Cyanobacteria are simple organisms which possess an endogenous circadian clock.Although the cyanobacterial clock has the same fundamental properties as circadian clocks in eukaryotes,its components are non-homologous to those of eukaryotes.The clock core of the cyanobacteria consists of the kai gene cluster and three Kai proteins KaiA,KaiB and KaiC,which the kai genes encode.The interactions among the Kai proteins modulate the phosphorylation state of KaiC,which generates circadian rhythm.The KaiC phosphorylation cycle constitutes the pacemaker of the cyanobacterial circadian rhythm.And signal transduction into and out of the clock core could occur via histidine protein kinase-based phosphorylation relays.

Objective To study and analyze technology of proxy server,VPN and specific remote access system.Methods The application of digital medical library was studied in such four aspects as adaptability,security,accessibility and extensibility.Result Many approaches were put forward to break the limits of IP address and realize remote access to digital resources.Conclusion In order to meet the actual requirements in the remote access of digital medical library,the following rules should be observed: the technical scheme with obvious functional limitations should be avoided;importance should be laid on mutual sharing and remote access between chief library and branch library;the maximum concurrent access should be born;multiple certification methods should be utilized as well as multiple techniques such as information distributing.

Objective To study the therapeutic effect of three dimensional valve prosthetic ring treatment of tricuspid incompetence at the same time in the replacement of mitral valve in patients with rheumatic mitral valve disease combined with tricuspid incompetence.Methods Eighteen patients with rheumatic mitral valve disease combined with tricuspid incompetence were given three dimensional valve prosthetic ring treatment of tricuspid incompetence at the same time in the replacement of mitral valve as treatment group.The same period 18 patients selected as control group,they were given De Vega purposes banding surgery at the same time in the replacement of mitral valve.The index of operation and echocardiogram after 2 weeks and 6 months were observed and compared.Results Two groups of patients were discharged.Right atrium transverse diameter,right ventricle transverse diameter and tricuspid regurgitation by ultrasonic examination after 2 weeks and 6 months were significantly improved,there were statistical differences (P ＜ 0.05),and the indexes in treatment group were significantly better than those in control group,there were statistical differences (P ＜ 0.05).Conclusion Three dimensional valve prosthetic ring in the treatment of tricuspid incompetence is safe and effective.

Objective To observe the bipolar radiofrequency ablation maze procedure (BRAMP) combined with heart valve replacement for rheumatic heart disease (RHD) complicated with atrial fibrillation (AF), and discuss the curative effect of the new operation method. Methods Fifteen patients with RHD complicated with AF were treated with heart valve replacement and BRAMP (treatment group). At the same time, 15 patients with RHD complicated with AF were only heart valve replacement without BR AMP(control group). Results Treatment group were all cured, and they had the sinoatrial rhythm after operation.Followed up 6 months, 14 patients maintained sinus rhythm,one had AF occasionally. In control group, 13 patients had AF after operation,2 patients had the sinoatrial rhythm after operation, but they tumed to AF one or two days later,and amiodarone hydrochloride had no effect to them. The two groups had obvious differences in the length of left atria, the length of left ventricle, the size of the heart, the function of the heart and LVEF before and after operation (P ＜ 0.01 or ＜ 0.05). But in treatment group, the length of left atria and the size of the heart had obvious difference after operation compared with control group [ (31.06 ± 2.28 ) mm vs. (36.16 ±2.23) mm,t = 11.645,P =0.002; (50 ±9)% vs. (56 ± 10)% ,t =8.052,P =0.008].Conclusion Compared with the operation that heart valve replacement without BRAMP,BRAMP is simple and little, should be promising.

Objective To explore the relationship between peritoneal lavage cytology in gastric carcinoma and lymph node metastasis.Methods From June 2012 to May 2014,intraoperative peritoneal lavage for cancer cells was carried out in 226 gastric cancer patients undergoing gastrectomy.During the process 63 patients were irrigated with 500 ml of normal saline,while the others were using 1 000 ml.D2+ lymph nodes dissection was performed to evaluate the relationship between peritoneal lavage cytology in gastric carcinoma and lymph nodes metastasis.Results The positive rates of exfoliative carcinoma cells were 11.1％ in the 500 ml group and 9.2％ in the 1 000 ml group (x2 =0.188,P=0.695).In both groups,rate of exforliative cancer cells were positively related to lymph node metastasis,the numbers of positive lymph nodes,the station of lymph nodes metastasis,the rate of the lymph nodes metastasis and that of the second station (all P ＜ 0.05),but not to the numbers of the lymph node cleaned (P ＞ 0.05).Conclusions Lymph nodes metastasis was an important risk factor that contribute to exfoliated carcinoma cells in patients with gastric carcinoma,and especially in those with lymph nodes metastasis at the second station.

Objective To study the characteristics and the related risk factors of coronary artery changes in the elderly patients of coronary heart disease complicated with diabetes mellitus. Methods According to WHO diagnostic standards of diabetes, coronary heart disease(CHD) complicated with diabetes mellitus(65 patients) was indicated as CHD+DM group, and the coronary heart disease without diabetes(68 patients) was indicated as CHD group. All patients were examined by coronary angiographic semiquantitative(CAG), and blood pressure, oral glucose tolerance test, level of blood sugar, insulin, lipid, BUN and Cr were measured. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis were evaluated by AHA standards. The related risk factors in coronary artery disease were analysed by pluralism straight line statistics. Results The coronary multivessel changes(75 4% vs 38 2%, P

Scaffolds provide a three-dimensional environment that is desirable for inducing and promoting the production of cartilaginous tissue.Ideally the scaffold should:① have directed and controlled degradation;② promote cell viability,differentiation,and extracellular matrix production;③ adhere and integrate with the surrounding native cartilage;④ span and assume the size of the defect;⑤ provide mechanical integrity depending on the defect location;⑥ have no toxicity,no immunogenicity or inflammatory induction;⑦ allow for the diffusion of nutrients and waste products.To date,a wide range of natural and synthetic materials have been investigated as a scaffold for cartilage repair.Based on the morphology and structure,these materials can be divided into hydrogel,sponge,fiber mesh and so on.Natural polymers that have been explored as bioactive scaffolds for cartilage engineering include:alginate,agarose,fibrin,hyaluronic acid,collagen,gelatin,chitosan,chondroitin sulfate,and cellulose.Synthetic polymers currently explored for cartilage repair include poly(?-hydroxy esters),polyethylene glycol,poly(NiPAAm),poly(propylene fumarates),and polyurethanes.

Stimulating factors have been employed to induce,accelerate,and/or enhance cartilage formation.For instance,stimulating factors and other additives may be added to culture media in vitro or incorporated into scaffolds for in vivo delivery to control cellular differentiation and tissue formation.At present,many growth factors and other dissoluble factors such as hyaluronic acid,chondroitin sulfate,and insulin have been used alone or synergistically in cartilage tissue engineering.The application efficacy depends on cell type and culture condition.In addition,gene therapy has emerged as another method of local delivery,where cells can be engineered to over-express bioactive molecules.An additional approach is the introduction of mechanical signals through loading regimes such as hydrostatic or dynamic compression or through the use of bioreactors.Current bioreactors used in cartilage tissue engineering include flat-sheet bioreactor,rotating wall vessel bioreactor and concentric cylinder bioreactor.Bioreactor can improve nutrition transmittability,provide hydrodynamic environment,induce shear stress,and promote production of cartilage specific matrix protein.

Objective: To observe the inlfuence of simvastatin combining ezetimibe on blood levels of glucose and lipids in patients of acute coronary syndrome (ACS) with impaired glucose tolerance (IGT).
Methods: A total of 316 patients with ACS and IGT were randomly divided into 2 groups: Treatment group, the patients received simvastatin 20 mg/day with ezetimibe 10 mg/day,n=160 and Control group, the patients received simvastatin 20 mg/day,n=156. All patients were treated for 24 months. Blood levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were observed at 6, 12 and 24 months of medication; fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) and the number of patients with new onset diabetes were examined at 6 days and 12, 24 months of medication.
Results:①In Treatment group, at 6 months of medication, blood levels of TC (mmol/L) and LDL-C (mmol/L) were (3.5 ± 0.5) and (2.1 ± 0.4) which were both lower than baseline levels (5.2±1.2) and (3.5±0.5),P<0.05; at 12 and 24 months, TC and LDL-C were (3.1 ± 1.0), (1.8 ± 0.6) and (3.0 ± 0.6), (1.8 ± 0.5), TC and LDL-C were consistently decreased, all P<0.05. In Control group, at 6 months of medication, TC and LDL-C were (4.0 ± 0.5) and (2.4 ± 0.5) which were both lower than baseline levels (5.3 ± 0.8) and (3.1 ± 0.4),P<0.05; at 12 and 24 months, TC and LDL-C were (3.8 ± 0.6), (2.3 ± 0.6) and (3.7 ± 0.5), (2.1 ± 0.7), allP<0.05. TC and LDL-C levels in Treatment group were lower than Control group at 6, 12 and 24 months of medication, allP<0.05.②In Treatment group, FBG (mmol/L) levels at 12 and 24 months were similar to 6 days,P>0.05; HbA1c at 12 and 24 months were similar to baseline,P>0.05; 2hPG (mmol/L) level at 24 months was higher than 6 days (9.5 ± 1.1) vs (8.7 ± 1.0),P<0.05; there were 26 patients with new onset diabetes at 24 months after medication. In Control group, 2hPG level at 24 months was higher than 6 days (9.6 ± 0.8) vs (8.7±0.7); there were 25 patients with new onset diabetes at 24 months after medication. The levels of FBG, 2hPG, HbA1c and the number of patients with new onset diabetes were similar between 2 groups, allP>0.05.
Conclusion: Ezetimibe combining simvastatin may better reduce blood lipids, while it had no real effect on blood glucose metabolism in patients with ACS and IGT.