Isikhali esisha sokuxilongwa kwesifo sofuba kanye nokutholwa kwezidakamizwa: Isizukulwane esisha esiqondisiwe sokulandelana (TLLS) sihlanganiswe nokufunda komshini wokuxilongwa kwe-huberculesis hybersensitivity ukuxilongwa
Umbiko Wezincwadi: I-CCA: Imodeli yokuxilonga esekelwe ku-TLLS kanye nokufunda komshini, okulungele abantu abanesifo se-bacterial tuberculosis kanye ne-tubercoour meningitisis.
Isihloko se-Thesis: Ukulungiswa okulandelayo kwesizukulwane esilandelayo kanye nokufunda komshini: Isu lokuxilonga elibukhali elizwakalayo lama-turmonary ama-turmonary kanye nama-tubular meningitis.
Ngezikhathi ezithile: "Clinica Chimica Acta"
Uma: 6.5
Usuku lokushicilelwa: ngoJanuwari 2024
Kuhlangene ne-University of Chinese Academy of Science kanye neBeijing Chest Hospital of Capital Offication University, iMacro & Micro-Test yasungula imodeli yokuxilongwa kwesifo esisuselwa kusizukulwane esisha sobuchwepheshe obuhle bokulandelana okuhlosiwe (i-THLMS) nendlela yokufunda yomshini, enikezela nge-Ultra-high indlela Ukuzwa ukuzwela kwesifo sofuba ngamabhaktheriya ambalwa kanye ne-tubercoousy meningitis, kuhlinzekwe ngendlela entsha ye-hypersensitivity ake for carilical Ukuxilongwa kwezinhlobo ezimbili zesifo sofuba, futhi kwasiza ukuxilongwa okunembile, ukutholwa kwezidakamizwa kanye nokwelashwa kwesifo sofuba. Ngasikhathi sinye, kutholakala ukuthi i-Plasma CFMA yesiguli i-CFDNA ingasetshenziswa njengohlobo oluhle lwesampula lwesampula yezemitholampilo ekutholweni kwe-TBM.
Kulolu cwaningo, amasampula e-plasma angama-227 namasampula angu-perebrospisinal fluid asetshenziselwa ukusungula ama-cohorts amabili emtholampilo, lapho amasampula yokuxilongwa kweqembu lokuxilongwa kwelabhorethri asetshenziselwa ukufunwa kwesifo somshini sokuxilongwa kwesifo sofuba, kanti amasampula e-Clinical Diagnostic Cohort asetshenziselwa ukuqinisekisa ukusungulwa imodeli yokuxilonga. Onke amasampula abhalwa okokuqala ngechibi le-PresePhores eklanywe ngokukhethekile eliqondiswe ku-Mycobacterium Tuberculosis. Ngemuva kwalokho, kususelwa kudatha yokulandelana kwe-TB-TNGS, imodeli yesihlahla sesinqumo isetshenziselwa ukwenza ukuqinisekiswa kwesiphambano esingu-5 kuphela kumasu wokuxilonga kwalebhuku, kanye nemikhawulo yokuxilonga yamasampula e-plasma atholakala. I-Phreshold etholakele ilethwa ngamasethi amabili wokuhlola umugqa we-Clinical Ukuxilonga Umugqa wokutholwa, futhi ukusebenza kwe-Diagnostic komfundi kuhlolwa ijika le-roc. Ekugcineni, kutholwe imodeli yokuxilongwa kwesifo sofuba.
Fig. 1 umdwebo we-schematic wokuklama kocwaningo
Imiphumela: Ngokwemibundu ethile yesampula ye-CSF DNA (AUC = 0.974) nesampula ye-PLASMA CFDNA Ukuzwela nokucaciswa kwesampula ye-plasma kwakungu-82.61% no-86.36%. Ekuhlaziyeni kwamasampula abhangqiwe abhangqiwe we-plasma CFDNA kanye ne-cerebrospinal fluid DNA kusuka ku-TBM iziguli, isu lokuxilonga lalolu cwaningo linokuvumelana okuphezulu kwe-90.91% (kanye nokuzwela yi-95.45% (42/44). Ezinganeni ezinesifo sofuba pulmonary, isu lokuxilonga lalolu cwaningo lizwela kakhulu kumasampula we-plasma kunemiphumela yokutholwa kwe-xpert yamasampula wejusi esiswini esivela ezigulini ezifanayo (28.57% vs 15.38%).
I-Fig. 2 Ukuhlaziywa kokuhlaziya kwemodeli yokuxilongwa kwesifo sofuba amasampula wabantu
Fig. 3 Imiphumela yokuxilonga yamasampula abhangqiwe
Isiphetho: Indlela yokuxilonga ye-huberculostic yasungulwa kulolu cwaningo, olunganikeza ithuluzi lokuxilonga ngokuzwela okuphezulu kakhulu kweziguli zemitholampilo ezinesifo sofuba se-oligobacillary (amasiko amabi). Ukutholwa kwesifo sofuba we-hypersensitive asuselwa ku-plasma CFDNA kungaba uhlobo olufanele lwesampula lokuxilongwa kwesifo sofuba esisebenzayo kanye nesifo sofuba (amasampula we-plasma kulula ukuwuqoqa kunoketshezi lwesifo sofuba).
Isixhumanisi sangempela: https://www.scieirect.com/Science/Article/Pii/s0009898123004990? nge% 3dihub
Ukwethulwa okufushane kweMacro & Micro-Test Tuberculosis Secounction Protection Product
Ngenxa yesimo esiyinkimbinkimbi sesampula yeziguli zesifo sofuba nezidingo ezahlukahlukene, iMacro & Micro-Test zinikeza isethi ephelele yezixazululo ze-ngs zokukhishwa kwe-pualtum, ukwakhiwa kwe-Qualcomm. Imikhiqizo emboza ukutholakala okusheshayo kweziguli zesifo sofuba, ukutholwa kwezidakamizwa kwesifo sofuba, ukuthayipha kwesifo sofuba i-Mycobacterium kanye ne-NTM, Ukuxilongwa kwe-Hypersensitivity of bacterculosisis nabantu abahlukumezayo, njll.
Amakhithi wokutholwa kwe-serial for tuberculosis kanye ne-mycobacteriac:
| Into Cha | Igama lomkhiqizo | Okuqukethwe komkhiqizo | Uhlobo lwesampula | Imodeli esebenzayo |
| I-HWTS-3012 | I-ejenti yokukhishwa kwesampula | Kusetshenziswe ekwelashweni kwe-liquefaction kwamasampula we-sputum, uthola inombolo yerekhodi lokuqala, imishini ye-Sutong imishini 20230047. | sputum | |
| I-HWTS-NGS-P00021 | I-Qualcomm Mance Detection Kit ye-Hypersensitive Tuberculosis (Indlela yokuthwebula) | Okungahlangene (i-liquid biopsy) ukutholwa kwe-hypersensitivity ukutholwa kwama-puller-negative pulmonary tuberculosis kanye ne-brain nodules; Amasampula abantu abasolwa ukuthi angenwe yisifo sofuba noma isifo sofuba ama-socobacteria ahlaziywa ngokulandelana okujulile, kanye nesifo sofuba noma isifo esingewona isisulu se-mycobacterium angenwe yi-Mycobacterium Tuberculosis kwanikezwa. | Igazi elihlanzekile, i-alveolar lavage fluid, i-hydrothorax nama-ascites, ukugxila kwesampula ye-puncture, uketshezi lwe-cerebrossinal. | Isizukulwane Sesibili |
| I-HWTS-NGS-T001 | I-MyCobacterium typing kanye ne-Drug Resermance Detection Kit (Indlela Yokulandelana Kwama-Multiplex Amplification) | Ukuhlolwa kokuthayipha kwe-Mycobacterium, kufaka phakathi i-MTBC ne-187 NTM;Ukutholwa kokumelana nezidakamizwa kwe-Mycobacterium Tuberculosis kuhlanganisa izidakamizwa eziyi-13 kanye nezindawo eziyi-16 zokuguqulwa kwezindawo zofuzo. | I-Sputum, i-alveolar lavage fluid, i-hydrothorax nama-ascites, ukugxila kwesampula ye-puncture, uketshezi lwe-cerebrossinal. | Isiteji sesibili / sesithathu mbamba |
Amaphuzu avelele: I-HWTS-NGS-T001 MyCobacterium typing kanye nekhithi yokutholwa kwezidakamizwa (indlela ye-Multiplex Amplification)
Isingeniso Somkhiqizo
Umkhiqizo ususelwa ezingutsheni eziphambili ze-Main kanye nezesibili ezichazwe kwizinkombandlela zokwelashwa kwe-TB, ama-macrolides nama-aminoglycosides asetshenziswa imihlahlandlela yokwelashwa kwe-NTM, kanye namasayithi okumelana nemithi amboza lonke iqembu elilodwa lezindawo ezihlobene nezidakamizwa ku Ngubani i-Mycobacterium Tuberculosis Cologuss Cologuss Cologuss, kanye nezinye izinhlobo zokungamelana nemithi ezibikiwe kanye nezindawo zokuguqulwa ngokuya ngophenyo kanye nezibalo zokuthola amaphuzu aphezulu Ukutangami kwekhaya nakwamanye amazwe.
Ukuthayipha Ukuhlonza kususelwa kuzinkomba ze-NTM ezifingqiwe kwizinkombandlela ze-NTM ezishicilelwe yi-China Journal of Tuberculosis kanye nezifo zokuphefumula kanye nokuvumelana kochwepheshe. Ama-primers aklanyelwe okuthayipha akwazi ukukhulisa, ukulandelana futhi afake phakathi izinhlobo zezinhlobo ezingaphezu kuka-190 ze-NTM.
Ngokubheka ubuchwepheshe obuhlosiwe, izinhlobo zofuzo lwe-geneps kanye nohlobo lokungazweli emithini lwe-mycobacterium kwandiswa yi-Multiplex PCR, kanye nenhlanganisela ye-amplicon yezakhi zofuzo eziqondiwe okufanele itholakale. Imikhiqizo ekhulisiwe ingakhiwa esizukulwaneni sesizukulwane sesibili noma esizukulwaneni sesizukulwane sesithathu esiphakeme, futhi zonke izingxenyekazi zesibili nesizukulwane sesithathu kanye nezindawo zokulandelana kwezizukulwane zesithathu zingahlelwa ngokulandelana okujulile ukuze uthole imininingwane yokulandelana kwezinhlobo ezihlosiwe. Ngokuqhathanisa ukuguqulwa okwaziwayo okuqukethwe kwi-database yereferensi eyakhelwe ngaphakathi (kufaka phakathi ikhathalogi ye-Mycobacterium Tuberculoshos nobudlelwano bayo nokuguqulwa kwezidakamizwa okuhlobene nezidakamizwa noma ukuthambekela kwezidakamizwa zokulwa nesifuba. Kuhlangene nesixazululo sokwelashwa sesampula esizivulekele sokwelashwa kweMacro & Micro-Test, inkinga yokusebenza kahle kwe-nucleic acid acibication yamasampula emitholampilo (amahlandla ayishumi aphezulu kunalokho kwezindlela zendabuko) azotholwa ukutholwa kwezindlela zendabuko, ngakho-ke ukuthi ukutholwa kokulandelana kwezidakamizwa kungaba khona isetshenziswe ngqo kumasampula we-pulical sputum.
Ibanga lokutholwa komkhiqizo
34ukumelana nezidakamizwa ezihlobene nezidakamizwa ze18Izidakamizwa zokulwa nofuba kanye6Kutholwe izidakamizwa ze-NTM, zimboze297Izindawo Zokumelana Nemithi; Izinhlobo eziyishumi ze-mycobacterium tuberculosis nokunye ukwedlula190Izinhlobo ze-NTM zatholakala.
Ithebula 1: Imininingwane ye-18 + 6 izidakamizwa + ngo-190 + NTM
Inzuzo yomkhiqizo
Ukuqina kwemitholampilo okuqinile: Amasampula we-sputum angatholwa ngokuqondile nge-ejenti yokuzilibazisa ngaphandle kwamasiko.
Ukusebenza kwe-Experimental kulula: umzuliswano wokuqala wokusebenza we-Amplification ulula, futhi ukwakhiwa komtapo wezincwadi kuqediwe ngamahora ama-3, okuthuthukisa ukusebenza kahle komsebenzi.
Ukuthayipha okuphelele kanye nokumelana nezidakamizwa: ukumboza amasayithi wokuthayipha kanye nezidakamizwa ze-MTB ne-NTM, okungamaphuzu asemqoka ukukhathazeka kwemitholampilo, ukutholwa okunembile kokuphikiswa kwemithi, ukusekela imibiko yokuhlaziya ngokuchofoza okukodwa.
Ukuvumelana: Ukuhambisana komkhiqizo, ukuzivumelanisa nezifo ezihamba phambili ze-IIWM ne-MGI / OntT.
Ukucaciswa komkhiqizo
| Ikhodi Yomkhiqizo | Igama lomkhiqizo | Isiteji sokutholwa | ukucacisa |
| I-HWTS-NGS-T001 | I-MyCobacterium typing kanye ne-Drug Resermance Detection Kit (Indlela ye-Multiplex Amplification) | I-Ont, i-Illina, MGI, Salus Pro | I-16 / 96RXN |
Isikhathi Seposi: Jan-23-2024