Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.

Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.

Objective:To explore the short-term clinical efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in thalamic pain.Methods:A prospective study was performed; 41 patients with thalamic pain who received hrTMS in Department of Neurology, Anqing Medical Center Affiliated to Anhui Medical University from December 2022 to August 2023 were selected. According to different stimulation sites, these patients were divided into S2 group (intervening secondary sensory cortex of the unaffected side, n=21) and M1 group (intervening primary motor cortex of the unaffected side, n=20). Before treatment, at the 1 st weekend after pseudo-stimulation treatment and at the 1 st, 2 nd and 3 rd weeks after effective stimulation treatment, short-form McGill Pain Questionnaire (SF-MPQ) was performed, and N100 amplitude was monitored by myoelectric evoked potentiometer; adverse reactions during treatment cycles were observed. Results:(1) Compared with those before treatment, scores of sensory item, emotional item and visual analogue scale (VAS), and present pain intensity in S2 group were significantly decreased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). Compared with those before treatment, scores of sensory item and VAS, and present pain intensity in M1 group were significantly decreased at the 2 nd weeks after effective stimulation treatment, and scores of sensory item, emotional item and VAS, and present pain intensity in M1 group were significantly decreased at the 3 rd weeks after effective stimulation treatment( P<0.05). At the 3 rd weeks after effective stimulation treatment, compared with the M1 group, the S2 group had significantly decreased scores of sensory item, emotional item, and VAS, and present pain intensity (5.35±0.54 vs. 4.86±0.74; 3.55±0.69 vs. 3.14±0.57; 5.50±0.69 vs. 5.00±0.78; 2.20±0.42 vs. 1.81±0.41, P<0.05). (2) Compared with those before treatment, N100 amplitude in S2 group and M1 group was significantly increased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). At the 3 rd weeks after effective stimulation treatment, the S2 group had significantly higher N100 amplitude than the M1 group (3.43±0.60 vs. 3.00±0.65, P<0.05). (3) No adverse reactions such as seizure or scalp burning occurred in the 2 groups during the treatment cycles, without significant difference in headache or tinnitus incidences ( P>0.05). Conclusion:The hrTMS on secondary sensory cortex and primary motor cortex of the unaffected side can relief the short-term pain intensity in patients with thalamic pain, without obvious side effects; and hrTMS on secondary sensory cortex enjoys better effect.

Objective:To observe the efficacy and safety of high frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic tension-type headache (CTTH) patients.Methods:Thirty-eight patients with CTTH, admitted to our hospital from February 2019 to September 2021, were randomly divided into rTMS group and control group ( n=19). In the rTMS group, the hot spot of the right abductor pollicis brevis was surface-labeled and the resting movement threshold (RMT) was calculated; the intensity of the stimulus was then adjusted to 70% of RMT, and stimulus was then located at 5 cm in front of the previously identified hot spot of the right thumb, namely the left dorsolateral prefrontal cortex (LDLPFC); the stimulus was delivered once every Monday, Wednesday and Friday, and lasted for 4 weeks with 12 rounds of stimulation. In the control group, the hot spot was not located and RMT was not calculated; the coil was placed perpendicular to LDLPFC; and the stimulation frequency was the same as that in the rTMS group with minimum stimulation intensity. Visual analogue scale (VAS), Headache Impact Test-6 (HIT-6), simplified McGill Pain Questionnaire (SF-MPQ) were used to evaluate the subjective pain status. The electrophysiological indices in the nociceptive flexion reflex (NFR) and conditioned pain modulation (CPM) were used to evaluate the objective pain status. Adverse events during treatment and 1-month follow-up were recorded in the two groups. Results:(1) Rating scales: scores of all rating scales in the rTMS group after treatment were significantly decreased as compared with those before treatment ( P <0.05); however, no significant difference was noted in the control group ( P>0.05). After treatment, the scores of VAS, HIT-6, present pain intensity (PPI) scale, and trait anxiety inventory in the rTMS group were significantly decreased as compared with those in the control group ( Z=-4.054, P<0.001; t= -6.083, P<0.001; Z=-4.246, P<0.001; Z=-3.740, P<0.001). (2) NFR RIII parameters: as compared with that before treatment, the minimum threshold in rTMS group after treatment was significantly increased ( P<0.05). There were no significant differences in NFR RIII parameters in the control group between those after treatment and before treatment ( P>0.05). After treatment, the minimum NFR minimumthreshold in the rTMS group was significantly increased as compared with that in the control group ( P<0.05). Cold compression test results showed that as compared with basic NFR RIII area, NFR RIII area before and after treatment in both rTMS group and control group was statistically increased ( P<0.05). (3) Adverse reactions: no serious adverse reactions occurred in the two groups during treatment and follow-up. Conclusion:Treatment with rTMS in CTTH patients enjoys good short-term efficacy without obvious adverse reactions.

Objective:To study the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in migraine without aura.Methods:A prospective sutdy was conducted; 74 patients with migraine without aura had definite diagnosis in our hospital from September 2019 to November 2020 were chosen and divided into hrTMS treatment group ( n=39) and control group ( n=35) by random number method. Patients in the hrTMS treatment group were treated with hrTMS once per d; the stimulation frequency was 20 Hz, each stimulus consisted of 20 sequences, and the amount of stimulus was 500 pulses; the treatment lasted for 6 d was as a course of treatment, and the next course of treatment was conducted at an interval of 1 d; a total of 4 courses of treatment was given. Patients in the control group were treated with pseudo-stimulation; treatment frequency was the same as above. Patients in the 2 groups were given oral conventional migraine drug (celecoxib, 0.2 g per time) according to the demands for analgesia (visual analog scale [VAS] scores≥4). The evoked potential N100 amplitudes and therapeutic effects 1, 2, and 4 weeks after treatment were evaluated and compared between the 2 groups; the occurrence of adverse reactions was observed. Results:There were significant differences in VAS scores and N100 amplitudes at each time point before and after treatment in the hrTMS treatment group ( P<0.05); the VAS scores decreased with time, while the N100 amplitudes increased with time. At 2 and 4 weeks after treatment, patients in the hrTMS treatment group had significantly lower VAS scores and statistically higher N100 amplitudes than those in the control group ( P<0.05). As compared with that in hrTMS treatment group before treatment and that in the control group at the same time point, the average days of headache per month in the hrTMS treatment group 4 weeks after treatment was significantly decreased ( P<0.05). No epileptic seizure, hearing loss, scalp burn or other adverse reactions occurred in the 2 groups after treatment. After treatment, there was no statistical significance in the incidence of dizziness, head discomfort, tinnitus or other adverse reactions between the 2 groups ( P>0.05). Conclusion:Long course of hrTMS can effectively improve the pain degree of patients with migraine without aura, and reduce the number of headache attacks, without obvious side effects, which is worthy of clinical application.

Objective To explore the characteristics of emotional memory in patients with earlystage Parkinson's disease (PD).Methods The methods of emotional memory neuro-cognitive test and event-related evoked potentials (ERPs) test were set.The emotional memory was detected in 30 early-stage PD patients without treatment (PD group) and 30 matched (including education level,etc) healthy controls (control group),who were recruited in the Department of Neurology,Anqing Municipal Hospital from June 2016 to June 2018.Results Compared with the control group (55.83％±4.17％),the negative valence picture recognition rate in the PD group (50.30％±4.04％) showed statistically significant difference (t=4.85,P＜0.05).The ERPs-P300 latency was (337.47 ± 7.87) ms,the amplitude was (6.34 ± 0.62) μV,and the reaction time was (3 729.21±226.85) ms in the control group,showing statistically significant difference (t=-3.30,4.04,2.76,P＜0.05) compared with that in the PD group ((344.20±7.94) ms,(5.75±0.52) μV,(3 935.33±222.24) ms,respectively).There was no statistically significant difference in positive and neutral stimuli recognition between the two groups (P＞0.05).In the PD group,the correct recognition in positive,neutral and negative valence pictures (57.97％ ±4.44％,49.77％ ±4.49％,50.30％ ±4.04％,respectively)showed statistically significant difference (F=39.17,P＜0.05),also seen in the reaction time ((3 725.87 ±210.10) ms,(4 085.80±231.67) ms and (3 935.33±222.24) ms,respectively;F=9.58,P＜0.05),P300 latency ((328.07±6,07) ms,(347.37±7.49) ms and (344.20±7.94) ms,respectively;F=60.32,P＜0.05),and amplitude ((6.55±0.66) μV,(5.57 ± 0.63) μV and (5.75 ± 0.52) μV,respectively;F=22.44,P＜0.05).But there was no statistically significant difference between negative and neutral stimuli recognition in the PD group (P＞0.05).In the control group,the correct recognition in positive,neutral and negative valence pictures (59.47％ ±4.61％,50.63％±4.96％,55.83％±4.17％,respectively) also showed statistically significant difference (F=25.85,P＜0.05),also seen in the reaction time ((3 657.13±218.85) ms,(4 026.81±221.23) ms and (3 729.21±226.85) ms,respectively;F=8.57,P＜0.05),P300 latency ((326.13±5.96) ms,(345.10±7.95) ms and (337.47±7.87) ms,respectively;F=51.04,P＜0.05),and amplitude ((6.69±0.68) μV,(5.59±0.67) μV and (6.34±0.62)μV,respectively;F=22.15,P＜0.05).There was no statistically significant difference in the rating of valence of emotional pictures between the PD and the control groups (P＞0.05).However,there was statistically significant difference in the latency and amplitude of P300 in the rating of negative valence of emotional pictures between the two groups (t=-5.63,4.16,P＜0.05).Conclusions The results suggest that there is emotional memory impairment in early stage of PD,which is mainly based on selective negative emotional valence.Testing the emotional memory of patients with PD is helpful for early identification and intervention.

Objective To explore the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in treatment of patients with primary trigeminal neuralgia. Methods Thirty-eight patients with primary trigeminal neuralgia were divided into hrTMS treatment group and control group (n=19) according to the willing of the patients; patients in the hrTMS treatment group were treated with 20 Hz hrTMS; those in the control group were given placebo-controlled transcranial magnetic stimulation. The visual analogue scale (VAS) scores one week before, and one, two and 4 weeks after treatment were compared between the two groups. Scores of pain scale of Barrow Neurologic Institute (BNI), evoked potential (N100) amplitude and incidence of adverse reactions one, two and 4 weeks after treatment were compared between the two groups. Results VAS scores in the hrTMS treatment group two and 4 weeks after treatment were significantly lower as compared with those in the control group (P<0.05). In patients from the hrTMS treatment group, VAS scores two and 4 weeks after treatment were significantly lower than those one week before and one week after treatment (P<0. 05); and those 4 weeks after treatment were significantly lower than those two weeks after treatment (P<0.05). Patients from the hrTMS treatment group two and 4 weeks after treatment had significantly lower BNI scores and statistically higher N100 amplitude as compared with those in the control group (P<0.05). In the hrTMS treatment group, BNI scores gradually decreased and N100 amplitude gradually increased one, two and 4 weeks after treatment, with statistically significant differences between each two time points (P<0.05). There were no significant differences in the incidence of headache (10.53％ vs. 21.05％) and head discomfort (36.84％ vs. 26.32％) after treatment between the two groups (P>0.05).Conclusion The hrTMS can effectively alleviate pain of primary trigeminal neuralgia, and it is safe and reliable.

Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function and safety in patients with lesions in prefrontal cortex (PFC).Methods Twenty-one patients with lesions in PFC hospitalized in the Department of Neurosurgery and Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University between January 2012 and October 2014 were enrolled and given regular drug treatment as a background.Event-related potential (ERP) P300 latency and amplitude,Montreal Cognitive Assessment (MoCA) scores were recorded and compared before and after 4-week rTMS treatment.Results Compared with those before rTMS treatment,P300 latency ((367.38 ± 9.79) ms vs (345.43 ± 11.31) ms;t =5.33,P ＜ 0.05) was significantly shortened,while amplitude ((4.79 ± 1.02) μV vs (7.84 ± 1.40) μV;t =-8.08,P ＜ 0.05),MoCA scores (19.57 ±2.06 vs 23.91 ± 1.30;t =-8.14,P ＜ 0.05),memory test scores (2.19 ± 0.81 vs 4.10 ± 0.89;t =-7.24,P ＜ 0.05) and executive function test scores (2.52 ± 1.08 vs 3.57 ± 0.93;t =-3.38,P ＜0.05) were obviously increased.MoCA scores (18.22 ± 1.56 vs 20.58 ± 1.83;t =-3.11,P ＜ 0.05),memory test scores (1.89 ± 0.78 vs 2.42 ± 0.79;t =-2.26,P ＜ 0.05) and executive function test scores (1.56 ± 0.53 vs 3.25 ± 0.75;t =-5.76,P ＜ 0.05) showed statistically significant difference before rTMS treatment in patients with lesions in either right or left front lobe.Conclusions rTMS which is thought to be a safe procedure can improve cognitive function in patients with lesions in prefrontal cortex.

Background and objective Studies on the epidermal growth factor receptor (EGFR) signaling pathways and the therapeutic effects of EGFR-tyrosine kinase inhibitors (EGFR-TKIs) have recently proven that targeted therapy has a major role in the treatment of lung cancer. However, the therapeutic effects of EGFR-TKIs on lung cancers with different EGFR mutation subtypes remain unclear. And if there is a signiifcant difference in the effects of EGFR-TKIs, the mechanisms for the difference remain unclear. hTe aim of this study was to investigate the clinical importance of EGFR mutations in exons 19 and 21 of lung cancer patients and to compare the outcomes of these patients. Methods hTe study recruited 113 patients who had non-small cell lung cancer (NSCLC) with EGFR mutations. EGFR mutations were detected for 47 patients using Real-time PCR or DNA sequencinag. hTe mutations of the remaining patients were determined using xTag-EGFR liquid chip technology. All stages I-III patients underwent radical resection followed by 4 cycles of postopera-tive chemotherapy. Patients with pleural metastases underwent pleural biopsy, pleurodesis, and chemotherapy only. Patients with distant metastases underwent biopsy and chemotherapy only. Collected clinical data were analyzed using SPSS 19.0 sotfware. Results EGFR exon mutations 19 and 21 were found in 56 and 57 patients, respectively. hTe mean age of patients with exon 19 mutations was lower than the age of the patients with exon 21 mutations (57.02±11.31 years vs 62.25±7.76 years, respectively;P<0.05). hTe primary tumors of patients with exon 19 mutations were more likely occur in the right lung. hTere were no signiifcant differences in gender, smoking status, histopathology, level of differentiation, and stage of disease (P>0.05) between the patients with exon 19 and 21 mutations;and survival analysis of 91 (80.5%) patients with complete clinical data found no differences in overall survival. Stratiifcation analysis found out that patients with exon 19 mutations had longer overall survival associated with age>61 years, male gender, ever smoking, and stage IV disease;al-though the differences were not signiifcant. Conclusion Compared to the lung cancer patients with EGFR exon 21 muta-tions, the patients with EGFR exon 19 mutations were younger, and their primary tumors were more likely to occur in the right lung. hTere were no signiifcant differences between the lung cancer patients with exon 19 and 21 mutations for overall survival, gender, smoking status, histopathology, level of differentiation, and disease stage.

Objective To explore the correlation of chemosensitivity in vitro of anti-cancer drugs between peripheral blood lymphocytes and tumor cells in non-small cell lung cancer of elderly patients.Methods The MTT method was used to test the sensitivity of the peripheral blood lymphocyte and the tumor cells of 52 patients with nonsmall cell lung cancer to 13 kinds of anti-cancer drugs.Results The sensitivity test in eleven drugs include CDDP,CBP,LOHP,PTX,CTX,ICTX,THP,VP-16,GEM,VCR and NVB in the peripheral blood lymphocyte were associated with that in the tumor cells.But no dependablity in two drugs,ADM and HCPT.Conclusion The peripheral blood lymphocytes could be replace tumor cells to test the chemosensitivity of anti-cancer drugs in patients with non-small cell lung cancer.