specificity

特异性
  • 文章类型: Journal Article
    布鲁氏菌病代表了全球主要的公共卫生问题。人类传播主要是由于受感染动物食用未经巴氏杀菌的牛奶和乳制品。反刍动物布鲁氏菌属诊断的金标准是细菌分离,但这很耗时。聚合酶链反应(PCR)是一种比细菌培养更快,更敏感的技术。液滴数字PCR(ddPCR)是一种新型的分子测定,在DNA含量低且对扩增抑制剂的敏感性较低的样品中显示出高灵敏度。本研究旨在开发一种用于检测水牛组织样品中流产布鲁氏菌的ddPCR方法。通过实时qPCR使用布鲁氏菌属的能力测试样品验证了该方案。此外,检查了599个组织样品。在参考资料中,qPCR和ddPCR表现出相同的性能并且能够检测到高达225CFU/mL。在现场样本中,ddPCR显示更高的灵敏度(100%),特异性和准确性分别为93.4%和94.15%,分别。ddPCR可以被认为是一种有前途的技术,用于检测兽医标本中的流产芽孢杆菌,通常以细菌数量少为特征,基质和物种多样性高,储存条件差。
    Brucellosis represents a major public health concern worldwide. Human transmission is mainly due to the consumption of unpasteurized milk and dairy products of infected animals. The gold standard for the diagnosis of Brucella spp in ruminants is the bacterial isolation, but it is time-consuming. Polymerase Chain Reaction (PCR) is a quicker and more sensitive technique than bacterial culture. Droplet digital PCR (ddPCR) is a novel molecular assay showing high sensitivity in samples with low amount of DNA and lower susceptibility to amplification inhibitors. Present study aimed to develop a ddPCR protocol for the detection of Brucella abortus in buffalo tissue samples. The protocol was validated using proficiency test samples for Brucella spp by real time qPCR. Furthermore, 599 tissue samples were examined. Among reference materials, qPCR and ddPCR demonstrated same performance and were able to detect up to 225 CFU/mL. Among field samples, ddPCR showed higher sensitivity (100%), specificity and accuracy of 93.4% and 94.15%, respectively. ddPCR could be considered a promising technique to detect B. abortus in veterinary specimens, frequently characterized by low amount of bacteria, high diversity in matrices and species and poor storage conditions.
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  • 文章类型: Journal Article
    特定的立体异构体是最重要的,因为它对于优化药物功效和安全性至关重要。对活性药物成分或关键中间体的所需立体异构体的分离的追求推动了药物合成和生物催化方法的创新。手性氨基磷酸酯是合成抗病毒药物如瑞司韦和索非布韦的重要组成部分。鉴于药物的(Sp)-非对映异构体的临床效力,需要能够完全水解(Rp)-非对映异构体的酶以通过生物催化反应获得纯化的非对映异构体。在这项研究中,磷酸二酯酶(PTE)的蛋白质工程旨在提高特异性。采用合理的设计和定点突变,我们产生了一个包含24个变异体的小文库用于活性筛选.值得注意的是,W131M和I106A/W131M变体证明了在非常短的水解时间(<20分钟)内成功制备了瑞德西韦和索非布韦前体的纯(Sp)-非对映异构体。我们的工作揭示了一种生产纯立体异构化合物的有前途的方法,利用新型生物催化剂使氨基磷酸酯核苷前药的化学酶合成成为可能。
    Specific stereoisomer is paramount as it is vital for optimizing drug efficacy and safety. The quest for the isolation of desired stereoisomer of active pharmaceutical ingredients or key intermediates drives innovation in drug synthetic and biocatalytic methods. Chiral phosphoramidate is an important building block for the synthesis of antiviral drugs such as remdesivir and sofosbuvir. Given the clinical potency of the (Sp)-diastereomer of the drugs, an enzyme capable of completely hydrolyzing the (Rp)-diastereomer is needed to achieve the purified diastereomers via biocatalytic reaction. In this study, protein engineering of phosphotriesterase (PTE) was aimed to improve the specificity. Employing rational design and site-directed mutagenesis, we generated a small library comprising 24 variants for activity screening. Notably, W131M and I106A/W131M variants demonstrated successful preparation of pure (Sp)-diastereomer of remdesivir and sofosbuvir precursors within a remarkably short hydrolysis time (<20 min). Our work unveils a promising methodology for producing pure stereoisomeric compounds, utilizing novel biocatalysts to enable the chemoenzymatic synthesis of phosphoramidate nucleoside prodrugs.
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  • 文章类型: Journal Article
    背景:受体酪氨酸激酶样孤儿受体1(ROR1)的过表达有助于癌细胞增殖,生存和迁移,在肿瘤的发展中起着至关重要的作用。ROR1已被提出作为癌症治疗的潜在治疗靶标。本研究旨在开发新型人源化ROR1单克隆抗体并研究其抗肿瘤作用。
    方法:用免疫组织化学和流式细胞术分析肿瘤组织和细胞系中ROR1的表达。通过互补决定区(CDR)移植技术将来自小鼠杂交瘤的抗体人源化。表面等离子体共振光谱,采用ELISA测定和流式细胞术表征人源化抗体。进行了体外细胞测定和体内小鼠实验以全面评估这些抗体的抗肿瘤活性。
    结果:ROR1在肺腺癌中表达明显增高,肝癌和乳腺癌,短发夹RNA靶向ROR1显著抑制癌细胞的增殖和迁移。成功研制出两种人源化ROR1单克隆抗体,定名为h1B8和h6D4,对ROR1卵白具有较高的特异性和亲和力。此外,这两种抗体在肺癌异种移植小鼠模型中有效抑制肿瘤生长,c-Myc/Alb-cre肝癌转基因小鼠模型和MMTV-PyMT乳腺癌小鼠模型。
    结论:成功开发了两种靶向ROR1h1B8和h6D4的人源化单克隆抗体,并在体内表现出显著的抗肿瘤活性。
    BACKGROUND: Overexpression of receptor tyrosine kinase-like orphan receptor 1 (ROR1) contributes to cancer cell proliferation, survival and migration, playing crucial roles in tumor development. ROR1 has been proposed as a potential therapeutic target for cancer treatment. This study aimed to develop novel humanized ROR1 monoclonal antibodies and investigate their anti-tumor effects.
    METHODS: ROR1 expression in tumor tissues and cell lines was analyzed by immunohistochemistry and flow cytometry. Antibodies from mouse hybridomas were humanized by the complementarity-determining region (CDR) grafting technique. Surface plasmon resonance spectroscopy, ELISA assay and flow cytometry were employed to characterize humanized antibodies. In vitro cellular assay and in vivo mouse experiment were conducted to comprehensively evaluate anti-tumor activity of these antibodies.
    RESULTS: ROR1 exhibited dramatically higher expression in lung adenocarcinoma, liver cancer and breast cancer, and targeting ROR1 by short-hairpin RNAs significantly inhibited proliferation and migration of cancer cells. Two humanized ROR1 monoclonal antibodies were successfully developed, named h1B8 and h6D4, with high specificity and affinity to ROR1 protein. Moreover, these two antibodies effectively suppressed tumor growth in the lung cancer xenograft mouse model, c-Myc/Alb-cre liver cancer transgenic mouse model and MMTV-PyMT breast cancer mouse model.
    CONCLUSIONS: Two humanized monoclonal antibodies targeting ROR1, h1B8 and h6D4, were successfully developed and exhibited remarkable anti-tumor activity in vivo.
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  • 文章类型: Journal Article
    癌症仍然是全球健康挑战,需要不断改进诊断和治疗策略。本文综述了非侵入性生物标志物在癌症诊断和治疗中的应用。它们在早期检测中的作用,疾病监测,和个性化的治疗干预措施。通过对文献的系统回顾,我们确定了45项相关研究,突出了这些生物标志物在各种癌症类型中的潜力,如乳房,前列腺,肺,和大肠癌。讨论的非侵入性生物标志物包括液体活检,表观遗传标记,非编码RNA,外泌体货物,和代谢物。值得注意的是,液体活检,特别是那些基于循环肿瘤DNA(ctDNA)的,已经成为早期最有前途的方法,非侵入性癌症检测,因为它们能够从易于获取的血液样本中提供全面的遗传和表观遗传信息。这篇综述展示了非侵入性生物标志物如何促进早期癌症检测,准确的子分型,和量身定制的治疗策略,从而改善患者的预后。它强调了非侵入性生物标志物在肿瘤学中的转化潜力,强调它们在加强早期检测方面的应用,存活率,和癌症护理中的治疗精度。
    https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD4202347474749PROSPERO,标识符CRD42023474749。
    Cancer remains a global health challenge, necessitating continuous advancements in diagnostic and treatment strategies. This review focuses on the utility of non-invasive biomarkers in cancer diagnosis and treatment, their role in early detection, disease monitoring, and personalized therapeutic interventions. Through a systematic review of the literature, we identified 45 relevant studies that highlight the potential of these biomarkers across various cancer types, such as breast, prostate, lung, and colorectal cancers. The non-invasive biomarkers discussed include liquid biopsies, epigenetic markers, non-coding RNAs, exosomal cargo, and metabolites. Notably, liquid biopsies, particularly those based on circulating tumour DNA (ctDNA), have emerged as the most promising method for early, non-invasive cancer detection due to their ability to provide comprehensive genetic and epigenetic information from easily accessible blood samples. This review demonstrates how non-invasive biomarkers can facilitate early cancer detection, accurate subtyping, and tailored treatment strategies, thereby improving patient outcomes. It underscores the transformative potential of non-invasive biomarkers in oncology, highlighting their application for enhancing early detection, survival rates, and treatment precision in cancer care.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023474749 PROSPERO, identifier CRD42023474749.
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  • 文章类型: Journal Article
    背景:由于氧氟沙星(OFL)滥用的严重问题,对OFL的准确、快速检测的需求日益迫切。免疫测定已成为在复杂基质中检测OFL的“黄金方法”,有利于其适用于大规模筛查,快速性,和简单。然而,免疫测定中使用的传统抗体面临挑战,如耗时的制备,不稳定的灵敏度和特异性,和方向性进化的困难。在本文中,为了解决这些问题,我们成功开发了一种基于鲨鱼源单域抗体(ssdAb)的OFL检测方法.
    结果:使用噬菌体展示技术和异源表达系统,OFL特异性克隆1O11、1O13、1O17、1O19、1O21和2O26被成功地分离并以可溶性形式表达。在所有OFL特定的ssdAb中,1O17ssdAb以浓度依赖性方式表现出对OFL的最高结合亲和力。1O17ssdAb的检测限(IC10)计算为0.34ng/mL,检测范围为3.40-1315.00ng/mL,其与其他类似物的交叉反应性经计算小于5.98%,表明高特异性和敏感性。分子对接结果表明,位于1O17ssdAbCDR3区域的100Trp和101Arg对于OFL结合至关重要。在鱼类基质性能测试中,1O17ssdAb在OFL阴性鱼类基质中没有表现出严重的基质干扰,达到令人满意的回收率范围从83.04%到108.82%,重现性高。
    结论:这项研究提供了一种新型高效的OFL检测识别元件,在免疫测定应用中具有显着的潜力,拓宽ssdAbs的应用场景。它为ssdAb和小分子之间的结构-活性关系提供了有价值的见解,为ssdAb在后续应用中的进一步定向修饰和成熟奠定理论基础。
    BACKGROUND: Due to the serious issue of ofloxacin (OFL) abuse, there is an increasingly urgent need for accurate and rapid detection of OFL. Immunoassay has become the \"golden method\" for detecting OFL in complex matrix beneficial to its applicability for a large-scale screening, rapidity, and simplicity. However, traditional antibodies used in immunoassay present challenges such as time-consuming preparation, unstable sensitivity and specificity, and difficulty in directional evolution. In this paper, we successfully developed an OFL detection method based on a shark-derived single-domain antibody (ssdAb) to address these issues.
    RESULTS: Using phage display technology and a heterologous expression system, OFL-specific clones 1O11, 1O13, 1O17, 1O19, 1O21, and 2O26 were successfully isolated and expressed in soluble form. Among all OFL-specific ssdAbs, the 1O17 ssdAb exhibited the highest binding affinity to OFL in a concentration-dependence manner. The limit of detection (IC10) of 1O17 ssdAb was calculated as 0.34 ng/mL with a detection range of 3.40-1315.00 ng/mL, and its cross reactivity with other analogs was calculated to be less than 5.98 %, indicating high specificity and sensitivity. Molecular docking results revealed that 100Trp and 101Arg located in the CDR3 region of 1O17 ssdAb were crucial for OFL binding. In fish matrix performance tests, the 1O17 ssdAb did not demonstrate severe matrix interference in OFL-negative fish matrix, achieving satisfactory recovery rates ranging from 83.04 % to 108.82 % with high reproducibility.
    CONCLUSIONS: This research provides a new and efficient OFL detection recognition element with significant potential in immunoassay applications, broadening the application scenarios of ssdAbs. It offers valuable insights into the structure-activity relationship between ssdAbs and small molecules, laying a theoretical foundation for the further directional modification and maturation of ssdAbs in subsequent applications.
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  • 文章类型: Journal Article
    人α1,4-半乳糖基转移酶(A4galt),居住在高尔基体上的GT,在糖蛋白(GP)上合成Gb3鞘糖脂(GSL)和P1糖位,它们是志贺毒素1型和2型的受体。尽管A4galt在糖基化过程中具有重要作用,其不同受体特异性的分子机制仍然知之甚少。这里,我们试图通过探索其与具有各种受体特异性的GTs的相互作用来阐明A4galt对GSL和GP的特异性,GP特异性β1,4-半乳糖基转移酶1(B4galt1)和GSL特异性β1,4-半乳糖基转移酶同工酶5和6(B4galt5和B4galt6)。使用一种新的NanoBiT分析,我们发现A4galt可以在两个细胞系中与B4galt1和B4galt5形成同二聚体和异二聚体,人胚肾细胞(HEK293T)和中国仓鼠卵巢细胞(CHO-Lec2)。我们发现A4galt-B4galts异二聚体优选N末端标记的相互作用,而在A4galt同源二聚体中,融合标签的有利定位取决于所用的细胞系。此外,通过使用AlphaFold进行最先进的结构预测,我们分析了这些酶复合物的相互作用和结构。我们的分析强调,A4galt-B4galt5异二聚体表现出最高的预测置信度,表明A4galt异源二聚化在确定对GSL和GP的酶特异性方面具有重要作用。这些发现增强了我们对A4galt受体特异性的了解,并可能有助于更好地理解志贺毒素相关疾病的病理机制。
    Human α1,4-galactosyltransferase (A4galt), a Golgi apparatus-resident GT, synthesizes Gb3 glycosphingolipid (GSL) and P1 glycotope on glycoproteins (GPs), which are receptors for Shiga toxin types 1 and 2. Despite the significant role of A4galt in glycosylation processes, the molecular mechanisms underlying its varied acceptor specificities remain poorly understood. Here, we attempted to elucidate A4galt specificity towards GSLs and GPs by exploring its interaction with GTs with various acceptor specificities, GP-specific β1,4-galactosyltransferase 1 (B4galt1) and GSL-specific β1,4-galactosyltransferase isoenzymes 5 and 6 (B4galt5 and B4galt6). Using a novel NanoBiT assay, we found that A4galt can form homodimers and heterodimers with B4galt1 and B4galt5 in two cell lines, human embryonic kidney cells (HEK293T) and Chinese hamster ovary cells (CHO-Lec2). We found that A4galt-B4galts heterodimers preferred N-terminally tagged interactions, while in A4galt homodimers, the favored localization of the fused tag depended on the cell line used. Furthermore, by employing AlphaFold for state-of-the-art structural prediction, we analyzed the interactions and structures of these enzyme complexes. Our analysis highlighted that the A4galt-B4galt5 heterodimer exhibited the highest prediction confidence, indicating a significant role of A4galt heterodimerization in determining enzyme specificity toward GSLs and GPs. These findings enhance our knowledge of A4galt acceptor specificity and may contribute to a better comprehension of pathomechanisms of the Shiga toxin-related diseases.
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  • 文章类型: Journal Article
    与具有其他典型发育的儿童相比,具有智力和发育障碍的青年通常有更高的抽动率和陈规定型观念。由于重叠的临床特征,区分这两种儿科运动障碍可能具有挑战性。但由于不同的治疗方式而相关。目前的研究评估了抽动筛查措施的敏感性和特异性,儿童样本中的运动型或声乐抽动量表(MOVEIT),富含刻板印象和抽动。在发育行为儿科诊所接受护理的儿童(n=199,年龄2-15岁)接受了tic专家的黄金标准诊断评估;这些评估与MOVeIT进行了比较。与tic专家相比,MOVeIT在检测整个样品中的tic表现出良好的灵敏度(89.8%)和相对较低的特异性(57.1%)。当排除具有共同发生的刻板印象的儿童时,MOVeIT识别抽动的特异性提高到75%。对于有抽搐和共存刻板印象的孩子,敏感性仍然较高(91.9%),但特异性较低(39.1%).与tic专家金标准相比,在MOVeIT上检测tic的曲线下面积(AUC)值对于没有刻板印象的儿童(AUC=85.7%)明显高于有刻板印象的儿童(AUC=64.3%,p<0.01)。总的来说,在没有共同发生的刻板印象症状的人群中,抽动的检测能力更好。需要进一步的工作来确定MOVeIT在很有可能同时发生抽动和刻板印象的人群以及一般人群环境中的实用性。准确区分抽搐和刻板印象将指导家庭的干预选择和预期指导。
    Youth with intellectual and developmental disabilities typically have higher rates of tics and stereotypies compared to children with otherwise typical development. Differentiating between these two pediatric movement disorders can be challenging due to overlapping clinical features, but is relevant due to distinct treatment modalities. The current study evaluated sensitivity and specificity of a tic screening measure, the Motor or Vocal Inventory of Tics (MOVeIT) in a pediatric sample enriched for stereotypy and tics. Children (n=199, age 2-15 years old) receiving care in a developmental-behavioral pediatrics clinic underwent a gold-standard diagnostic assessment by a tic expert; these evaluations were compared to the MOVeIT. The MOVeIT demonstrated good sensitivity (89.8%) and relatively lower specificity (57.1%) compared to tic expert for detecting tics in the overall sample. Specificity of the MOVeIT to identify tics improved to 75% when excluding children with co-occurring stereotypy. For children with tics and co-occurring stereotypy, sensitivity remained high (91.9%) but specificity was low (39.1%). The area under the curve (AUC) value to detect tics on the MOVeIT compared to the tic expert gold standard was significantly higher for children without stereotypy (AUC=85.7%) than those with stereotypy (AUC=64.3%, p <0.01). Overall, the ability to detect tics was better in those without co-occurring stereotypy symptoms. Further work is needed to establish the utility of the MOVeIT in populations where there is a high likelihood of co-occurring tics and stereotypy and in general population settings. Accurate distinction between tics and stereotypy will guide choices for intervention and anticipatory guidance for families.
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  • 文章类型: Journal Article
    基于进化的深度生成模型代表了理解和设计蛋白质的令人兴奋的方向。一个悬而未决的问题是,此类模型是否可以学习专门的功能约束,以控制特定生物学环境中的适应性。这里,我们研究了生成模型产生Src-同源性3(SH3)结构域的合成版本的能力,这些结构域介导酵母Sho1渗透应激反应途径中的信号传导。我们证明了变分自动编码器(VAE)模型产生的人工序列可以通过实验概括自然SH3域的功能。更一般地说,该模型组织了所有真菌SH3结构域,使得模型潜在空间中的局部性(而不仅仅是序列空间中的局部性)丰富了合成直向同源物的设计,并暴露了分布在SH3配体结合位点附近和远处的非明显氨基酸约束。生成模型在体内设计直系同源样功能的能力为在特定细胞背景和环境中工程化蛋白质功能开辟了新途径。
    Evolution-based deep generative models represent an exciting direction in understanding and designing proteins. An open question is whether such models can learn specialized functional constraints that control fitness in specific biological contexts. Here, we examine the ability of generative models to produce synthetic versions of Src-homology 3 (SH3) domains that mediate signaling in the Sho1 osmotic stress response pathway of yeast. We show that a variational autoencoder (VAE) model produces artificial sequences that experimentally recapitulate the function of natural SH3 domains. More generally, the model organizes all fungal SH3 domains such that locality in the model latent space (but not simply locality in sequence space) enriches the design of synthetic orthologs and exposes non-obvious amino acid constraints distributed near and far from the SH3 ligand-binding site. The ability of generative models to design ortholog-like functions in vivo opens new avenues for engineering protein function in specific cellular contexts and environments.
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  • 文章类型: Journal Article
    为了开发一种简短的筛查工具,该工具由12个项目组成,可以自我管理,以快速识别有认知脆弱(CF)风险的老年人,被命名为认知虚弱筛查工具(CFST)。
    总共选择了1318名60岁及以上的社区居民,并使用一组神经心理学电池和身体功能测试对其认知弱点进行了评估。使用二元逻辑回归(BLR)来识别CF的预测因子,以用作筛选工具中的项目。使用接收器工作特性分析开发了合适的截止点。
    筛选工具中包含了12个项目,包括性别,教育年,病史,抑郁症状和功能状态以及生活方式活动。曲线下面积(AUC)为0.817(95%CI:0.774-0.861),显示出优秀的鉴别力。截止值7的敏感性和特异性分别为80.8%和79.0%,筛查工具的阳性预测值(PPV)(73.3%)和阴性预测值(NPV)(85.2%)的可接受范围。CFST评分与标准认知和虚弱评估工具的并发有效性显示出与CFST总分的显着关联,具有低到中等的相关性(所有参数p<0.05)。
    CFST具有良好的敏感性和特异性,对社区居住的老年人有效。有必要进一步评估实施CFST作为社区CF风险筛查的成本效益。其在临床环境中的使用需要进一步验证。
    UNASSIGNED: To develop a brief screening tool consisting of twelve items that can be self-administered for rapid identification of older adults at risk of cognitive frailty (CF), named as Cognitive Frailty Screening Tool (CFST).
    UNASSIGNED: A total of 1318 community-dwelling individuals aged 60 years and above were selected and assessed for cognitive frailty using a set of neuropsychology batteries and physical function tests. A binary logistic regression (BLR) was used to identify predictors of CF to be used as items in the screening tool. A suitable cut-off point was developed using receiver operating characteristic analysis.
    UNASSIGNED: Twelve items were included in the screening tool, comprising of gender, education years, medical history, depressive symptoms and functional status as well as lifestyle activities. The area under the curve (AUC) was 0.817 (95 % CI:0.774-0.861), indicating an excellent discriminating power. The sensitivity and specificity for cut-off 7 were 80.8 % and 79.0 %, with an acceptable range of positive predictive value (PPV) (73.3 %) and negative predictive value (NPV) (85.2 %) for screening tools. Concurrent validity of CFST score with standard cognitive and frailty assessment tools shows a significant association with the total score of CFST with low to moderate correlation (p < 0.05 for all parameters).
    UNASSIGNED: CFST had good sensitivity and specificity and was valid for community-dwelling older adults. There is a need to evaluate further the cost-effectiveness of implementing CFST as a screening for the risk of CF in the community. Its usage in clinical settings needs further validation.
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  • 文章类型: Journal Article
    目的:确定手持式脂质层检查仪测量的非侵入性泪膜破裂时间(NIBUT)的诊断准确性。
    方法:108例患者被纳入本横断面研究,分为两组:干眼症患者(n=57),根据Schein问卷获得的干眼症状和最少一个客观干眼症(泪膜破裂时间<10s或角膜,结膜和眼睑边缘荧光素染色),和健康受试者(n=51)。
    结果:干眼受试者的NIBUT明显短于健康受试者(6svs20s,p<0.001)。Logistic回归分析显示,NIBUT值较短是干眼症的优良指标(p<0.001),具有一致性,测量之间没有显著差异,即使在对年龄和性别的结果进行标准化之后。区分干眼与健康受试者的NIBUT切点为12s(灵敏度90.2%,特异性88.5%,PPV92.5%,净现值85.2%,LR+7.82,LR-0.11,DOR70.92,DE89.6%)。很好,但在10s的截止值下观察到较低的精度(灵敏度为87.8%,特异性88.5%,PPV92.3%,净现值82.1%,LR+7.61,LR-0.14,DOR55.2,DE88.1%)。0.944的ROC曲线下面积(AUC)将NIBUT分类为具有非常高准确性的诊断测试。
    结论:这项研究显示了通过手持式脂质层检查仪器测量的NIBUT的高诊断准确性。这个简单的,可靠,客观和可用的工具可能会定期进行,标准的干眼诊断,几乎每个眼科专家都可以使用。
    OBJECTIVE: To determine the diagnostic accuracy of non-invasive tear film break-up time (NIBUT) measured by the handheld lipid layer examination instrument.
    METHODS: 108 patients were enrolled in this cross-sectional study and divided into two groups: patients with dry eye (n = 57) categorized by the presence of dry eye symptoms obtained by Schein Questionnaire and minimally-one objective dry eye sign (tear film break-up time <10 s or corneal, conjunctival and lid margin fluorescein staining), and healthy subjects (n = 51).
    RESULTS: Dry eye subjects had significantly shorter NIBUT than healthy subjects (6 s vs 20 s, p < 0.001). Logistic regression analysis showed that shorter NIBUT values were excellent indicators of dry eye disease (p < 0.001), with consistency and no significant difference between measurements, even after standardizing the results for age and sex. NIBUT cut-off point to distinguish dry eye from healthy subjects was 12 s (sensitivity 90.2 %, specificity 88.5 %, PPV 92.5 %, NPV 85.2 %, LR +7.82, LR- 0.11, DOR 70.92, DE 89.6 %). Good, but lower accuracy was observed at cut-off value of 10 s (sensitivity 87.8 %, specificity 88.5 %, PPV 92.3 %, NPV 82.1 %, LR+ 7.61, LR- 0.14, DOR 55.2, DE 88.1 %). The area under the ROC curve (AUC) of 0.944 classified NIBUT as a diagnostic test with very high accuracy.
    CONCLUSIONS: This study showed a high diagnostic accuracy of NIBUT measured by the handheld lipid layer examination instrument. This simple, reliable, objective and available instrument might regularly take place in routine, standard dry eye diagnostic and can be used by almost every eye specialist.
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