Objective To evaluate the effects of fluid restriction in combination with small dose of norepinephrine on cerebral oxygen metabolism in elderly patients undergoing gastrointestinal surgery.Methods Forty elderly patients of both sexes,aged 65-80 yr,with body mass index of 18-24 kg/m2,of ASA physical status Ⅰ or Ⅱ (NYHA Ⅰ or Ⅱ),with left ventricular ejection fraction≥50％,undergoing elective gastrointestinal surgery,were randomly divided into 2 groups (n =20 each) using a random number table:routine fluid administration group (group S) and restricted fluid administration + small dose of norepinephrine group (group RN).In group S,lactated Ringer's solution was given routinely,ephedrine 5 mg (per time) was injected intravenously,and MAP was maintained ≥ 65 mmHg during operation.In group RN,lactated Ringer's solution was infused intravenously at 5 ml · kg-1 · h-1 starting from 30 min before anesthesia,norepinephrine was infused intravenously at 0.01-0.03 μg · kg-1 · min-1 after induction of anesthesia,and MAP was maintained ≥ 65 mmHg.Intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl starch 130/0.4 sodium chloride injection in both groups.At 5 min before skin incision,1 and 2 h after skin incision and postanesthesia care unit discharge time,arterial and jugular bulb venous blood samples were obtained for blood gas analysis,and arterial oxygen content,jugular bulb venous oxygen content,arteriovenous oxygen content difference,cerebral oxygen extraction rate,and the ratio of cerebral blood flow to cerebral oxygen metabolic rate were calculated.Results There were no significant differences between the two groups in arterial oxygen content,jugular bulb venous oxygen content,arteriovenous oxygen content difference,cerebral oxygen extraction rate,and the ratio of cerebral blood flow to cerebral oxygen metabolic rate.Conclusion Fluid restriction combined with small dose of norepinephrine produces no effects on cerebral oxygen metabolism in elderly patients undergoing gastrointestinal surgery.

Neisseria meningitidis is the agent of invasive meningococcal disease,including cerebral meningitis and septicemia.Because the diseases caused by different clonai groups (sequence types) have their own epidemiological characteristics,it is important to understand the differences among the genomes of the N.meningitidis clonal groups.To this end,a novel interpretation of a structural dot plot of genomes was devised and applied;exact nucleotide matches between the genomes of N.meningitidis serogroup A strain Z2491 and serogroup B strain MC58 were identified,leading to the specification of various structural regions.Known and putative virulence genes for each N.meningitidis strain were then classified into these regions.We found that virulence genes of MC58 tend more to the translocated regions (chromosomal segments in new sequence contexts) than do those of Z2491,notably tending towards the interface between one of the translocated regions and the collinear region.Within the collinear region,virulence genes tend to occur within 16 kb of gaps in the exact matches.Verification of these tendencies using genes clustered in the cps locus was sufficiently supportive to suggest that these tendencies can be used to focus the search for and understanding of virulence genes and mechanisms of pathogenicity in these two organisms.

Objective:To explore the application value of "Internet +" model in esophageal cancer patients in chemotherapy.Methods:A total of 90 patients with esophageal cancer treated in the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2019 were selected by convenient sampling method, and all received chemotherapy. They were divided into observation group ( n=45) and control group ( n=45) according to the random number table method. The control group adopts routine nursing management, and the observation group adopts the "Internet +" management model. Blood samples were taken before the nursing intervention and 6 months after the intervention to measure the nutritional indicators of the two groups, including serum prealbumin (PA) , albumin (ALB) , and transferrin (TRF) levels. The Connor-Davidson Psychological Resilience Scale was used to evaluate the psychological resilience of the two groups of patients. Results:The levels of serum PA, ALB, and TRF in the two groups after intervention were higher than those before intervention, and the observation group were higher than the control group, the differences were statistically significant ( P<0.05) . After intervention, the mental impact, acceptance changes, tolerance of negative emotions, ability, control scores, and total psychological elasticity scores of the two groups were higher than before the intervention, and the observation group were higher than the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Compared with traditional nursing management, the "Internet +" management model can further improve the nutritional level and mood of esophageal cancer patients in chemotherapy, and the overall application effect is good.