or LAAfV (17.40 ± 10.09 cm/s). Only LA dimension ≥ 40 mm was independently associated with the thrombus state in the multivariable model. Conclusion This cohort study identified rare thrombus morphology and systematically summarized the classification of thrombus morphology. The distribution of thrombus and sludge outside limited to LAA was updated, including bilateral atrial and appendage involvement and rare atrial septal aneurysm sludge. LAAeV and LAAfV were of limited value in distinguishing solid thrombus from sludge. Clinical Trial Number ChiCTR-OCH-13,003,729.

The extraction of total flavonoids from Hylotelephium spectabile (Boreau) H. Ohba (H. spectabile) leaves was studied through the use of a double enzyme-assisted ultrasonic method, and the extraction process was optimized using the Box–Behnken design. Eight different macroporous resins were screened for purification in single-factorial experiments, and the flavonoid compounds in the extract of H. spectabile leaves were identified using HPLC-MS. Through the evaluation of the total reducing capacity and capacity for reducing 1,1-diphenyl-2-trinitrophenylhydrazine (DPPH), hydroxyl radicals (·OH), and 2,2’-biazobis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS), the in vitro antioxidant activities of the crude extracts of the total flavonoids and purified total flavonoids of H. spectabile leaves were investigated. The results showed that the most efficient conditions for flavonoid extraction were an ultrasonic extraction time of 60 min, an ethanol concentration of 35%, a liquid-to-material ratio of 20:1 mL/g, and an amount of enzyme (cellulose/pectinase = 1:1) of 1.5%, forming H. spectabile powder. Under these conditions, the total flavonoid extraction rate in the H. spectabile leaf extract was 4.22%. AB-8 resin showed superior performance in terms of purification, and the optimal adsorption and desorption times were 1.5 h and 3 h, respectively. The recommended parameters for purification included a liquid volume of 5.5 BV, a flow rate of 1.2 BV/min, a pH of 5, and a concentration of 0.8 mg/mL. The observed order for reducing capacity was ascorbic acid (VC) > rutin > purified total flavonoids > crude extract of total flavonoids. The purified total flavonoid extract from H. spectabile showed a good scavenging ability against DPPH, ·OH, and ABTS·+, suggesting strong antioxidant activity. Therefore, this study can serve as technical support and reference data for the further development and utilization of H. spectabile resources.

Introduction Mild cognitive impairment (MCI) is an important intervenable stage for the prevention of dementia. Hypertension is associated with impaired cognition, and when combined with MCI, it may lead to a poor prognosis. Digital computerised cognitive training (CCT) has recently become a potential instrument for improving cognition, but evidence for its efficacy remains limited. This study aims to evaluate the efficacy of a digital adaptive CCT intervention in older patients with hypertension and MCI.Methods and analysis The multicentre, double-blinded, randomised, actively -controlled clinical trial will recruit 200 older (≥60 years) patients with hypertension and MCI from 11 hospitals across China. Participants will be randomly assigned in a 1:1 ratio to the intervention group (multidomain adaptative CCT) and active control group (non-adaptive cognitive training) for 12-week cognitive training for 30 min/day and 5 days/week. Those who have completed their 12-week training in the intervention group will be rerandomised into the continuation and discontinuation training groups. All participants will be followed up to 24 weeks. Neuropsychological assessments and structural and functional 7.0 T MRI will be obtained at baseline and at 12-week and 24-week follow-up. The primary outcome is the possible improvement of global cognitive function at 12 weeks, as measured by the Basic Cognitive Aptitude Tests. Secondary and exploratory endpoints include the major cognitive domain function improvement, self-efficacy, mental health, quality of life and MRI measurements of the brain.Ethics and dissemination The trial has been approved by the institutional review board of Beijing Anzhen Hospital and thereafter by all other participating centres. Trial findings will be disseminated in peer-reviewed journals and conference presentations.Trial registration number NCT05704270.

The finite element method （FEM） is a mathematical method for obtaining approximate solutions to a wide variety of engineering problems. With the development of computer technology， it is gradually applied to the study of biomechanics of human body. The application of the combination of FEM and biomechanics in exploring the relationship between vascular injury and disease， and pathological mechanisms will be a technological innovation for traditional forensic medicine. This paper reviews the construction and development of human vascular FEM modeling， and its research progress on the vascular biomechanics. This paper also looks to the application prospects of FEM modeling in forensic pathology.

Abstract Aims This study aims to provide representative information on heart failure (HF) patients in China, especially older adults aged ≥75 years. We aim to clarify the age‐related discrepancies in performance measures and the modifying effect of age on the impact of HF patients' characteristics on clinical outcomes. Methods and results All HF patients admitted into five tertiary and four secondary hospitals of the Capital Medical University were divided into two groups according to age: 1419 (53.3%) were

In this study, polysaccharides were extracted at a rate of 87.5% ± 1.5% from native dandelion roots, and the dandelion root polysaccharides (DRPs) were then chemically modified to obtain sulfated polysaccharides (SDRPs) with a degree of substitution of 1.49 ± 0.07. The effects of modification conditions, physicochemical characterizations, structural characteristics, antioxidant properties, hypoglycemic activity, and proliferative effects on probiotics of DRP derivatives were further investigated. Results showed that the optimum conditions for sulfation of DRPs included esterification reagents (concentrated sulfuric acid: n-butanol) ratio of 3:1, a reaction temperature of 0 °C, a reaction time of 1.5 h, and the involvement of 0.154 g of ammonium sulfate. The DRPs and SDRPs were composed of six monosaccharides, including mannose, glucosamine, rhamnose, glucose, galactose, and arabinose. Based on infrared spectra, the peaks of the characteristic absorption bands of S=O and C-O-S appeared at 1263 cm−1 and 836 cm−1. Compared with DRPs, SDRPs had a significantly lower relative molecular mass and a three-stranded helical structure. NMR analysis showed that sulfated modification mainly occurred on the hydroxyl group at C6. SDRPs underwent a chemical shift to higher field strength, with their characteristic signal peaking in the region of 1.00–1.62 ppm. Scanning electron microscopy (SEM) analysis indicated that the surface morphology of SDRPs was significantly changed. The structure of SDRPs was finer and more fragmented than DRPs. Compared with DRPs, SDRPs showed better free radical scavenging ability, higher Fe2+chelating ability, and stronger inhibition of α-glucosidase and α-amylase. In addition, SDRPs had an excellent promotional effect on the growth of Lactobacillus plantarum 10665 and Lactobacillus acidophilus. Therefore, this study could provide a theoretical basis for the development and utilization of DRPs.

High-frequency temperature measurements were carefully conducted for a 15 kW buoyant turbulent ethylene diffusion flame over a 15.2 cm diameter gas burner with air co-flow. A dual-thermocouple probe, consisting of two fine-wire thermocouples with 25 μm and 50 μm wire diameters, was used to determine a compensated turbulent gas temperature. A sensitivity analysis shows that temperatures resolved using this dual-thermocouple technique are less sensitive to changes in thermocouple bead size, therefore, uncertainty is greatly reduced even when soot deposition on the thermocouple bead occurs in sooty flames. Mean and root-mean square (rms) fluctuations of gas temperature were recorded in a two-dimensional plane across the flame centerline. The mean gas temperature monotonically decreases away from the flame centerline at most flame heights, except for 1 diameter above the burner, where a temperature dip is observed. The rms temperature peaks shift from the edge of the flame to the center as the height increases. This is due to the enhanced mixing between fuel and air, which is further shown using probability density functions of the local gas temperature. A systematic temperature dataset with high spatial resolution is established for sooty flames, which is valuable for future soot and radiation model validation.

Abstract Chronic obstructive pulmonary disease (COPD) is an irreversible disease with the leading causes of morbidity, mortality, and several physical limitations. Isodon Suzhouensis is a unique Chinese medicinal plant used for both medicine and food. It possesses strong anti‐inflammatory effects that may treat COPD. Considering the fact that the effects of Isodon Suzhouensis extract (WZZE) and its active ingredient glaucocalyxin A (GLA) on COPD have never been reported before, this study aimed to investigate the effects of WZZE and GLA against COPD and its underlying mechanistic pathway in COPD model rats or in CSE‐induced NR8383 cells. The variation in lung physiology was measured through spirometry while histopathological changes were studied via H&E staining of the COPD model rats lung samples. The levels of cytokine and other immunomodulatory proteins were determined by ELISA. Apoptosis of lung tissue cells was detected by TUNEL staining. Western blot and immunohistochemistry were used to detect the expression of related pathways and other proteins. The results show that WZZE improved the relevant lung function indicators, while restoring the activity of immunoglobulins (Ig A, IgG) and inhibiting the levels of TNF‐α and IL‐1β in serum and bronchoalveolar lavage fluid, thereby improving the body's immunity and inhibiting inflammation of the airways and lungs, slowing the progression of COPD. The results of H&E staining indicated that WZZE is capable of improving the pathological injury associated with COPD. In addition, the administration of WZZE reduced the expression of MUC5AC protein induced and the apoptosis rate of lung tissue cells in COPD model rats. The results also showed that WZZE significantly increased the expression of SOCS3 and inhibited the expression of JAKs/STATs pathway‐related proteins in COPD rats. In addition, GLA can also upregulate the expression of SOCS3 protein, inhibit JAKs/STATs pathway, inhibit the expression level of MUC5AC, upregulate the expression level of immunoglobulin, and downregulate the expression level of proinflammatory factors in NR8383 cells induced by CSE. Present study findings suggest that WZZE and GLA may ameliorate the progression of COPD via the SOCS3–JAKs/STATs pathway in COPD rats or in CSE‐induced NR8383.