Objective To investigate the effect of integrated traditional Chinese ( TCM ) and western medicine fast-track surgery ( FTS) in the perioperative management of laparoscopic cholecystectomy ( LC) .Methods One hundred and fifty patients with acute cholecysititis undergoing LC from June 2012 to January 2015, were recruited and divided randomly into 3 groups.Patients in group A (n=30) were treated with routine method in perioperative period, patients in group B ( n=60) were treated with western medicine FTS, and patients in group C (n=60) were treated with integrated TCM and western medicine FTS.The first exhaust time after operation, length of stay, times of clinic visit, symptoms, levels of IL-6, CRP and ALB, postoperative complications, readmission rate, reoperation rate, and patient satisfaction were evaluated in three groups.Results The first exhaust time after operation of group B and group C was earlier than that of group A [(25.16 ±8.36)h and (21.61 ±6.52)h vs.(36.06 ±10.88)h, P<0.05], and the first exhaust time of group C was earlier than that of group B (P<0.05).The length of stay of group B and group C were shorter than that of group A [(4.30 ±1.07)d and (3.98 ±1.16)d vs.(6.11 ±1.26)d, P<0.05].The nausea and vomiting, and abdominal distension of group C were lighter than those of group B [(0.27 ±0.08) vs.( 0.31 ±0.09); (0.35 ±0.09 ) vs.(0.40 ±0.13), respectively].There were no difference of the level of IL-6, CRP and ALB between group B and group C [(57.12 ±16.29) ng/L vs. (53.91 ±17.15) ng/L, (53.93 ±17.18) mg/L vs.(51.16 ±16.67) mg/L,(40.50 ±4.65) g/L vs. (41.01 ±4.60)g/L, respectively, all P<0.05].There was no difference among the three groups in the complication rate, readmission rate and reoperation rate(all P>0.05).Conclusion Integrated traditional Chinese and western medicine FTS in the perioperative period of LC can promote recovery, reduce symptoms and operation stress and maintain albumin level.

Objective To investigate the surgical operation incision infection risk factors and nursing countermeasure. Methods From 2010 January to 2014 January in our hospital, selected 120 cases hospitalized in department of general surgery, clinical data of patients were completed, the incision infection rate used χ2test for univariate analysis, and used nonconditional Logistic for multivariate regression analysis, and the corresponding nursing measures for the relevant factors. Results A total of 120 cases were selected, a total of 11 cases of incision occurred hospital infection, infection rate was 9.17%. Age, basic disease, operation time, incision type, length of hospital stay, length of incision, incision drainage and surgical incision infection closely related (P<0.05). Above the age of 60 years (OR=6.384), had basic dis-eases (OR=5.237), operation time ≥3 h (OR=4.726), incision type Ⅲ (OR=7.153) were the risk factors for surgical op-eration incision infection. Conclusion Age, basic disease, operation time, incision type, length of hospital stay, length of incision, incision and drainage is closely related with infection in surgical operation, including older than 60 years old, have basic diseases, operation time, incision type class Ⅲ≥3 h are the risk factors for surgical operation incision infection. Surgical operation incision infection directly affects the operation quality and patient's living standards, the nursing staff should clear the risk factors causing infection of incision, at the same time take care by effective inter-vention measures on the risk factors of infection of incision surgical operation, to reduce the incidence of operation in-cision infection, so as to promote the recovery of disease.

Objective To study the application value of traditional Chinese medical continuing nursing care in follow-up of patients with gastrointestinal carcinoma .Methods Sixty-four patients with advanced gastrointestinal carcinoma from September 2010 to January 2013 were randomly divided into the control group (n=31) and the experimental group (n =33).The control group received the routine follow-up, while the experimental group received routine follow-up plus traditional Chinese medical continuing nursing care including pressing the auricular point by magnetic beads , foot bath in the traditional Chinese medicine , massage at the plantar reflex zone and oral shiquandabu decoction .The quality of sleep , the intensity of pain , appetite and cancer-related fatigue ( CRF ) were evaluated before and four weeks after the follow-up in two groups. Results Before the follow-up, Pittsburgh sleep quality index (PSQI) was (10.39 ±3.84) in the control group, and (10.15 ±3.73) in the experimental group; the score of pain numerical rating scale was (2.26 ± 1.03) in the control group, and (2.21 ±1.05) in the experimental group;the cases of the mild, moderate and severe according to CRF score were respectively 8, 20, 3 cases in the control group , and respectively 10, 21, 2 cases in the experimental group , and the differences in the three indexes between two groups were not statistically significant (P>0.05).Four weeks after the follow-up, PSQI was (10.10 ±3.35) in the control group, and (8.48 ±2.50) in the experimental group, and the difference was statistically significant (t =2.170,P<0.05);the score of pain numerical rating scale was (2.19 ±0.83) in the control group, and (1.76 ±0.75) in the experimental group, and the difference was statistically significant (t =2.201,P <0.05);the cases of the mild, moderate and severe according to CRF score were respectively 11, 16, 4 cases in the control group , and respectively 20, 13, 0 cases in the experimental group , and the difference was statistically significant (Z =-2.330,P <0.05).Conclusions The traditional Chinese medical continuing nursing care can improve the symptoms in the follow-up of patients with advanced gastrointestinal carcinoma .

Objective To explore the effects of transitional care based on network cooperation in patients with gastrointestinal tumors surgery treated with nursing care according to fast track surgery (FTS). Methods A total of 120 patients with gastrointestinal tumors surgery were recruited as the study subjects from January 2012 to March 2015. They all received nursing care according to FTS in duration of hospital stay. They were divided into experimental group (transitional care based on network cooperation) and control group (traditionally transitional care by telephone of the general hospital + traditional community follow-up of the community hospital) in accordance with the random number table according to 1:1 proportions. The visit times,readmission rates,symptoms,anxiety,depression and satisfaction at the thirtieth day after surgery were compared between two groups.Results At the thirtieth day after surgery,the visit times of experimental group was less than that of control group with a significant difference (Z=-2.730,P=0.006). There was no significant difference in readmission rates between two groups (χ2=0.158,P=0.691). There was no significant differences in the incidence rates of pain,nausea and vomiting,the degree of abdominal distension between two groups (Z=-0.655,-0.356,-0.785;P=0.513,0.722,0.433). The scores of anxiety and depression of patients in experimental group were significantly lower than those in control group (t=-2.580,-2.380;P=0.011,0.019). The satisfaction with the general hospital and community hospital of experimental group was higher than those of control group with significant differences (Z=-2.133,-2.331;P=0.033,0.020).Conclusions The application of transitional care based on network cooperation after FTS on the stomach and intestine can nicely make patients to avoid unnecessary return visit in outpatient and emergency department,can meet the requirements of patients for social and mental support so as to make the general hospital and community hospital be recognised by patients.

Objective To study the value of cooperative training for general hospital and community hospital based on network in improving the cancer pain management ability of community health care workers. Methods From January 2015 to May 2016, 60 community health workers were recruited as research subjects and randomly divided into experimental group and control group. The experimental group received the general hospital-community hospital cooperative network training, the control group accepted the traditional training methods. After the training, 180 cancer patients who were in the charge of the relevant community from June 2015 to December 2016 were selected as the study subjects. Patients in the control group and experimental group were randomly assigned to cancer pain management for 6 months. After 6 months, the pain management knowledge of two group nursing staff was compared. The NRSscores of two groups of patients, the satisfaction of medical staff and the quality of life of the patients were compared. Results In the aspect of cancer pain knowledge, the score of experimental group was significantly higher than that of control group (P＜0. 05). In both groups, NRSscore of experimental group was significantly lower than that of control group (P＜0. 05). The Chinese version of QLT-C30 V3. 0 in both groups showed that the experimental group was better than the control group(P＜0. 05) except for three aspects: shortness of breath, diarrhea and economic difficulty (P＞0. 05). Conclusion Cooperative training based on Internet can better improve cancer care management in community health care.