Fifty patients with intractable epilepsy were treated in the years from 1984-1986. Anterior callo-sotomy was performed on all the patients, and cingulectomy was added in 19 patients with psychorea-ction. There was no mortality or any serious operative complication. The effective rate was 88%. In this paper the mechanism of the operative procedure and indication are briefly discussed. In conclusion, it may be stated that the operative results are satisfactory.

Objective To evaluate the safety and efficacy of OUR Rotating Gamma System in neurosurgical clinical application. Methods Based on the results of animal experiments, 2381 patients with intracranial disease were treated using OUR Rotating Gamma System in Aohai Gamma Knife Center of Navy General Hospital of PLA betwean December 1996 and November 2002. There were 1288 males and 1093 females and their age ranged from 3 to 84 years (mean 45.8 years). 1020 patients had benign intracranial tumors, and of them 446 suffered from pituitary tumors, 254 meningioma, 148 craniopharyngioma and 103 vestibular schwannomas. Malignant tumors were diagnosed in 796 patients, among them glioma was found in 360 and metastasis in 360. 374 patients had cerebral arteriovenous malformations (AVMs) and 191 functional neurological disorders. Treatment technique of Gamma Knife Stereotactic Radiosurgery, dose prescription and precise orientation performed in intracranial tumor or foci were analyzed, and the preliminary outcome of treatment was evaluated in this study. In addition, the management of the possible complication and adverse reaction was studied. Results Gamma Knife Stereotactic Radiosurgery alone, or combined with other treatment procedures, could cure some of selected patients with benign brain lesions including pituitary neoplasms, meningioma, vestibular schwannomas, AVMs, and craniopharyngioma etc. And this treatment was also beneficial to some patients with malignant tumors. The incidence of radiation edema was 0.75%. Conclusions The clinical results suggest that Gamma Knife Stereotactic Radiosurgery is a very effective, accurate and relatively safe neurosurgical tool used either as a primary or adjuvant procedure for treatment of intracranical pathologic processes. However, it might lead to some severe or fatal complications if used inappropriately. Thus, optimal result would not be obtained unless a careful and precise Gamma treatment based on the operative rules and the effective management for postoperative complications are well planned.

Fifty-five patients with brain lesions were treated with gamma knife combined with stereotaxic technique. There were 33 males and 22 females, and their age ranged from 12 to 72, averaged 41 years. The lesions were located in the sellar area in 21 patients, in the deep cerebrum in 10,in the basal ganglion in 9, in the cerebellum in 5, in the brain stem in 4. Intracranial multiple lesions were found in 6 patients. Twenty-four patients were treated with gamma knife combined with stereotaxic biopsy, 21 with gamma knife combined with stereotaxic aspiration for the cyst and 8 with gamma knife combined with stereotaxic biopsy and aspiration. In the other 2 cases, conservative therapy was used because their pathogenesis was parasite and abscess. Of the 47 biopsies, glioms were diagnosed pathologically in 15 cases, metastasis in 9, craniopharyngioma in 7, pituitary adenoma in 4, germinoma in 3, other tumor in 4, parasite in 1 and abscess in 1. The biopsy positive rate was 93.6%. Aspirated cytic fluid ranged from 1 to 30ml, and the symptoms improved dramatically after aspiration. There were no severe complications and deaths related to stereotaxic procedures. It suggested that gamma knife combined stereotaxic technique is a useful and safe procedure for neuropathological diagnosis and an appropriate management for certain brain lesions.

To study time and dose related changes after gamma knife radiosurgery (GKR) in rat brain, right caudate nucleuses of rats were irradiated by OUR XGD gamma units. The maximum dosages of 20,50,75 and 160Gy were given using a 4 mm collimator. HE, Nissl, Luxol fast blue staining and immunohistochemistry were utilized to observe histological changes.Histological changes in the right caudate nucleuses such as microvessel injury, which appeared as telangiectasia, vasodilatation, vessel wall thickening and edema, and astrocyte changes, which appeared as hypertrophy and proliferation, were observed at various time points after GKR. These findings demonstrate time dependent and dosage dependent changes are found in normal cerebral tissue after GKR. These results provide an explanation of the process taking place during the latent period before delayed radiation necrosis develops.

Objective To analyze clinical pathological characteristics of gastric cancer in elderly people,and to study the characteristics of gastric cancer incidence.Methods A retrospective analysis of clinical data of gastric cancer in elderly people which were diagnosed by gastroscopy and pathology from 2003 to 2008 was undertaken,and compared to it in young people at the same period about gender,clinical symptoms,lesion,pathological types.Results There were 70 cases of men(77.8%)and 20 cases of woman(22.2%)in elderly group,but there were 3 cases of man(25.0%)and 9 cases of woman(75.0%)in young group,there wsa significant difference between two group(P ＜0.01);The first symptoms in elderly group and young group were loss of appetite(50 cases,55.6% and 1 case,8.3%),thin and weak(38 cases,42.2% and 1 case,8.3%).difficulty swallowing(23 cases,25.6% and o case),anehia(29 cases ,32.2% and 2 cases,16.7%),upper abdominal pain(34 cases,37.1 % and 4 cases,33.3%)re spedtively.There was no significant difference between two group(P ＞ 0.05).The lesion of gastric cancer in two group were funds of stomach and cardia(39 cases,43.3% and 1 case,8.3%),antral(26 cases,28.9% and 7 cases,58.3%).body of stomach(22 cases,24.4% and 4 cases,33.3%).entire stomach(3 cases,3.3% and 0 case)respectively.There was significant difference between two group(P ＜0.05).The main of pathological types was abeno carcinoma.and the main in elderly group was moderate,high differentiation(85%),and the main in young group was moderate,low differentiation(59%).There was significant difference between two group(P ＜ 0.05).Conclusions The symptoms of gastric cancer in elderly people was non-specific,and it had more complications.We found that early diagnosis of gastric cancer in elderly people was difficult and it had poor prognosis.

Objective To evaluate the efficacy and safety of high-frequency electric dissection for colorectal cysts.Methods The personal information,clinical data,operation methods and postoperative complications of patients who were diagnosed as having colorectal cysts and underwent high-frequency electric dissection in Nanfang hospital and Zhujiang Hospital of Southern Medical University between January 1st,2005 and July 1st,2015 were analysed.All patients enrolled in the study were followed up to obtain their resuits of colonoscopy.Results A total of 63 patients were enrolled into our study,9 lesions located in the ileocecus,17 in the ascending colon,19 in the transverse colon,10 in the descending colon,7 in the sigmoid colon and 1 in the rectum.The maximum diameter of the cysts was 20.2+7.5 mm (5-40 mm).All patients underwent high-frequency electric dissection to remove the cysts completely or part of the cyst wall for drainage.Hemorrhage occurred in only one patient and bleeding stopped after being clipped by Titanium clip.Forty-five patients were followed up and there were no delayed complications or recurrence during a postoperative follow-up of 24.1 + 14.3 months (6-87 months).Conclusion High-frequency electric dissection is a safe and effective procedure for the treatment of colorectal cysts.

Objective To investigate the effects of recombinant human granulocyte colony stimulating factor (rhG-CSF) therapy on pulmonary hypertension,and its influence on number and functions of circulating endothelial progenitor cells (EPCs) in rats.Methods Eight week old Sprague-Dawlay rats were randomized into model group,treatment group and control group (8 rats in each group).The rats in model group and treatment group were treated with single subcutaneous injection of 1％ monocrotaline (50 mg/kg) to induce pulmonary hypertension models,while the control group was treated with phosphate buffered saline.Five days later,the rats in treatment group were administrated with 50 μg/(kg· d) rhG-CSF for 3 days.On day 21,peripheral blood was collected from caudal vein in all groups,and the percentage of EPCs in 100 000 mononuclear cells was evaluated by flow cytometry.Right ventricular systolic pressure was assessed,and the pathological changes of lung tissue and pneumoangiogram were observed by HE staining.Meanwhile,peripheral mononuclear cells collected from caudal vein were separated and cultured in vitro for EPCs.The cell ffunctions as proliferation,adhesion and migration ability were assessed.ANOVA and LSD test were applied as statistical analysis methods.Results (1) The right ventricular systolic pressure of rats in model group was higher than that in the controls [(48.13 ± 2.85) mm Hg vs (27.88 ± 3.04) mm Hg,t=2.016,P＜0.01],the lesion of endothelial cells in pulmonary arteriolar was evident,and the vessel wall was thickened.The pulmonary artery pressure of rats in the treatment group [(30.38 ± 2.83) mm Hg] was lower than that in the model group and close to the level of control group (t=0.376,P＞0.05) with mild pulmonary pathological changes.(2) The percentage off peripheral blood EPCs in mononuclear cells in the model group was decreased as compared to the control group [(0.016±0.007) ％ vs (0.031±0.011) ％,t=2.617,P＜0.01].After administration ofrhG-CSF,the EPCs in treatment group [(0.042±0.013) ％] was increased evidently as compared to the model group (t=4.325,P＜0.01) and the control group (t =1.942,P＜0.05).(3) The proliferation,adhesive and migrated cells of EPCs in model group were 0.49 ± 0.04,(6.93 ± 1.47) cells/HPF and (7.22±1.53) cells/HPF,lower than those in control group [0.68±0.07,(11.05±1.73) cells/HPF and (12.58±2.15) cells/HPF] and treatment group [0.63±0.06,(12.35±1.82) cells/HPF and (12.97±2.84) cells/HPF],the differences were statistically significant(all P＜0.05).Conclusions rhG-CSF may be effective in treating pulmonary hypertension through up-regulating the number and function of circulating EPCs in rat model of pulmonary hypertension.

A 43-year-old man was diagnosed as massive left occipital lobe hemorrhage with the hematoma expanded into the entire ventricular system. On admission, he was in deep coma with clinical signs of brain herniation and a Glasgow Coma Scale (GCS) score of 4. Vascular malformations were highly suspected since he was young with no history of hypertension. Considering the life-threatening situation, open craniotomy and hematoma evacuation was proposed as the first therapeutic option, but this was refused by his family members for non-medical reasons. In order to save his life, stereotactic aspiration was suggested again and was accepted. UK at an aggressive dosage of 50 000 IU was administered during and after the surgical procedure for 5 days. One month later, this patient gained an excellent recovery with a Glasgow Outcome Scale (GOS) score of 5.

Objective To explore intervention efficacy of clinical application of antimicrobial agents in internal medicine departments of a hospital.Methods 1 880 medical records from internal medicine and pediatrics departments this hospital in July-December 2010 were randomly selected as control group (before intervention),and 2 207 medical records in July-December 2011 were as trial group (after intervention),antimicrobial use of two groups was compared.Results The over-all usage rate of antimicrobial agents after intervention was lower than before intervention (48.12% vs 58.62%,χ2 =44. 45,P <0.001).Except endocrinology,pediatrics and hematology departments,the usage rates of antimicrobial agents in the other departments after intervention were all obviously lower than before intervention(all P <0.05).The usage rate of antimicrobial agents in endocrinology and hematology departments were both low(<40%),which met the requirements of Ministry of Health.Conclusion Comprehensive intervention in clinical use of antimicrobial agents reduced the usage rate of antimicrobial agents in internal medicine and pediatrics departments in this hospital.

Objective: To study the effect of gamma irradiation on the permeability of the blood brain barrier(BBB) in rat brains. Methods:The right caudate nucleuses of Sprague Dawley rats were irradiated by OUR XGD gamma units.Maximum dosages of 20,50,75 and 160 Gy were given using a 4 mm collimator.Immunohistochemistry with antibody of serum albumin was used for detecting the extravasation of endogenous serum components.Ultrastructural changes of BBB were observed through injection of lanthanum nitrate into blood vessels. Results: Extravasation of albumin and BBB opening in the right caudate nucleuses were detected as early as 12 h after irradiation at 50,75 and 160 Gy,and were detected 1 d after irradiation at 20 Gy.Immunoreactivity and emematous water reached their maximum after 3 d, gradually decreased during the following few days,and disappeared by day 7(20,50 Gy) or day 14(75 Gy).Irradiation at 160 Gy elicited persistent extravasation of albumin and BBB opening for 14 d. Conclusion: These are transient impairments to BBB after irradiation at 20,50,75 Gy,and persistent impairments after irradiaton at 160 Gy.