Sabon Makami don Ganewar Cutar Tarin Fuka da Ganewar Juriya na Magunguna: Sabbin Ƙirar da Aka Nufi (tNGS) Haɗe tare da Koyon Injin don Ciwon Tuberculosis
Rahoton wallafe-wallafe: CCA: samfurin bincike bisa tNGS da koyon inji, wanda ya dace da mutanen da ke da ƙananan tarin fuka da tarin fuka.
Taken littafin: Tuberculous-niyya na gaba-ƙarni na gaba da koyo na inji: dabarun bincike mai zurfi don paucific pulmonary tubulars da tubular meningitis.
Na lokaci-lokaci: 《Clinica Chimica Acta》
Idan: 6.5
Ranar bugawa: Janairu 2024
Haɗe tare da Jami'ar Kwalejin Kimiyya ta kasar Sin da Asibitin Kirji na Jami'ar Kiwon Lafiya ta Beijing, Macro & Micro-Test sun kafa samfurin gano cutar tarin fuka bisa sabon ƙarni na fasahar jeri (tNGS) da fasahar koyon injin, wanda ya ba da ultra-high. gano ji na cutar tarin fuka tare da ƴan kwayoyin cuta da tarin fuka sankarau, samar da wani sabon hypersensitivity ga ganewar asali na asibiti ganewar asali na tarin fuka iri biyu, da kuma taimaka wajen ganewar asali, gano juriya magani da kuma maganin tarin fuka.A lokaci guda, an gano cewa ana iya amfani da plasma cfDNA na majiyyaci a matsayin nau'in samfurin da ya dace don samfurin asibiti a cikin ganewar asali na TBM.
A cikin wannan binciken, an yi amfani da samfuran plasma 227 da samfuran ruwa na cerebrospinal don kafa ƙungiyoyi biyu na asibiti, a cikin abin da aka yi amfani da samfuran gwajin gwajin gwaji don kafa tsarin koyon injin na gano cutar tarin fuka, kuma an yi amfani da samfuran gwajin gwajin asibiti don tabbatar da kafuwar da aka kafa. samfurin bincike.Dukkan samfuran an fara niyya ne ta hanyar wani wurin bincike na musamman da aka ƙera don tarin fuka na Mycobacterium.Bayan haka, dangane da bayanan jeri na TB-tNGS, ana amfani da ƙirar bishiyar yanke shawara don aiwatar da ƙimar giciye mai ninki 5 akan horo da ingantattun saiti na layin bincike na dakin gwaje-gwaje, kuma ana samun madaidaicin gwajin samfuran plasma da samfuran ruwa na cerebrospinal.An kawo ƙofa da aka samu cikin jeri biyu na gwaji na layin bincike na asibiti don ganowa, kuma ana kimanta aikin ɗan koyo ta hanyar lanƙwasa ROC.A ƙarshe, an samo samfurin ganewar cutar tarin fuka.
Hoto na 1 na tsari na ƙirar bincike
Sakamako: Dangane da ƙayyadaddun ƙayyadaddun ƙofofin samfurin DNA na CSF (AUC = 0.974) da samfurin cfDNA na plasma (AUC = 0.908) da aka ƙaddara a cikin wannan binciken, a cikin samfuran 227, ƙwarewar samfurin CSF shine 97.01%, ƙayyadaddun shine 95.65%, kuma Hankali da ƙayyadaddun samfurin plasma sun kasance 82.61% da 86.36%.A cikin nazarin samfuran 44 guda biyu na plasma cfDNA da DNA ruwa na cerebrospinal daga marasa lafiya TBM, dabarun bincike na wannan binciken yana da babban daidaito na 90.91% (40/44) a cikin cfDNA plasma plasma da DNA ruwa na cerebrospinal, kuma hankali shine 95.45% (42/44).A cikin yara masu fama da tarin fuka, dabarun bincike na wannan binciken ya fi dacewa da samfuran plasma fiye da sakamakon binciken Xpert na samfuran ruwan ciki daga marasa lafiya guda (28.57% VS 15.38%).
Hoto 2 Nazari na samfurin gano cutar tarin fuka don samfuran yawan jama'a
Hoto 3 Sakamakon bincike na samfurori guda biyu
Kammalawa: An kafa hanyar gano cutar tarin fuka a cikin wannan binciken, wanda zai iya samar da kayan aikin bincike tare da mafi girman ganewar ganewa ga marasa lafiya na asibiti tare da oligobacillary tuberculosis (al'ada mara kyau).Gano cutar tarin fuka ta hypersensitive dangane da plasma cfDNA na iya zama nau'in samfurin da ya dace don gano cutar tarin fuka mai aiki da cutar sankarau (samfuran plasma sun fi sauƙin tattarawa fiye da ruwan cerebrospinal ga marasa lafiya da ake zargi da cutar tarin fuka).
Hanya ta asali: https://www.sciencedirect.com/science/article/pii/s0009898123004990?ta%3Dihub
Taƙaitaccen gabatarwar samfuran gano jerin samfuran tarin tarin Macro & Micro-Test
Dangane da yanayin yanayi mai rikitarwa na masu fama da tarin fuka da bukatu daban-daban, Macro & Micro-Test yana ba da cikakkiyar saiti na mafita na NGS don hakar liquefaction daga samfuran sputum, ginin ɗakin karatu na Qualcomm da jeri, da kuma nazarin bayanai.Samfuran sun haɗa da saurin ganewar cutar tarin fuka, gano juriya na maganin tarin fuka, buga nau'in tarin fuka na mycobacterium da NTM, ganewar rashin lafiyar ƙwayoyin cuta-ƙananan tarin fuka da mutanen tarin fuka, da sauransu.
Na'urorin gano serial don tarin fuka da mycobacteria:
| Abu Na'a | sunan samfur | abun ciki gwajin samfur | nau'in samfurin | m model |
| HWTS-3012 | Samfurin saki wakili | An yi amfani da shi a cikin maganin liquefaction na samfuran sputum, ya sami lambar rikodin aji na farko, Sutong Machinery Equipment 20230047. | sputum | |
| HWTS-NGS-P00021 | Kit ɗin gano adadin Qualcomm don cutar tarin fuka (hanyar kama bincike) | Ƙunƙarar ƙwayar cuta mai haɗari (biopsy na ruwa) gano rashin hankali ga kwayoyin cutar tarin fuka mara kyau da nodules na kwakwalwa;An yi nazarin samfuran mutanen da ake zargi da kamuwa da cutar tarin fuka ko kuma mycobacteria marasa tarin fuka ta hanyar zurfafa bincike na metagenomics, da kuma bayanan gano ko cutar tarin fuka ko kuma mycobacteria marasa tarin fuka sun kamu da babban layin farko na juriya na magani na mycobacterium tarin fuka. aka bayar. | Jini na gefe, ruwan lavage na alveolar, hydrothorax da ascites, samfurin huda hankali, ruwan cerebrospinal. | ƙarni na biyu |
| HWTS-NGS-T001 | Buga Mycobacterium da kayan gano juriya na miyagun ƙwayoyi (hanyar ƙara ƙarawa da yawa) | Gwajin bugun Mycobacterium, gami da MTBC da 187 NTM;Gano juriyar ƙwayar ƙwayar cuta ta Mycobacterium tarin fuka ya ƙunshi magunguna 13 da mahimman wuraren maye gurbi guda 16 na kwayoyin juriyar ƙwayoyi. | Sputum, ruwan lavage alveolar, hydrothorax da ascites, samfurin huda hankali, ruwan cerebrospinal. | dandamali na ƙarni na biyu/na uku |
Mahimman bayanai: HWTS-NGS-T001 Mycobacterium typing da kayan gano juriya na miyagun ƙwayoyi (hanyar haɓakawa da yawa)
Gabatarwar samfur
Samfurin ya dogara ne akan manyan magungunan layi na farko da na biyu da aka bayyana a cikin jagororin jiyya na tarin fuka na WHO, macrolides da aminoglycosides da aka saba amfani da su a cikin jagororin jiyya na NTM, kuma wuraren juriya na miyagun ƙwayoyi sun rufe duk rukunin rukunin yanar gizo masu alaƙa da juriya a cikin WHO Mycobacterium tarin fuka hadaddun kundin maye gurbi, da kuma sauran rahotannin da aka bayar da rahoton kwayoyin juriya na miyagun ƙwayoyi da wuraren maye gurbi bisa ga bincike da kididdigar wallafe-wallafen da suka fi girma a gida da waje.
Ƙididdigar bugu ya dogara ne akan nau'ikan NTM da aka taƙaita a cikin jagororin NTM da aka buga ta Jaridar Tarin Fuka da Cututtukan Numfashi da kuma ijma'in masana.Ƙirƙirar firikwensin bugawa na iya haɓakawa, jeri da kuma bayyana nau'ikan NTM sama da 190.
Ta hanyar fasahar haɓakawa na Multix PCR da aka yi niyya, ƙwayoyin halittar ƙwayoyin cuta da ƙwayoyin ƙwayoyin cuta na Mycobacterium an haɓaka su ta hanyar Multix PCR, kuma an sami haɗin amplicon na ƙwayoyin da za a iya ganowa.Za a iya gina samfuran da aka haɓaka zuwa ƙarni na biyu ko na uku na manyan ɗakunan karatu na jerin abubuwan da suka dace, kuma duk dandamali na ƙarni na biyu da na uku za a iya aiwatar da babban tsari mai zurfi don samun bayanan jeri na kwayoyin halitta.Ta hanyar kwatanta da sanannun maye gurbi da ke ƙunshe a cikin bayanan bayanan da aka gina (ciki har da kundin tarihin maye gurbi na WHO Mycobacterium tarin fuka da alakarsa da juriya na miyagun ƙwayoyi), an ƙaddara maye gurbin da ke da alaƙa da juriya na miyagun ƙwayoyi ko kamuwa da magungunan anti-tuberculosis.A hade tare da kai-bude sputum samfurin magani bayani na Macro & Micro-Test, matsalar low nucleic acid amplification yadda ya dace na asibiti sputum samfurori (sau goma mafi girma fiye da na gargajiya hanyoyin) da aka warware, don haka da cewa magani juriya jerin za a iya gano. kai tsaye shafi samfuran sputum na asibiti.
Kewayon gano samfur
34kwayoyin juriya na kwayoyi na18magungunan rigakafin tarin fuka da6An gano magungunan NTM, suna rufewa297wuraren juriya na miyagun ƙwayoyi;Iri goma na tarin fuka na Mycobacterium da fiye da haka190an gano nau'ikan NTM.
Tebur 1: Bayanin Magunguna 18+6 +190+NTM
Amfanin samfur
Ƙarfi mai ƙarfi na asibiti: ana iya gano samfuran sputum kai tsaye tare da wakili mai shayarwa ba tare da al'ada ba.
Ayyukan gwaji yana da sauƙi: zagaye na farko na aikin haɓakawa yana da sauƙi, kuma an kammala ginin ɗakin karatu a cikin sa'o'i 3, wanda ya inganta aikin aiki.
Cikakkun bugu da juriya na miyagun ƙwayoyi: rufe wuraren bugawa da juriya na magunguna na MTB da NTM, waɗanda sune mahimman abubuwan damuwa na asibiti, ingantaccen bugu da gano juriya na ƙwayoyi, tallafawa software na bincike mai zaman kansa, da samar da rahotannin bincike tare da dannawa ɗaya.
Daidaituwa: dacewa da samfur, daidaitawa zuwa manyan dandamali na ILM da MGI/ONT.
Ƙayyadaddun samfur
| Lambar samfur | sunan samfur | Dandalin ganowa | ƙayyadaddun bayanai |
| HWTS-NGS-T001 | Buga Mycobacterium da kayan gano juriya na miyagun ƙwayoyi (hanyar haɓakawa da yawa) | ONT, Illumina, MGI, Salus pro | 16/96rxn |
Lokacin aikawa: Janairu-23-2024