1.Analysis of adverse events in stereotactic radiosurgery with Gamma Knife
Mingqun ZHANG ; Dadi QIAN ; Xiaoyu LIU ; Li ZUO ; Kewan WANG
China Medical Equipment 2024;21(12):178-184
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.
2.Analysis of adverse events in stereotactic radiosurgery with Gamma Knife
Mingqun ZHANG ; Dadi QIAN ; Xiaoyu LIU ; Li ZUO ; Kewan WANG
China Medical Equipment 2024;21(12):178-184
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.
3.Therapeutic effect of Buyang Huanwu Decoction combined with hyperbaric oxygen therapy on acute cerebral infarction of Qi deficiency and blood stasis type
Kewan LIU ; Xiaowei LIU ; Liangliang MIAO ; Chengcheng CHEN ; Keqiong WANG ; Yuxing LIU ; Houdong MEI ; Yulei LIANG
Chinese journal of nautical medicine and hyperbaric medicine 2020;27(6):691-695
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.
4.Therapeutic effect of Buyang Huanwu Decoction combined with hyperbaric oxygen therapy on acute cerebral infarction of Qi deficiency and blood stasis type
Kewan LIU ; Xiaowei LIU ; Liangliang MIAO ; Chengcheng CHEN ; Keqiong WANG ; Yuxing LIU ; Houdong MEI ; Yulei LIANG
Chinese journal of nautical medicine and hyperbaric medicine 2020;27(6):691-695
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.
5.Effect of different pressure hyperbaric oxygen therapy on patients with diffuse axonal injury
Yanyan YANG ; Houdong MEI ; Jiachuan LIU ; Kewan LIU ; Jinbiao WANG ; Wenjiang SUN ; Jun LI
Chinese journal of nautical medicine and hyperbaric medicine 2015;22(5):378-381
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.
6.Effect of different pressure hyperbaric oxygen therapy on patients with diffuse axonal injury
Yanyan YANG ; Houdong MEI ; Jiachuan LIU ; Kewan LIU ; Jinbiao WANG ; Wenjiang SUN ; Jun LI
Chinese journal of nautical medicine and hyperbaric medicine 2015;22(5):378-381
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.
7.Inhibition of mitochondrial permeability transition pore opening reduced Aβ-mediated inflammatory effects on the apoptosis of neural stem cell
Qingzhuang CHEN ; Ning ZHU ; Jizhong LIN ; Yan WAN ; Kewan WANG ; Yong WANG
The Journal of Practical Medicine 2014;(9):1380-1384
Objective The aim of this study is to investigate the protective effect of inhibiting the open of mitochondrial permeability transition pore on neural stem cells. Methods In present study, four groups were set up, such as control, conditioned medium control group, Aβ1-42 group and CsA group. The levels of inflammatory mediators were detected by LiquiChip technique. The apoptotic rate of neural stem cells was detected by flow cytometry and the expression of caspase-3 was confirmed by western blotting. Results The levels of IL-6 and TNF-αwere 7.92 and 1.22 times higher than those in control group after Aβ1-42 acting on microglia for 96 h. After being exposed to inflammatory media, the apoptotic rate of neural stem cells reached 41.17%, these was significant increase compared to control (P<0.001);while the apoptotic rate were decrease significantly if the open of the mitochondrial permeability transition pore was inhibited. In the meantime, the activation of caspase-3 was reduced obviously. Conclution Inhibiting the open of mitochondrial permeability transition pore can markedly reduced the apoptotic rate of neural stem cells , and dramatically impaired the effect of inflammatory on the apoptosis of neural stem cells , suggesting that inhibiting the opening of the mitochondrial permeability transition pore have protective effect on neural stem cells.
8.Clinical observation of efficacy of Haijiyi under nasal endoscope in the treatment of allergic rhinitis
Chinese Journal of Primary Medicine and Pharmacy 2013;20(16):2452-2453
Objective To evaluate the efficacy and safety of Haijiyi under nasal endoscope in the treatment of allergic rhinitis(AR).Methods 213 cases with AR were randomly divided into treatment group(112 cases) and control group(101 cases).Patients in the treatment group were treated with Haijiyi under nasal endoscope.The control group was treated with traditional microwave therapeutic equipment.Both two groups were followed up for 1 year,and long-term clinical efficacy was observed and compared between the two groups.Results The total effective rate of the treatment group was 80.4%,which was higher than 61.4% of the control group,and the difference was statistically significant(P< 0.01).Conclusion Haijiyi CZB type in the treatment of AR has advantages of exact allocation,no bleeding,less complication,good long-term efficacy,which is worth clinical popularizing and application.
9.Development and application of a device for stretch-induced injury to cultured cell and testing system
Zhiyong YIN ; Zhengguo WANG ; Jianxin JIANG ; Zhihuan YANG ; Ping ZHOU ; Kewan WANG ; Xiaolin MA
Journal of Third Military Medical University 2003;0(13):-
Objective To develop a device for stretch-induced injury to cultured cells and measure the injury parameters.It makes possible to observe the changes of cell configuration and function directly after injury. Methods The device was developed based on aero-dynamical principle,and consisted of mini-type air compressor,electromagnetic valve,pressure transmitter,PGA amplifier,A/D converter and computer.The computer can accurately control the injury parameters.A new method and device were first introduced to measure the deformation rate and deformation degree of silastic membrance in the stretch induced cultured cell injury process.The device controlled by the computer was used to cause the astrocyte injury.The degree of cell injury was assessed qualitatively by electron microscopy,and quantitatively by lactate dehydrogenase(LDH) enzyme release and trypan blue staining.Results The experiment results showed that the injury of different levels could be reproduced by our device under the injury parameters we set.Conclusion The injury device and the measuring system meet the requirements of our design.The results suggested that the new device and the method were much better than those reported in foreign literature.It has the advantages of simple and convenient manipulation,high precision and real-time processing.It can be used for the cell-level experiment research.
10.Low-dosage radiosurgical treatment for intractable epilepsy following brain injury through positron emission tomography localization
Kewan WANG ; Songtao QI ; Huaping WU ; Kaijun YANG
Chinese Journal of Trauma 1993;0(05):-
Objective To treat the patients suffering from intractable epilepsy after brain injury with low-dosage linac accelerator stereotactic radiosurgery through positron emission tomography (PET) localization. Methods PET examination based on 18 F-2-fluorine-2-deglucose (FDG) was carried out in 32 patients in order to localize epileptogenic foci followed by radiosurgery with peripheral radiation dose of 9-13 Gy. The follow-up was conducted over one year. The seizure frequency of epilepsy was recorded to evaluate the therapeutic effect. Results The PET imaging showed that the cortical area around the cerebromalacia caused by primary injury presented low metabolic change. The metabolic changes in different injury areas mainly concentrated in the epileptic foci. In some cases,the low metabolic areas not only was localized at the part of impact lesion but also at the part of contrecoup lesion. The seizure frequency gradually decreased after radiosurgical treatment in most patients,with obvious statistical significance compared with pretreatment. According to Wieser's classification of operative effect,the cases at the grades Ⅰ-Ⅱ accounted for 44% (14/32),grades Ⅲ-Ⅳ for 41% (13/32) and grades Ⅴ-Ⅵ for 16%(5/32). No fresh complications were found in all the cases. Conclusions Low-dosage stereotactic radiosurgery with the PET localization is a safe,effective and minimally invasive surgical approach to intractable posttraumatic epilepsy.

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