Objective To explore the influence of hospital- based transitional care on the rehabilita-tion of patients with enterostomy, and provide evidence- based reference for specialist care of the enterostomy patients. Methods The randomized controlled trials on the hospital- based transitional care in enterostomy patients were collected by computer using China National Knowledge Infrastructure Database, Chinese Science Technology Periodical Database, Wanfang Periodical Database, Foreign Medical Information Resources Database and PubMed from the building of the database till December 2014, and analyzed by RevMan 5.2 software. Results Sixteen articles were included in the study, involving 1 263 patients with enterostomy. The results of Meta- analysis revealed that the incidence of complications in transitional care patients was lower than that in conventional discharge guidance patients, odds ratio(95% confidence interval) was 0.31 (0.21-0.45), the difference was significant (Z=6.02, P<0.01), and the quality of life was raised (including the physical function, cognitive function, role function, emotional functions, social function and the total quality of life), weighted mean differences (95% confidence interval) were 13.81 (8.23-19.39), 22.00 (17.21-26.79), 15.22(11.71-18.73), 16.68(13.01-20.35), 22.60(16.58-28.62), 17.46(13.53-21.38),the differences were significant(P<0.01). Conclusions The transitional care model giving priority to hospital service resources can provide a higher level professional care for patients after enterostomy, and avoid or reduce the complications, promote the recovery earlier as well as constantly improve the quality of life.

BACKGROUND:The existed artificial anal sphincter cannot sense whether there are intestinal contents in the bowel and the state of intestinal contents, and the previous studies on the intestinal content signal did not included the different parts of colon and the signals of different intestinal content status.
OBJECTIVE:To compare the differences of ultrasound signals of different intestinal content status in different parts of New Zealand rabbits detected with transmission-type ultrasonic signal detection system.
METHODS:Twenty healthy New Zealand rabbits were used;the rabbits were divided into groups according to distal part of proximal colon, distal colon and distal rectum. Five positions of solid stool particles were selected randomly as the detection point in each group. The voltage signals of stool were measured under solid, fluid, gaseous, and deflation status of the lumen.
RESULTS AND CONCLUSION:In rectum, there were no significant differences in voltage signals between solid and gaseous conditions, while there were significant differences between fluid and deflation conditions (P=0.000). Multiple comparison showed there were significant differences between four conditions in distal part of proximal colon and distal colon (P=0). There were significant differences in voltage singles between rectum, distal colon and proximal colon under solid and fluid conditions (P=0). Multiple comparison showed there were significant differences in any part of large bowel for solid and fluid status (P=0). There were no significant differences in voltage singles between rectum, distal colon and proximal colon under gaseous and deflation conditions. There was interactive effect of intestinal contents between three parts of large bowel under the four conditions (P=0.000). Transmission-type ultrasonic detection system can distinguish artificial intestinal contents sensory nerves of various intestinal contents. And the application of ultrasonic detection system to detect the intestinal contents under different conditions can provide a new effective method for the research on artificial intestinal content sensory nerves.

Objective Comparative study of gastric tube implantation at different times in patients with invasive mechanical ventilation. Methods Random sampling was used to divide 160 patients who were incubated with mechanical ventilation at the hospital into two groups,There were 80 patients in each group. Two groups of patients were routinely placed gastric tube by a stationary nurse.The observation group was treated with ordinary silica gel stomach tube at early stage(immediately)after trachea cannula, the control group still used the ordinary silica gel stomach tube after the trachea cannula late (24 hours later).The one-time successful rate,the total successful rate,the operation time and the result of the two Methods were observed in the two groups. Results The observation group Placing stomach tube one-time successful rate and the total successful rate was 75% (60/80), 97.5% (78/80), significantly higher than the control group 27.5%(22/80),72.5%(58/80),the difference was statistically significant(χ2=36.12, 19.61,P<0.01).The operation time of gastric tube in observation group was(1.49 ± 0.45)min,which was significantly lower than that of control group(3.07 ± 0.32)min,the difference was statistically significant (t=25.48,P<0.01).The observation group only heard gurgling not pumped to the gastric juice of 10 cases (12.50%), only smoke into the gastric juice does not hear the gurgling in 0 cases, both in 70 cases (87.50%),both in 0 cases,the control group were 37 cases(46.25%),0 cases,40 cases(50.00%),3 cases (3.75%). There were significant differences between the 2 groups in determining the success of gastric tube placement,and the difference was statistically significant(χ2=39.36,P<0.01). Conclusions After the trachea cannula,the ordinary silica gel gastric tube was placed in the early stage(immediately),which improved the successful rate of gastric tube placement in the mechanical ventilation patients, Shortened the operation time,improved the work efficiency and alleviated the patient's pain.

BACKGROUND: Because of the specificity and complexity of hepatic portal, carcinoma of bile duct of the hepatic portal is a difficulty in the surgical treatment. OBJECTIVE: To evaluate the safety and feasibility of simultaneous pancreaticoduodenectomy and liver transplantation for the end-stage hilar cholangiocarcinoma. RESULTS AND CONCLUSION: Pathology demonstrated a middle or low differentiation of hilar cholangiocarcinoma, and left, right hepatic duct, together with lobus quadratus were invaded. The tumor metastasized to hilar and posterior pancreatic lymphonodes, without involving the head of pancreas, duodenum and stomach. The function of transplanted liver recovered smoothly, and the endocrine and exocrine functions of pancreas were kept well. CA19-9 dropped to the normal levels. The patient recovered and discharged at 1 month after surgery, and still survived after one year follow up. These suggest that simultaneous pancreaticoduodenectomy and liver transplantation as a treatment of hilar cholangiocarcinoma are safe and feasible.