Objective:To explore the current status of barriers to participation in phaseⅡcoronary artery bypass grafting (CABG) patients and the factors influencing them, and to provide new ideas for reducing barriers to participation in rehabilitation and improving the participation rate in cardiac rehabilitation.Methods:For this study, a cross-sectional survey research method was utilized. The study included 334 patients who underwent CABG and were admitted to the Second Hospital of Hebei Medical University between June 2022 and May 2023. These patients were selected using the convenience sampling method. A General Information Questionnaire, the Cardiac Rehabilitation Barriers Scale (CRBS-C/M), and a Questionnaire on the Knowledge of Information Related to Cardiac Rehabilitation were used to conduct the survey. Multiple linear regression was used to analyze the independent influencing factors on barriers to participation in phase Ⅱ cardiac rehabilitation in post-CABG patients.Results:Out of 334 patients, 248 were males and 86 were females with age (54.74 ± 7.61) years old. The total average score of CRBS-C/M in patients after CABG surgery was 3.20 ± 0.43, with the highest external logistic factors score of 3.42 ± 0.58. The knowledge status score of information related to cardiac rehabilitation was 42.11 ± 7.94. Multiple linear regression analysis revealed that the following factors independently influenced post-CABG patients′ barriers to participating in phaseⅡcardiac rehabilitation: marital status, whether or not they had completed phase I cardiac rehabilitation,number of other comorbidities, knowledge of cardiac rehabilitation information. All of these differences were statistically significant ( t values were -4.87-3.35, all P<0.05). Conclusions:The barriers to participation in phase Ⅱ cardiac rehabilitation in post-CABG patients are at an intermediate to high level, and healthcare professionals should emphasize the assessment of barrier factors in these patients, and target the development and implementation of phase Ⅱ cardiac rehabilitation in terms of the influencing factors.

A patient suffered a sustained soft tissue necrosis and infection at the radial interphalangeal joint of left thumb after laser nevus removal. He was treated in the Department of Orthopaedics, No. 920 Hospital of Joint Logistic Support Force of Chinese People's Liberation Army in February 2020. CTA combined with digital technology of Mimics software was used to accurately locate the perforator of posterior tibial artery septal perforator flap at the appropriate part of the calf and the super flap (1.20 cm×0.80 cm×0.46 cm) for the repair was designed. After 1 year of follow-up, the left thumb flap had no swelling with a satisfactory texture and appearance. The sensory recovered to S 3, and the left thumb movement was completely normal. Only a linear scar remained at the donor site of the calf.

Objective To explore the relation of gamma knife radiation of different doses with trigeminal nerve radiation damage by investigating the pathologic changes of trigeminal nerve roots after different doses of gamma knife radiation.Methods Fifteen New Zealand rabbits were randomly divided into 60 Gy radiation group,80 Gy radiation group,100 Gy radiation group,120 Gy radiation group and control group (n=3).Bilateral trigeminal nerves of all New Zealand rabbits,excepted for the control group,were irradiated;and a 4-mm isocenter was placed at trigeminal nerver root entry zone.All New Zealand rabbits for pathological observation were sacrificed after six months.The roots were examined by light microscopy,immunohistochemistry,and electron microscopy.Integrated optical density of the myelin staining and immunohistochemistry staining results of the four groups were examined by Image-pro plus 6.0 image processing system,and analyzed using method of statistics.Results Pathological observation showed the result of 60 Gy group after irradiation did not differ significantly as compared with the result of control group;in 80 Gy group,there was part nerve fiber fragmentation and degeneration,and demyelination;in 100 Gy group,there was nerve fiber fragmentation,degeneration and demyelination,and part of nervous necrosis;in 120 Gy group,there was almost all nerve fiberdissolution,disappearance and demyelination,and most of nervous necrosis.The integrated optical density of the myelin staining and immunohistochemistry staining results of 60 Gy group did not differ significantly as compared with that of the control group (P＞0.05);the results of 80 Gy,100 Gy and 120 Gy group differed significantly as compared with that of control group (P＜0.05) and decreased following the increase of irradiation doses.Conclusions The histopathological changes of the trigeminal nerve irradiated by gamma knife have significant correlation with irradiation doses.The result of 60 Gy group after irradiation does not change significantly;the radiation injury of 80 Gy-120 Gy group aggravates with the increase of irradiation doses;irradiation of high dose (100 Gy and 120 Gy) can cause nervous necrosis.

Objective To explore the relation of gamma knife radiation doses and changes of trigeminal nerves after gamma knife irradiation by studying the changes of trigeminal somatosensory evoked potentials (TSEP) characteristics oftrigeminal nerve roots irradiated by gamma knife in normal animals.Methods Fifteen New Zealand rabbits were divided into 60 Gy irradiation group,80 Gy irradiation group,100 Gy irradiation group,120 Gy irradiation group and control group in accordance with random number table (n=3).The first 4 groups used Gamma Plan 5.34 planning system to design the radiation targets and radiation doses.The target was placed at trigeminal nerve root entry zone,bilateral irradiation was performed,and the central dose was divided into 60 Gy,80 Gy,100 Gy and 120 Gy.The bilateral TSEP was monitored before and 6 months after irradiation.The monitoring data were recorded and statistical analysis was performed.Results P1,N1,P2 wave latencies,P1-N1,N1-P2 interpeak latencies and amplitudes in the 60 Gy irradiation group after irradiation showed no significant differences as compared with those in the control group (P＞0.05);P1,N1,P2 wave latencies,P1-N1,N1-P2 interpeak latencies and amplitudes in the 80 Gy irradiation group,100 Gy irradiation group,and 120 Gy irradiation group after irradiation showed significant differences as compared with those in the control group (P＜0.05),and these changes increase with increase of doses.Conclusion The changes of TSEP,which increase with increase of doses,are closely related to the doses of gamma knife irradiation,of which 80 Gy is the lowest dose to produce changes.