Gamma Knife stereotactic radiosurgery is a highly precise radiotherapy technology,including the head Gamma Knife treatment system and the body Gamma Knife treatment system. Through multi-beam gamma rays focused on a specific target area,the lesion is exposed to high-dose radiation to cause radiation damage and necrosis,and the dose outside the target area is sharply reduced,thereby protecting the normal tissue outside the target area. Gamma Knife treatment has the advantages of being minimally invasive and effective treatment. Due to its precise and steep dose distribution,side effects are relatively few,and it can partially replace surgery or serve as a supplementary treatment after surgery. It was originally used for the treatment of craniocerebral diseases. In my country,Gamma Knife treatment was first applied to the treatment of body tumors. In recent years,with the widespread application of Gamma Knife radiosurgery technology,the incidence of adverse events associated with Gamma Knife radiotherapy has also increased. Gamma Knife adverse events mainly include those caused by treatment equipment failure and improper operation,as well as adverse events and complications resulting from tissue radiation damage. This article aims to comprehensively review and analyze the adverse events related to the use of Gamma Knife,and to explore the types,causes,preventive measures and coping strategies of these adverse events,in order to provide theoretical support and practical guidance for the safe use of Gamma Knife.

Gamma Knife stereotactic radiosurgery is a highly precise radiotherapy technology,including the head Gamma Knife treatment system and the body Gamma Knife treatment system. Through multi-beam gamma rays focused on a specific target area,the lesion is exposed to high-dose radiation to cause radiation damage and necrosis,and the dose outside the target area is sharply reduced,thereby protecting the normal tissue outside the target area. Gamma Knife treatment has the advantages of being minimally invasive and effective treatment. Due to its precise and steep dose distribution,side effects are relatively few,and it can partially replace surgery or serve as a supplementary treatment after surgery. It was originally used for the treatment of craniocerebral diseases. In my country,Gamma Knife treatment was first applied to the treatment of body tumors. In recent years,with the widespread application of Gamma Knife radiosurgery technology,the incidence of adverse events associated with Gamma Knife radiotherapy has also increased. Gamma Knife adverse events mainly include those caused by treatment equipment failure and improper operation,as well as adverse events and complications resulting from tissue radiation damage. This article aims to comprehensively review and analyze the adverse events related to the use of Gamma Knife,and to explore the types,causes,preventive measures and coping strategies of these adverse events,in order to provide theoretical support and practical guidance for the safe use of Gamma Knife.

Objective:To observe the clinical effect of Buyang huanwu decoction combined with hyperbaric oxygen therapy on acute cerebral infarction (ACI) of qi deficiency and blood stasis type.Methods:A total of 78 patients with acute cerebral infarction of qi deficiency and blood stasis type admitted to the 901 Hospital of CPLA from June 2016 to May 2019 were selected as study objects and randomly divided into 3 groups according to random number table method: Traditional Chinese medicine (TCM) group, HBO group, and combination group ( n=26). The TCM group was treated with traditional Chinese medicine decoction on the basis of the conventional treatment of ACI; the HBO group was treated with HBO on the basis of conventional treatment of ACI; the combination group was treated with traditional Chinese medicine decoction and HBO on the basis of the conventional treatment of ACI. After 20 days of treatment, the National Institute of Health stroke scale (NIHSS) scores and TCM syndrome scores of the 3 groups were statistically analyzed according to their basic clinical characteristics. Results:There were no significantly statistical differences in terms of NIHSS score or TCM syndrome score before treatment among the 3 groups ( H=0.304, P=0.859; H=0.379, P=0.827). After treatment, the NIHSS score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.033, P’=0.011). The difference of NIHSS score after treatment in the combination group was higher than those in the TCM group and the HBO group ( P’=0.025, P’=0.003). After treatment, the TCM syndrome score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.016, P’=0.046). After treatment, the difference of TCM syndrome score in the combination group was higher than those in the TCM group and the HBO group ( P’=0.005, P’=0.023). The overall clinical efficacy of the combination group was better than those of the TCM group and the HBO group ( P’=0.045, P’=0.010)). Conclusion:Buyang Huanwu decoction combined with hyperbaric oxygen therapy has a synergistic effect in the treatment of ACI, which is worthy of clinical application.

Objective:To observe the clinical effect of Buyang huanwu decoction combined with hyperbaric oxygen therapy on acute cerebral infarction (ACI) of qi deficiency and blood stasis type.Methods:A total of 78 patients with acute cerebral infarction of qi deficiency and blood stasis type admitted to the 901 Hospital of CPLA from June 2016 to May 2019 were selected as study objects and randomly divided into 3 groups according to random number table method: Traditional Chinese medicine (TCM) group, HBO group, and combination group ( n=26). The TCM group was treated with traditional Chinese medicine decoction on the basis of the conventional treatment of ACI; the HBO group was treated with HBO on the basis of conventional treatment of ACI; the combination group was treated with traditional Chinese medicine decoction and HBO on the basis of the conventional treatment of ACI. After 20 days of treatment, the National Institute of Health stroke scale (NIHSS) scores and TCM syndrome scores of the 3 groups were statistically analyzed according to their basic clinical characteristics. Results:There were no significantly statistical differences in terms of NIHSS score or TCM syndrome score before treatment among the 3 groups ( H=0.304, P=0.859; H=0.379, P=0.827). After treatment, the NIHSS score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.033, P’=0.011). The difference of NIHSS score after treatment in the combination group was higher than those in the TCM group and the HBO group ( P’=0.025, P’=0.003). After treatment, the TCM syndrome score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.016, P’=0.046). After treatment, the difference of TCM syndrome score in the combination group was higher than those in the TCM group and the HBO group ( P’=0.005, P’=0.023). The overall clinical efficacy of the combination group was better than those of the TCM group and the HBO group ( P’=0.045, P’=0.010)). Conclusion:Buyang Huanwu decoction combined with hyperbaric oxygen therapy has a synergistic effect in the treatment of ACI, which is worthy of clinical application.

Objective To investigate the value of different pressure hyperbaric oxygen (HBO) therapy on clinical outcomes and effect on prognosis of the patients with severe diffuse axonal injury (DAI).Methods Thirty cases of diffuse axonal injury admitted into our hospital from September 2013 to March 2015 were randomly divided into 3 groups: the control group, the lower hyperbaric oxygen group (or the lower HBO group) and the higher hyperbaric oxygen group (or the higher HBO group) , each consisting of 10 cases.The control group was just given routine treatment, the lower HBO group received 3 courses of 0.2 MPa HBO therapy in addition to routine treatment after vital signs became stable, and the higher HBO group received 3 courses of 0.25 MPa HBO therapy in addition to routine treatment.Neural functions of the 3 groups were evaluated by using GOS and NIHSS.Magnetic resonance spectroscopy was used to observe changes in the indicators of N-acetylaspartate (NAA)/ creatine (Cr), choline-containing compounds (Cho)/Cr and mINs/Cr.Results Statistical differences could be seen in the scores of GOS and NIHSS, when comparisons were made between the groups (P ＜0.05 or P ＜0.01).As compared with those of the lower HBO group and the control group, the levels of NAA/Cr, Cho/Cr, mlNs/Cr in the splenium of corpus callosumin, and NAA/Cr and Cho/Cr in basal ganglia for the 0.25 MPa HBO group were either elevated or decreased, with statistical significance (P ＜ 0.05 or P ＜ 0.01).Conclusions For the patients with severe diffuse axonal injury, higher pressure HBO therapy could obviously enhance metabolism of brain tissues in the splenium of corpus callosumin and basal ganglia and improve neurological deficits prognosis of the disorder.

Objective To investigate the value of different pressure hyperbaric oxygen (HBO) therapy on clinical outcomes and effect on prognosis of the patients with severe diffuse axonal injury (DAI).Methods Thirty cases of diffuse axonal injury admitted into our hospital from September 2013 to March 2015 were randomly divided into 3 groups: the control group, the lower hyperbaric oxygen group (or the lower HBO group) and the higher hyperbaric oxygen group (or the higher HBO group) , each consisting of 10 cases.The control group was just given routine treatment, the lower HBO group received 3 courses of 0.2 MPa HBO therapy in addition to routine treatment after vital signs became stable, and the higher HBO group received 3 courses of 0.25 MPa HBO therapy in addition to routine treatment.Neural functions of the 3 groups were evaluated by using GOS and NIHSS.Magnetic resonance spectroscopy was used to observe changes in the indicators of N-acetylaspartate (NAA)/ creatine (Cr), choline-containing compounds (Cho)/Cr and mINs/Cr.Results Statistical differences could be seen in the scores of GOS and NIHSS, when comparisons were made between the groups (P ＜0.05 or P ＜0.01).As compared with those of the lower HBO group and the control group, the levels of NAA/Cr, Cho/Cr, mlNs/Cr in the splenium of corpus callosumin, and NAA/Cr and Cho/Cr in basal ganglia for the 0.25 MPa HBO group were either elevated or decreased, with statistical significance (P ＜ 0.05 or P ＜ 0.01).Conclusions For the patients with severe diffuse axonal injury, higher pressure HBO therapy could obviously enhance metabolism of brain tissues in the splenium of corpus callosumin and basal ganglia and improve neurological deficits prognosis of the disorder.