Objective To discuss the impact of bundles of nutritional nursing interventions on nutritional status and quality of life of esophageal cancer patients who underwent concurrent radiotherapy and chemotherapy .Methods We selected eighty esophageal cancer patients admitted to our department for concurrent radio-chemotherapy during July 2012 to June 2014 .We divided them into experimental and control group according to random number table , and each of forty cases .After a course of treatment , hemoglobin (Hb), serum albumin (ALB), serum pre-albumin (PA), total lymphocyte count (TLC) and the score of QLQ-C3.0 were compared between two groups .Results When patients admitted hospital , there were no statistical differences in index of the patients between two groups (P>0.05).After one course of treatment,the data of Hb(110.0 ±6.1) g/L,ALB(30.8 ±5.4) g/L,PA(181.6 ±58.4) mg/L,TLC(2.8 ±0.4) ×109/L, score of whole healthy status ( 55.6 ±10 .2 ) in the experimental group which were higher than those in the control group (t=2.484 2,3.272 2,3.255 5,9.877 7,5.527 5,respectively;P<0.05).Conclusions Bundle of nutrition interventions can significantly improve the nutritional status and the quality of life of esophageal cancer patients who underwent concurrent radio-chemotherapy , and it is worthy to promote .

Objective: To report the clinical effect of skin grafting in small wounds with exposed vascular anastomosis. Methods: From January, 2011 to May, 2018, 16 small wounds with anastomotic vascular exposure were treated by full-thickness skin grafting. Of which, 4 performed after replantation, 9 after reconstruction and 3 after flap transplantation. Thirteen wounds were on hand and 3 in foot. After anastomosing the vessels, 3 arterial anastomoses, 9 venous anastomoses and 4 arterial-and-venous anastomoses were left exposure in wounds. Sizes of artery exposed in wound were 0.8 to 2.3 mm with an average of 1.0 mm. Sizes of vein exposed in wound were 0.8 to 2.5 mm with an average of 1.2 mm. The areas of soft tissue defect were 1.0 cm×1.5 cm to 2.6 cm×6.0 cm, and the areas of grafted skins were 1.0 cm×1.5 cm to 2.6 cm×6.0 cm. Grafted skin were covered without package nor pressurization. Donor areas were directly sutured. Postoperative follow-up was conducted to observe the postoperative effect. Results: Fourteen grafted skin completely survived, one partially survived and healed after immobilization of the limb and change of dressing, and one developed necrosis. All patients were followed-up for 6-24 months (mean 14.4 months). CDU, HHD or CTA were used at the final follow-up. Vascular anastomoses were patency in 15 patients, and 1 patient had embolism developed. No pigmentation was found on the grafted skin. All grafted skin was soft and wearable with two point discrimination at 7-10 mm. The pulse of anastomotic artery could be felt on the grafted skins. Only linear scars were left in the donor sites. Conclusion The operation of full-thickness skin grafting in small wounds with exposed vascular anastomosis was easy to perform and with high survival rate. The effect of operation is satisfactory. The exposure of anastomosed vessels does not affect the patency of anastomotic vessels, and has considerable clinical values.