Objective To observe the efficacy and safety of repetitive transcranial magnetic stimulation(rTMS)on refractory tinnitus and the differences of resting-state functional magnetic resonance imaging(rs-fMRI)imaging between before and after treatment,and to explore the possible central mechanism of rTMS regulation of tinnitus.Methods Thirty-seven patients with refractory tinnitus admitted in Affiliated Hospital of North Sichuan Medical College from September 2022 to February 2023 were selected and were divided into experimental group(n=20)and control group(n=1 7).The experimental group was given true rTMS treatment,and the control group was given sham stimulation with the same parameters.Tinnitus handicap inventory(THI)score,tinnitus loudness visual analogue scale(VAS)score and rs-fMRI scan were performed before and after treatment.Regional homogeneity(ReHo)was calculated after scanning,and the different brain regions were selected as the area of interest(ROI)and the whole brain functional connection(FC)was performed.Results There were no significant differences in age,gender,education level,tinnitus side,course of disease,hearing level,self-rating depression scale,self-rating anxiety scale the experimental group and control group.There were no significant differences in THI and VAS scores between the two groups before treatment;the THI and VAS scores in the experimental group decreased after 2 weeks of rTMS treatment(P＜0.001),while there was no significant difference in the two scores in the control group before and after treatment.Only 3 patients in the experimental group experienced left facial muscle tremor or transient mild scalp pain during treatment,without other serious side effects.The ReHo of the left cerebellar area 9 increased in the experimental group after rTMS(P＜0.005);the ReHo values in the right inferior temporal gyrus,left posterior central gyrus and left anterior central gyrus increased in the control group after intervention(P＜0.005).The FCs between the right inferior temporal gyrus and the left orbital inferior frontal gyrus,the left anterior cingulate gyrus increased in the experimental group(P＜0.005),and FC between the right inferior temporal gyrus and the left superior marginal gyrus decreased(P＜0.005).The FCs between the right cuneus and the left fusiform gyrus,right superior occipital gyrus decreased in the experimental group after rTMS(P＜0.005).The FC between the right cuneus and the left fusiform gyrus increased in the control group after intervention(P＜0.005),while other FCs remained unchanged.Conclusions rTMS has a certain therapeutic effect on refractory tinnitus with higher safety;regulation of auditory brain network and related non-auditory brain network may be one of the central mechanisms of rTMS treating refractory tinnitus.

Objective:To compare the differences of brain activation in patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) under contact heat stimulation (CHS), and to explore the characteristics of pain-related brain networks in NMOSD and MS patients.Methods:Fourteen NMOSD patients (NMOSD group) and 12 MS patients (MS group) admitted to Affiliated Hospital of North Sichuan Medical College from September 2022 to December 2022 who met the diagnostic criteria were collected. Twelve healthy individuals (HC group) matched with gender and age were recruited during the same period. Visual Analogue Scale (VAS) score was used to evaluate the pain of the subjects, CHS painful stimuli were given, and task-state functional magnetic resonance imaging (fMRI) scans were performed at the same time, and the differences in brain activation among the 3 groups were analyzed and compared.Results:(1) Compared with the HC group, the NMOSD group had a stronger activation degree than the HC group in the brain regions including the cortex around the left distance fissure, bilateral medial superior frontal gyrus; the activation degree of the NMOSD group was weaker than that of the HC group in the brain areas including the left medial and paracingulate gyrus, right superior parietal gyrus, left postcentral gyrus, and right supplementary motor area (all P<0.05). (2) Compared with the HC group, the brain regions whose activation degree was weaker in the MS group included the left caudate nucleus, left medial and paracingulate gyrus, left paracentral lobule, right superior parietal gyrus, left postcentral gyrus, left precuneus, right supplementary motor area, right superior temporal gyrus and right thalamus, and there was no brain area in the MS group whose activation degree was stronger than that of the HC group (all P<0.05). (3) Compared with the MS group, the brain regions with stronger activation degree in the NMOSD group included the left perifissure cortex and right thalamus, but no brain regions with weaker activation degree were found in the NMOSD group (all P<0.05). (4) There was a correlation between somatic pain VAS scores and activation of the medial superior frontal gyrus in the NMOSD group ( r=0.66, P<0.05). Conclusions:The results of CHS-fMRI in the NMOSD group, MS group and HC group showed that multiple brain regions were activated, indicating that multiple brain regions were involved in the generation and processing of pain, and there was a pain-related brain network. Pain-related brain networks were altered in NMOSD patients and MS patients, and there were differences in pain-related brain networks between the two diseases.

Objective:To observe the changes in brain functional magnetic resonance imaging (fMRI) in migraine patients under olfactory stimuli and analyze the characteristics of olfactory-related brain networks.Methods:Twenty-seven migraine patients (migraine group) enrolled in the Department of Neurology, Affiliated Hospital of North Sichuan Medical College from January 2021 to January 2022 were included, and 20 healthy adults were recruited as control group during the same period. All subjects underwent synchronous fMRI scanning under olfactory task stimulation, and magnetic resonance imaging data processing was performed using SPM12 and Matlab2019b softwares, and statistical analysis was performed with SPSS 23.0 software.Results:The activated brain regions in the control group included the left cerebellum, left inferior temporal gyrus, left fusiform gyrus, right middle frontal gyrus, right anterior central gyrus, insula, right central sulcus, superior marginal gyrus, right lenticular putamen, middle cingulate gyrus, paracentral lobule, and superior parietal gyrus ( P<0.05). The activated brain regions in the migraine group included the left cerebellum, right fusiform gyrus, right inferior temporal gyrus, right anterior central gyrus, and right posterior central gyrus ( P<0.05). Compared with the control group, the activation intensity of the migraine group was weaker in the right insula, right middle frontal gyrus orbit, left inferior frontal gyrus orbit, right dorsolateral superior frontal gyrus, right superior temporal gyrus, right superior occipital gyrus, medial and paracingulate gyrus, and right superior parietal gyrus ( P<0.05). Conclusion:Migraine patients have multiple brain regions involved in olfactory processing and have specific olfactory-related brain networks.

Objective:To analyze the epidemiological and clinical characteristics of imported COVID-19 cases after SARS-CoV-2 vaccination and to provide evidence for the prevention and control of COVID-19.Methods:The imported COVID-19 cases in Chengdu as of April 15, 2021 were divided into the vaccinated group and unvaccinated group according to the history of SARS-CoV-2 vaccination. The epidemiological and clinical data of the cases were collected retrospectively, and the differences in epidemiological and clinical characteristics of the two groups were compared. Laboratory tests consisted of nucleic acid test, clinical index test, serum antibody test and lymphocyte test. Software WPS2019 was used for data management and software R 4.0.3 was used for statistical analysis.Results:A total of 75 COVID-19 cases were included in the analysis, in which 20 had received SARS-CoV-2 vaccination and only 4 with clinical symptoms, 55 patients did not receive SARS-CoV-2 vaccination, and 16 had clinical symptoms. In vaccinated group, the first injection time of vaccination ranged from July to November 2020, and 10 cases received two doses of vaccine simultaneously and 10 cases received two doses of vaccine at intervals of 14-57 days. The intervals between the completion of vaccination and the onset ranged from 87 days to 224 days. The differences in classification and clinical type between the two groups were significant. Significant differences were observed in case classification and clinical type between vaccinated group and unvaccinated group ( P<0.05). The vaccinated group had a relatively high proportion of asymptomatic infections (40.00%, 8/20), while mild infections were mainly observed in the unvaccinated group(76.36%,42/55). The differences in Ct values (ORF1ab gene and N gene) at the diagnosis were not significant between vaccinated group and unvaccinated group ( P>0.05), similar results were also observed in lymphocyte subtypes, procalcitonin and C-reactive protein level comparisons. Serum amyloid A level was higher in unvaccinated group than in vaccinated group ( P<0.05). However, the SARS-CoV-2 related serum antibody of IgM, IgG and total antibody levels were significantly higher in vaccinated group ( P<0.05). Conclusions:Risk of infection still exists with SARS-CoV-2 after vaccination, which can facilitate the production of specific serum antibody of IgM and IgG when people are exposed to the virus. It has a certain protective effect on SARS-CoV-2 infected persons. Vaccination can reduce the clinical symptoms and mitigate disease severity.

Objective::To explore the effect of strong light stress on the growth, physiological and biochemical and key enzyme gene expression of the Atractylodes lancea, in order to provide the scientific basis for the standardized cultivation of the A. lancea. Method::The two-year-old A. lancea seedlings were taken as experimental materials. Poplar forest (light transmittance between 18.26%-36.04%) was taken as control group(ck). Different density shading networks were used to simulate different degrees of high light stress (51.10%, 80.73%, 100%) in late July. The growth state of A. lancea was observed. On the 0^th, 5^th, 10^th, 15^th, 20^th days, the physiological and biochemical indexes of malondialdehyde (MDA) content, cell membrane permeability, proline (Pro) content, antioxidant enzyme activity and chlorophyll content in the leaves of A. lancea were measured. The relative expression levels of 3-hydroxy-3-methylglutarate monoacyl coenzyme A reductase (3-hydroxy-3-methylglutaryl coenzyme A, HMGR) and farnesyl pyrophosphate synthase gene (farnesyl pyrophosphate synthase, FPPS) in leaves of A. lancea under intense light stress were determined by real-time fluorescence quantitative PCR(Real-time PCR). Result::After strong light stress, the color of the leaves of A. lancea changed from dark green to light green and yellowish green, and the burn of leaves became more and more serious. The contents of MDA, conductivity and Pro showed an upward trend with the increase of transmittance. Peroxidase (POD), superoxide dismutase (SOD) and catalase (CAT) tended to increase first and then decrease. The chlorophyll content decreased with the increase of light transmittance. The relative expression of HMGR in leaves of A. lancea decreased with the increase of light transmittance, while FPPS increased first and then decreased. Conclusion::The results showed that A. lanceaa could alleviate the inhibition of strong light stress by increasing the activity of antioxidant enzymes and regulating the content of osmotic pressure under certain strong light stress. Excessively strong intensity light stress leads to disequilibrium of metabolic mechanism of A. lancea, and seriously inhibits the plant growth.