Objective:To evaluate the immunogenicity, safety, and immune persistence of the sequential booster with the recombinant protein-based COVID-19 vaccine (CHO cell) in healthy people aged 18-84 years.Methods:An open-label, multi-center trial was conducted in October 2021. The eligible healthy individuals, aged 18-84 years who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, were recruited from Shangyu district of Shaoxing and Kaihua county of Quzhou, Zhejiang province. All participants were divided into three groups based on the differences in prime-boost intervals: Group A (3-4 months), Group B (5-6 months) and Group C (7-9 months), with 320 persons per group. All participants received the recombinant COVID-19 vaccine (CHO cell). Blood samples were collected before the vaccination and after receiving the booster at 14 days, 30 days, and 180 days for analysis of GMTs, antibody positivity rates, and seroconversion rates. All adverse events were collected within one month and serious adverse events were collected within six months. The incidences of adverse reactions were analyzed after the booster.Results:The age of 960 participants was (52.3±11.5) years old, and 47.4% were males (455). The GMTs of Groups B and C were 65.26 (54.51-78.12) and 60.97 (50.61-73.45) at 14 days after the booster, both higher than Group A′s 44.79 (36.94-54.30) ( P value<0.05). The GMTs of Groups B and C were 23.95 (20.18-28.42) and 27.98 (23.45-33.39) at 30 days after the booster, both higher than Group A′s 15.71 (13.24-18.63) ( P value <0.05). At 14 days after the booster, the antibody positivity rates in Groups A, B, and C were 91.69% (276/301), 94.38% (302/320), and 93.95% (295/314), respectively. The seroconversion rates in the three groups were 90.37% (272/301), 93.75% (300/320), and 93.31% (293/314), respectively. There was no significant difference among these rates in the three groups (all P values >0.05). At 30 days after the booster, antibody positivity rates in Groups A, B, and C were 79.60% (238/299), 87.74% (279/318), and 90.48% (285/315), respectively. The seroconversion rates in the three groups were 76.92% (230/299), 85.85% (273/318), and 88.25% (278/315), respectively. There was a significant difference among these rates in the three groups (all P values <0.001). During the sequential booster immunization, the incidence of adverse events in 960 participants was 15.31% (147/960), with rates of about 14.38% (46/320), 17.50% (56/320), and 14.06% (45/320) in Groups A, B, and C, respectively. The incidence of adverse reactions was 8.02% (77/960), with rates of about 7.50% (24/320), 6.88% (22/320), and 9.69% (31/320) in Groups A, B, and C, respectively. No serious adverse events related to the booster were reported. Conclusion:Healthy individuals aged 18-84 years, who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, have good immunogenicity and safety profiles following the sequential booster with the recombinant COVID-19 vaccine (CHO cell).

Objective:To investigate risk factors for in-stent restenosis (ISR) after percutaneous transluminal angioplasty and stenting (PTAS) in patients with severe symptomatic intracranial carotid stenosis.Methods:Consecutive patients with severe symptomatic intracranial carotid stenosis underwent PTAS in the Department of Neurology, Jining First People's Hospital from December 2021 to June 2023 were retrospectively included. Clinical and procedure related data were collected, and periprocedural complications were recorded. Imaging follow-up was used to evaluate ISR after 6 months. Multivariate logistic regression analysis was used to determine independent risk factors for ISR. Results:A total of 73 patients were enroled, including 45 males (61.6%), aged 61.49±7.78 years. The median follow-up time was 8 months (interquartile range, 7-9 months; range, 6-10 months), with 19 cases (26.0%) experiencing ISR, of which 1 (1.4%) had symptomatic ISR. Multivariate logistic regression analysis showed that the higher degree of residual stenosis immediately after procedure (odds ratio [ OR] 1.102, 95% confidence interval [ CI] 1.004-1.209; P=0.040), accompanied by moderate to severe cerebrovascular stenosis in other areas ( OR 6.638, 95% CI 1.106-39.835; P=0.038) and low preprocedural white blood cell count ( OR 0.541, 95% CI 0.308-0.952; P=0.033) were the independent risk factors for ISR. Conclusion:The higher degree of residual stenosis immediately after procedure, accompanied by moderate to severe cerebrovascular stenosis in other areas, and lower preprocedural white blood cell count are the risk factors for the occurrence of ISR after PTAS in patients with severe intracranial carotid stenosis.

Intracranial atherosclerotic stenosis (ICAS) is closely associated with cognitive impairment and dementia. This article reviews the manifestations, mechanisms, and interventions of cognitive impairment in patients with ICAS, aiming at increasing attention to ICAS, early identification and intervention, and delaying the occurrence and deterioration of cognitive impairment.

Intracranial atherosclerotic stenosis (ICAS) is the main cause of ischemic stroke. Endovascular therapy (EVT) is a method of treating symptomatic ICAS, and in-stent restenosis (ISR) is an important factor affecting the efficacy of EVT. This article summarizes the influencing factors of ISR in patients with ICAS receiving EVT treatment.

Homocysteine is closely associated with extracranial and intracranial atherosclerosis, and its main pathogenesis includes oxidative stress, lipid metabolism disorder and vascular endothelial dysfunction. As a protein modification related to homocysteine, homocysteinylation can promote the occurrence and development of cerebral atherosclerosis by promoting oxidation, changing lipid function and destroying vascular endothelial function. This article reviews the role of homocysteinylation in cerebral atherosclerosis, and discusses the possibility of preventing cerebral atherosclerosis by homocysteinylation.

Objective:To explore the feasibility and safety of endovascular interventional embolization in pregnancy-related acute large vessel occlusive stroke.Methods:Three patients with pregnancy-related acute large-vessel occlusive stroke accepted endovascular interventional embolization in Department of Neurology, Jining First People's Hospital from November 2017 to June 2021 were chosen; their clinical data and treatment efficacy were retrospectively analyzed.Results:Two patients were in early pregnancy and one was in puerperium; they were with acute anterior circulation large vessel occlusion, including one with occlusion of the M1 segment of the right middle cerebral artery, one with occlusion of the ophthalmic segment of the left internal carotid artery, and one with occlusion of the traffic segment of the left internal carotid artery; cardiogenic embolism was considered, and the risk factors for embolism included unclosed foramen ovale ( n=1), rheumatic heart disease ( n=1), and atrial fibrillation ( n=1); embolization was performed by catheter aspiration in one patient and stenting in two patients; all vessels were well re-canalized with modified thrombolysis in cerebral infarction (mTICI) 3; two patients had a good prognosis 90 d after embolization (mRS scores of 0 and 2) and one had a poor prognosis (mRS scores of 4); no surgical complications occurred. Conclusion:Endovascular interventional embolization after individualized evaluation may be a safe and effective approach for patients with pregnancy-related acute large vessel occlusive stroke.

Objective    To analyze the clinical efficacy of right minithoracotomy approach in the treatment of patients with regurgitation after left-sided valve surgery (LSVS). Methods    The clinical data of 77 patients who suffered tricuspid regurgitation (TR) after LSVS and received surgical treatment in the Heart Center of Henan Provincial People's Hospital from 2012 to 2019 were selected. According to the operation method, the patients were divided into a right minithoracotomy group (n=32), including 13 (40.6%) males, aged 57.3±5.3 years and a median sternotomy group (n=45), including 17 (37.8%) males, aged 55.7±6.6 years. Preoperative and postoperative clinical data of the two groups were compared and analyzed. Results    There was no significant difference in preoperative data between the two groups. There were 24 patients of tricuspid valvuloplasty (TVP) and 8 patients of tricuspid valve replacement (TVR) in the right minithoracotomy group. There were 29 patients of TVP and 16 patients of TVR in the median sternotomy group. The operation time, postoperative hospitalization time, intubation time and ICU stay time of the right minithoracotomy group were shorter than those of the median sternotomy group (P<0.001). The operative bleeding, postoperative drainage in 24 hours, postoperative blood transfusion rate and incision poor healing of the right minithoracotomy group were significantly decreased compared with those of the median sternotomy group (P<0.05). The extracorporeal circulation time between the two groups was not significantly different (P=0.382). The postoperative complications and mortality of the righ minithoracotomy group were significantly lower than those of the median sternotomy group (P<0.05). Conclusion    The procedure of right minithoracotomy access can reduce perioperative morbidity and mortality compared with the median sternotomy, and results in satisfied clinical efficacy.

To explore the different chloroplast genome characteristics of Sinopodophyllum hexandrum, five chloroplast genome sequences of S. hexandrum were compared. Its genome map, repeat sequence, codon preference, inverted repeat (IR)/single-copy (SC) boundary, alignment of chloroplast genome sequences and phylogenetic were analyzed using bioinformatics tools. The results showed that: the total length of five chloroplast genomes of S. hexandrum, with a typical tetrad structure, were 157 203-157 940 bp, and a total of 133-137 genes were annotated, reflecting the diversity of chloroplast genomes of S. hexandrum. Different chloroplast genomes of S. hexandrum has different simple sequence repeat (SSR), where simple repeat of single nucleotide of A/T were the majority among the SSR detected. The interspersed repetitive sequences included direct, palindromic and inverted repeats. The value of effective number of codon (ENc) which was analyzed by using codon bias was 51.14~51.17, the proportion of GC and GC3s was less than 50%, the codon usage pattern tended towards frequently use of A/U-ending bases. Genome sequences and the IR/SC boundaries of five chloroplast genomes of S. hexandrum were relatively conservative. Phylogenetic analysis showed that S. hexandrum and Podophyllum pettatum had the closest genetic relationship. In summary, the chloroplast genome characteristics and evolutionary relationship of different chloroplast genomes of S. hexandrum were obtained, which may facilitate the utilization, protection, variety identification and genetic evolution of S. hexandrum resources.
Phylogeny ; Genome, Chloroplast ; Chloroplasts/genetics* ; Genomics ; Evolution, Molecular

Objective:To investigate the efficacy and safety of endovascular treatment (EVT) in patients with acute ischemic stroke due to acute primary medium vessel occlusion (MeVO).Methods:Patients with primary MeVO received EVT in the stroke center of Jining First People's Hospital from January 2019 to January 2022 were enrolled retrospectively. MeVO was defined as occlusion of M2/M3 segment of middle cerebral artery, A2/A3 segment of anterior cerebral artery and P2/P3 segment of posterior cerebral artery. The symptoms, vascular recanalization and surgical complications were documented. The National Institutes of Health Stroke Scale (NIHSS) score at discharge and the modified Rankin Scale (mRS) score at 90 d after onset were followed up.Results:A total of 17 patients with primary MeVO were included, among them 16 successfully achieved vascular recanalization, 1 had distal emboli escape, and 1 had asymptomatic intracranial hemorrhage. There was significant difference in NIHSS scores before and after thrombectomy ( P<0.01). Ten patients (62.5%) had good functional outcome (mRS score 0-2), and 1 died of secondary pulmonary infection at 20 d after procedure. Conclusion:After strict risk/benefit evaluation and screening, EVT of acute ischemic stroke due to primary MeVO was technically feasible, and had good efficacy and safety.

Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic cerebrovascular disease. Compared with other causes such as extracranial diseases or cardiogenic embolism, symptomatic ICAS (sICAS) has a higher risk of stroke recurrence, often leading to the aggravation of neurological impairment and even death. More and more evidence shows that imaging features play an important role in predicting the risk of stroke recurrence and individualized secondary prevention in patients with sICAS. This article reviews the imaging features of ischemic stroke recurrence in patients with sICAS, which provides a basis for identifying sICAS patients with high risk of recurrent stroke and effective secondary prevention.