Objective To discuss the barriers influencing the application of evidence-based nursing. Methods Nine hundred nurses from August 2013 to February 2014 were selected from five polyclinics in Shenzhen by randomly cluster sampling according to different departments and wards. We carried out the survey with the Chinese version of cognitive of impairment of nursing scientific research scale. Results The sores of 4 dimesions of scientific application of evidence-based nursing from high to low were effectiveness and system of research, resource to evidence-based nursing, quality of research and attitude and ability of nursing staff. The main barriers in applying scientific research payoffs by the nursing staff included the deficient resource and equipment provided by hospitals (68.09%), the jumbled medical development information confused the nurses in selecting related reference (66.75%), failing to put the scientific achievements into practice (66.01%),insufficient time to actualize new ideas (64.15%), and difficulty in obtaining the reference of scientific research (64.04%). Conclusion The barriers to scientrfic application of evidence-based nursing were the deficient resource and time and difficulties to find evidence. The nursing policy makers should adopt efficient measures aimed at the difficulties the nursing staff in applying their research results, thereby popularize the application of research achievements in hospitals.

The effects of fructose 1, 6-diphosphate (FDP)on the hemodynamic variations in twelve dogs with endotoxin shock were observed. Following anesthesia,arterial and Swan-Gang catheters were inserted correspondingly into femoral and pulmonary arteries At 30mins and 90 mins following intravenous injection of endotoxin(IIE),these subjects were randomly assigned to receiving intravenous infusion of FDP at a dosage of 375mg/kg(group I,n= 6) or the equivalent volume of saline as control(group ,n= 6) The hemodynamic parameters of both groups were measured before IIE and every hour during 8 hours after IIE respectively. The results demonstrated that before IIE,there were not significant differences in the values of all parameters between both groups;im- mediately followillg IIE, the values of CI, MAP, PAMP, PCWP, SVI, LSWI, RSWI markedly decreased in both groups (P

Objective To study the protection mechanism of HO-1 with the gas-blood analysis and MAP of femoral artery in rats with hemorrhagic shock.Methods A model of hemorrhagic shock was established in 20 SD healthy clean male rats.The rats were randomly divided into the L.Lactis recombinant HO-1 gene group (HO group)and phosphate buffer solution group (PBS group).The gas-blood analysis and MAP of femoral artery in hemorrhagic shock were compared during the test.The mortality rate,MPO activity,bacterial translocation,the pathologic and content of HO-1,TNF-α and IL-10 in the low intestine were detected and compared 1h after resuscitation.Results Compared to PBS group,the mortality rate,Chiu's grade,bacterial translocation and MPO activity in HO group were significantly decreased[10％ vs40％,(1.51 ±0.23) points vs(2.15 ±0.48) points,44.4％ vs 100.0％,(0.16 ±0.05)U/g vs (0.99 ± 0.28)U/g,all P ＜0.05],PaO2 and MAP during the resuscitation,the content of HO-1 and the gray level of IL-10 were significantly increased.Conclusion L Lactis recombinant HO-1 gene has the virtue to maintain the higher level of PaO2 and MAP,which is beneficial to the intestine mucosa barrier and anti-inflammation response of low intestine significantly.

Objective To explore the effect of parental accompany on relieving pain and acute stress reaction in children with circumcision.Method Sixty children were divided into the experiment group and control group randomly with 30 cases in each group. Parental accompany was applied in the experiment group besides routine nursing method, while in the control group, only routine nursing method was used.The data of HR、MAP、SpO2、MOPS、VAS were recorded and compared during the operation between the two groups. Result There were significant differences in the MOPS,VAS , SpO2 , the quickest HR and the highest MAP between the two groups (all P<0.05).Conclusion The method of parental accompany during the operation can alleviate the stress reaction and enhance the threshold of pain in children.

Objective To explore the appropriate pneumoperitoneum pressure in different surface area children during pediatric laparoscopic surgery,so as to attenuate the intederence with physiological function and avoid pneumoperitoneum correlative complications.Methods 120 patients underwent laparoscopic surgery were divided into three groups by different surface area:A(0.43～0.67m2),B(0.68～0.92m2),C(0.93～1.17m2).Each group was divided into two subgroups again by different pneumoperitoneum pressure:A1(4 mm Hg),A2(6mm Hg),B1(7mm Hg),B2(9mm Hg),C1(10mm Hg),C2(12 mm Hg).The cardiorespiratory function and blood gas analysis in different time point before and after pneumoperitoneum were monitored.Results The increase of PET CO2,Paw,HR,MAP and PaCO2 in A2,B2,C2 were more obvious than in A1,B1,C1(P ＜ 0.01).The eligible pneumoperitoneum pressure for A,B,C were 4,7,10mmHg respectively.The complications of gastric contents back-streaming and respiratory acidosis were 7 cases in A2,B2,C2 in all,and 3 cases in A1,B1,C1.Conclusion Using a compatible pneumoperitoneum pressure for different surface area children could attenuate the interference of physiological function and avoid pneumoperitoneum correlative complications.

Objective To evaluate the effect of propofol postconditioning on necroptosis during hy-poxia-reoxygenation (H∕R) injury in diabetic cardiomyocytes. Methods Normally cultured H9C2 cardio-myocytes were divided into 5 groups (n= 19 each) using a random number table: control group (group C), high glucose group (group HG), H∕R group, propofol postconditioning (group P) and solvent dimethyl sulfoxide (DMSO) control group (group DMSO). H9C2 cells were incubated for 48 h in DMEM culture medium containing 5. 5 and 25 mmol∕L glucose in group C and group HG, respectively. In group H∕R, H9C2 cells were incubated for 48 h in DMEM culture medium containing 25 mmol∕L glucose and then un-derwent H∕R. H9C2 cells were incubated for 48 h in DMEM culture medium containing 25 mmol∕L glucose and then underwent H∕R, and propofol at the final concentration of 50 μmol∕L was added at the onset of reoxygenation in group P. In group DMSO, H9C2 cells were incubated for 48 h in DMEM culture medium containing 25 mmol∕L glucose and then underwent H∕R, and DMSO at the final concentration of 150μmol∕L was added at the onset of reoxygenation. The model of cardiomyocyte H∕R injury was established by subjecting cardiomyocytes to 6 h of hypoxia followed by 12 h of reoxygenation. At 12 h of reoxygenation, the cell viability was measured by CCK8 assay, the product of lactate dehydrogenase (LDH) in culture medium was measured, the level of reactive oxygen species (ROS) was determined by flow cytometry, cardiomyo-cyte apoptosis was detected by TUNEL, and the expression of receptor-interacting protein 1 ( RIP1), RIP3, Bax, Bcl-2, activated caspase-3 and caspase-3 was determined by Western blot. The apoptotic rate and ratio of activated caspase-3∕caspase-3 were calculated. Results Compared with group C, the cell via-bility was significantly decreased, the product of LDH was increased, the level of ROS and apoptotic rate were increased, the expression of RIP1, RIP3 and Bax was up-regulated, the expression of Bcl-2 was down-regulated, and the ratio of activated caspase-3∕caspase-3 was increased in group HG ( P < 0. 05). Compared with group HG, the cell viability was significantly decreased, the product of LDH was increased, the level of ROS and apoptotic rate were increased, the expression of RIP1, RIP3 and Bax was up-regula-ted, the expression of Bcl-2 was down-regulated, and the ratio of activated caspase-3∕caspase-3 was in-creased in group H∕R (P<0. 05). Compared with group H∕R, the cell viability was significantly increased, the product of LDH was decreased, the level of ROS and apoptotic rate were decreased, the expression of RIP1, RIP3 and Bax was down-regulated, the expression of Bcl-2 was up-regulated, and the ratio of acti-vated caspase-3∕caspase-3 was decreased in group P (P<0. 05), and no significant change was found in the indexes mentioned above in group DMSO (P>0. 05). Conclusion The mechanism by which propofol post-conditioning ameliorates H∕R injury in diabetic cardiomyocytes may be related to inhibiting necroptosis.