Objective To observe the impact of different pacing sites in hemodynamic and cardiovascular events after restoration of spontaneous circulation.Methods A total of 76 patients with-in hospital cardiac arrest occurred from November 2010 to January 2014 were confirmed by electrionic device monitoring or electrocardiogram and they received cardiopulmonary resuscitation,and their ages were over 18 years.Patients with end-stage of various disease,malignancy and cardiac arrest due to incurable diseases or debility of physical conditions were excluded.The 76 patients were divided into two groups according to pacing site checked by X-ray fluoroscopy in emergency rescue unit:right ventriclular outflow trace pacing group [n =36,male 26 cases,female 10 cases,age (57.31 ± 16.65) years] and right ventricular apex pacing group [n =40,22 male cases and 18 female cases,age (60.43 ± 15.48) years].All patients' QRS duration were measured by ECG after pacemaker implantition and left ventricular ejection fraction (LVEF),left ventricular short axis reduced rate (FS),heart rate (HR),cardiac index (CI) were tested by bedside echocardiography and non-invasive hemodynamic monitoring was used during the early to middle stage.All the hemodynamic variables and the cardiac events were observed after spontaneous circulation recovery.All the data were analyzed by SPSS version 13.0 statistical software.Results There were no significant differences in age,gender,the primary disease,the time from cardiac arrest to spontaneous circulation restoration and dosage of epinephrine (P ＞ 0.05).In comparison with right ventricular apex pacing group,LVEF,FS,HR,CI were higher in right ventriclular outflow trace pacing group [(0.46 ± 0.04)％ vs.(0.44 ±0.05)％,(0.34±0.05) vs.(0.32±0.04),(0.04±0.46) L/minvs.(3.47±0.46) L/min,(0.46±0.29) L/ (min · m2) vs.(2.46 ±0.26) L/ (min · m2),P ＜ 0.05] and right ventriclular outflow trace pacing group had shorter QRS duration than right ventriclular apex pacing group [(128.25 ± 6.06) ms vs.(151.93 ± 8.99) ms,P ＜ 0.05]; fewer atrial fibrilation event was detected in right ventriclular outflow trace pacing group after restoration of spontaneous circulation than that in right ventricular apex pacing group.But incidences of cardiac failure and thrombus were not different between two groups (P ＞ 0.05).Conclusions The right ventriclular outflow trace pacing resulted in better hemodynamic and fewer atrial fibrilation after restoration of spontaneous circulation.

Objective To understand the effect of mindfulness-based stress reduction(MBSR)on death anxiety and job burnout in Intensive Care Unit(ICU) nurses. Methods Using cluster sampling method, ICU nurses from two ClassⅢ Grade A hospitals in Dazhou city of Sichuan Province were selected as the research objects. In order to avoid mutual influence, nurses were divided into groups according to hospitals. Totally 32 ICU nurses in one hospital were set as the control group and 38 ICU nurses in another hospital as the observation group. During the course of the study, one nurse in the observation group quit the study due to personal reasons, and 37 nurses finally completed the study. The nurses in the control group did not receive any intervention, while the nurses in the observation group were adopted the MBSR intervention. The intervention effect was evaluated by the Chinese Version of Templer-death Anxiety Scale(CT-DAS) and Job Burnout Scale. Results There was no statistically significant difference between the two groups before intervention in terms of their Death Anxiety Scale score (P＞0.05); the score in Death Anxiety Scale in the observation group was lower than the control group after intervention and the difference was statistically significant (P＜ 0.05). Before the intervention, there was no statistically significant difference in the total score and the scores of each dimension of Job Burnout Scale between the two groups (P＞0.05); after intervention, the total score of Job Burnout Scale and the score of "emotional fatigue" in the observation group were lower than those in the control group with statistical significances (P＜0.05). There was no statistically significant difference between the two groups in the scores of indifference to work and personal lacking in sense of achievement between the two groups(P＞0.05). Conclusions MBSR therapy can reduce the death anxiety level and job burnout of ICU nurses.