Correlation study of sleep efficiency with C-reactive protein and IL-6 in patients with infective endocarditis

Background Sleep disorders have been found in patients with infective endocarditis(IE)and are reported to have a strong correlation with inflammation. In this study,we measured the serum levels of inflammatory factors and evaluated the correlations of postoperative sleep efficiency with C-reactive protein and interleukin-6(IL-6)in IE patients. Methods A total of 117 post-operative patients with IE were enrolled in the study. All patients were tested using a wearable actigraphy device for their sleep efficiency. All patients were examined for C-reactive protein,and 72 patients were tested for IL-6. Results A correlation analysis was performed between C-reactive protein and IL-6. The average sleep efficiency of most of the IE patients was 80.81±8.52%,and the average result of the C-reactive protein test was 29.98±26.3 mg/L. The correlation coefficient between sleep efficiency and C-reactive protein was-0.3011. The average result of the IL-6 test was 24.52±23.85 pg/mL,and the correlation coefficient between sleep efficiency and IL-6 was-0.3543. Conclusions Postoperative sleep efficiency is negatively correlated with serum levels of C-reactiveprotein and IL-6 in patients with IE.[S Chin J Cardiol2019;20(2):103-107]     

小鼠巨噬细胞cDNA酵母表达文库的构建与鉴定

Objective To construct and identify the cDNA library suitable for yeast expression of mouse macrophage by Gateway technique. Methods The mRNA extracted from mouse macrophage was purified. Moreover, cDNA were synthesized by biotin-conjugated Oligo (dT) primer. The double-strand cDNA was bound to attB Adapter and then purified by the cDNA size fractionation columns. BP recombination reaction between the attB- flanked cDNAs ( ＞500 bp) and attP- containing donor vector pDONRTM222 was performed, and the products were transformed into ElectroMAXTM DH10BTMT1 Phage Resistant Cells to generate a Gateway entry cDNA library. Colonies were randomly selected from the plating assay plates. Plasmid DNA was isolated and the cDNA library qualified by plasmid digestion. A reading frame cassette to pGADT7 vector was ligated to construct a Gateway destination vector. The cDNA entry library was transformed into yeast expression library after LR recombination reaction with destination vector and the Gateway entry cDNA library. Results An entry cDNA library was constructed with a titer of (6.80±0.10)× 105 cfu/ml, total clones of 7.48×106 cfu, an average insertion size of about (2.20±0.20) kb and the percentage of recombinant clones was 100%. A yeast expression library was constructed with a titer of (3.24±0.10)× 106 cfu/ml, total clones of 3.89×107 cfu, a mean insertion size about (2.27±0.15) kb and the percentage of recombinant clones was 95.83% (23/24). Conclusion The entry cDNA library and the yeast expression cDNA library meet the requirements of standard library, thereby can be used in further study.     

感染性心内膜炎患者的血培养病原菌分布及耐药性分析

目的 分析感染性心内膜炎患者的血培养病原菌构成及药敏结果，为患者的临床用药提供参考依据。方法 选取我科(广东省人民医院二区)2015年1月-2018年12月473例住院治疗的感染性心内膜炎患者作为对象，对其血培养结果进行病原菌分布和耐药性分析。结果 473例感染性心内膜炎患者血培养阳性97例，阳性率20.8%。共分离出病原菌102株，其中革兰阳性菌92株占90.20%，革兰阴性菌4株占3.92%，真菌6株占5.88%。链球菌属对青霉素、头孢曲松敏感率分别81.43%、87.30%，左氧氟沙星敏感率为79.37%，对克林霉素、红霉素、四环素耐药率较高，对氯霉素耐药率低。葡萄球菌对青霉素的耐药率为100%、对苯唑西林耐药率50%，克林霉素、红霉素次之，对左氧氟沙星、庆大霉素和利福平的耐药率较低，均<10.00%。耐甲氧西林葡萄球菌检出率较高，耐甲氧西林金黄色葡萄球菌(MRSA)4株占66.7%，耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)4株占50%，肠球菌属对青霉素、庆大霉素耐药率均为16.67%，对喹诺酮类敏感，对红霉素、四环素耐药率较高。均未见对万古霉素、替考拉宁、利奈唑胺耐药菌株。真菌均对5-氟胞嘧啶、氟康唑、伊曲康唑、伏立康唑、两性霉素B均敏感。结论 链球菌和葡萄球菌是感染性心内膜炎的主要致病菌。结合药敏分析结果，在经验性治疗感染性心内膜炎时，选用青霉素联合氨基糖苷类药物治疗存在较大风险，尤其对于急性重症感染合并耐药菌感染高危因素的患者，万古霉素是理想的选择。     

小鼠巨噬细胞cDNA酵母表达文库的构建与鉴定

目的 采用Gateway技术构建适合酵母表达的小鼠巨噬细胞cDNA文库并进行鉴定.方法 将小鼠巨噬细胞的mRNA分离纯化后,以生物素标记的寡聚胸苷酸Oligo(dT)为引物反转录后连接attB衔接子(attB Adapter),层析柱纯化,通过BP重组反应将500 bp以上的片段克隆到含attP衔接子的pDONRTM222载体,电转化入ElectroMAXTM DH10BTMT1 Phage Resistant Cells,构建Gateway入门cDNA文库,并完全随机挑取单菌落,提取质粒酶切鉴定重组子插入片段大小.构建Gateway目的 载体,通过LR重组反应将入门文库转入此目的 载体成为酵母表达文库,挑取单克隆鉴定重组子插入片段大小.结果 经鉴定,入门文库平均滴度为(6.80±0.10)×105 cfu/ml,文库总容量为7.48×106 cfu,平均插入片段为(2.20±0.20)kb,重组率为100%.酵母表达文库平均滴度为(3.24±0.10)×106 cfu/ml,文库总容量为3.89×107 cfu,平均插入的片段为(2.27±0.15)kb,重组率为95.83%(23/24).结论 构建的小鼠巨噬细胞cDNA入门文库和酵母表达文库都符合高质量文库的要求,可用于进一步的研究.     

146例感染性心内膜炎临床特征及预后影响因素分析

目的 总结感染性心内膜炎(IE)患者的临床特点、治疗及预后,为提高IE患者预后提供参考.方法 对广东省人民医院综合二区2016年11月至2017年12月收治的146例IE患者的临床资料(基本情况、血常规、肝肾功能、血培养、心电图、超声心动图、治疗与手术情况及预后)进行回顾性分析,对基础病因、血培养、超声心动图及临床转归情况、预后影响因素进行单因素及多因素logistic回归分析.结果 146例患者平均年龄(44.4±14.5)岁.有基础心脏疾病者122例(83.56％),依次为非风湿性心脏病62例(42.47％)、先天性心脏病41例(28.08％)、风湿性心脏病10例(6.85％)、人工瓣膜植入8例(5.48％)及起搏器植入1例(0.68％).临床表现主要为心脏杂音、发热及贫血,术前反复发热99例(67.81％)、贫血115例(78.77％).并发症依次为心力衰竭128例(87.67％)、心律失常42例(28.77％)和栓塞37例(25.34％).术前144例患者进行血培养,阳性64例(43.84％),最常见的致病菌为链球菌49例(76.56％).136例(93.15％)患者超声心动图有阳性发现,118例术中所见与超声心动图相符.患者死亡6例(3.75％),复发3例(2.05％).logistic回归分析显示是否采取手术治疗、血清清蛋白水平是IE患者预后的独立影响因素(P<0.05).结论 IE多发生于有基础心脏疾病患者,链球菌为最常见的致病菌,IE血培养阳性率低,超声心动图是IE的重要诊断手段,血清清蛋白水平、是否采取手术治疗是患者预后的影响因素.