diagnostics

诊断
  • 文章类型: Journal Article
    通用DNA“条形码”片段(细胞色素C氧化酶I[COI]基因的658个碱基对)已被确立为物种鉴定的有用工具,并被广泛批评为理解一个群体的进化史。已经产生了大量的COI序列数据,这些数据有望快速鉴定物种,例如,生物安全。果蝇部落Dacini拥有大约一千种,其中80是经济关注的害虫。我们使用环状共有测序产生了265种Dacini的COI参考文库,其包含跨越大部分COI基因的5601序列。我们比较了距离指标与单亲评估的物种识别,尽管我们发现了一个“软”条形码间隙,大约2%的成对距离,该规则的例外情况表明,单方评估是物种鉴定的唯一可靠方法。我们发现,所有定期用于Dacini果蝇鉴定的片段>450个碱基对提供相似的分辨率。在我们的数据集中,11.3%的物种在COI树中是非单系的,这主要是由于物种复合物。最后,我们为COI库的未来生成和使用提供了建议。我们修改了Dacustransversusstat的通用赋值。rev.哈代1982年,达克斯·佩尔普西勒斯。rev.Drew1971和我们建立了DacusmaculipterusWhite1998syn。11月。作为DacussatanasLiang等人的初级同义词。1993.
    The utility of a universal DNA \'barcode\' fragment (658 base pairs of the Cytochrome C Oxidase I [COI] gene) has been established as a useful tool for species identification, and widely criticized as one for understanding the evolutionary history of a group. Large amounts of COI sequence data have been produced that hold promise for rapid species identification, for example, for biosecurity. The fruit fly tribe Dacini holds about a thousand species, of which 80 are pests of economic concern. We generated a COI reference library for 265 species of Dacini containing 5601 sequences that span most of the COI gene using circular consensus sequencing. We compared distance metrics versus monophyly assessments for species identification and although we found a \'soft\' barcode gap around 2% pairwise distance, the exceptions to this rule dictate that a monophyly assessment is the only reliable method for species identification. We found that all fragments regularly used for Dacini fruit fly identification >450 base pairs long provide similar resolution. 11.3% of the species in our dataset were non-monophyletic in a COI tree, which is mostly due to species complexes. We conclude with recommendations for the future generation and use of COI libraries. We revise the generic assignment of Dacus transversus stat. rev. Hardy 1982, and Dacus perpusillus stat. rev. Drew 1971 and we establish Dacus maculipterus White 1998 syn. nov. as a junior synonym of Dacus satanas Liang et al. 1993.
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  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19)是一种由严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)引起的高度流行和有效的传染病。直到现在,世界仍在努力开发新的诊断和治疗COVID-19的方法。目前,COVID-19的临床防治主要针对SRAS-CoV-2表面的刺突蛋白。然而,随着SARS-CoV-2变体(VOC)的不断出现,靶向刺突蛋白治疗显示出高度的局限性。SARS-CoV-2的核衣壳蛋白(N蛋白)在病毒进化中高度保守,参与病毒感染和组装的关键过程。它是人类SARS-CoV-2感染后表达最多的病毒结构蛋白,具有很高的免疫原性。因此,N卵白作为病毒沾染和复制的症结因子在基本研讨和临床运用中具有伟大的潜伏研讨价值。本文综述了SARS-CoV-2N蛋白的结构和生物学功能的研究进展,靶向N蛋白的诊断和药物研究,为了促进研究人员进一步了解SARS-CoV-2N蛋白,为未来可能爆发的新型突发性冠状病毒传染病奠定理论基础。
    Corona Virus Disease 2019 (COVID-19) is a highly prevalent and potent infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Until now, the world is still endeavoring to develop new ways to diagnose and treat COVID-19. At present, the clinical prevention and treatment of COVID-19 mainly targets the spike protein on the surface of SRAS-CoV-2. However, with the continuous emergence of SARS-CoV-2 Variants of concern (VOC), targeting the spike protein therapy shows a high degree of limitation. The Nucleocapsid Protein (N protein) of SARS-CoV-2 is highly conserved in virus evolution and is involved in the key process of viral infection and assembly. It is the most expressed viral structural protein after SARS-CoV-2 infection in humans and has high immunogenicity. Therefore, N protein as the key factor of virus infection and replication in basic research and clinical application has great potential research value. This article reviews the research progress on the structure and biological function of SARS-CoV-2 N protein, the diagnosis and drug research of targeting N protein, in order to promote researchers\' further understanding of SARS-CoV-2 N protein, and lay a theoretical foundation for the possible outbreak of new and sudden coronavirus infectious diseases in the future.
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  • 文章类型: Journal Article
    基于荧光染料的环介导等温扩增(LAMP)是一种灵敏的核酸检测方法,但仅限于单重检测,可能产生非特异性信号。在这项研究中,我们提出了一种基于双功能探针的实时LAMP扩增方法,用于单路或多路检测。双功能探针是通过修饰荧光团的5'末端和LAMP引物之一上的内部猝灭剂而衍生的;因此,它可以同时参与LAMP过程和信号放大。在将双功能探针掺入双链DNA扩增子期间,荧光强度经历累积指数增加。基于双功能探针的LAMP方法简化且具有成本效益,因为引物设计和实验操作与普通LAMP完全一致。与其他基于当前探针的方法不同,这种方法不需要额外的酶,序列,或特殊的探头结构。此外,它比其他几种基于探针的LAMP方法快10分钟。基于双功能探针的LAMP方法允许在一锅反应中同时检测目标副溶血性弧菌DNA和内部扩增对照,展示了其多路检测的潜力。
    Fluorescence dye-based loop-mediated isothermal amplification (LAMP) is a sensitive nucleic acid detection method, but is limited to single-plex detection and may yield non-specific signals. In this study, we propose a bifunctional probe-based real-time LAMP amplification method for single-plexed or multiplexed detection. The bifunctional probe is derived by modifying the 5\' end of the fluorophore and an internal quencher on one of the LAMP primers; therefore, it can simultaneously be involved in the LAMP process and signal amplification. The fluorescence intensity undergoes a cumulative exponential increase during the incorporation of the bifunctional probe into double-stranded DNA amplicons. The bifunctional probe-based LAMP method is simplified and cost-effective, as the primer design and experimental operations align entirely with the ordinary LAMP. Different from other current probe-based methods, this method does not require additional enzymes, sequences, or special probe structures. Also, it is 10 min faster than several other probe-based LAMP methods. The bifunctional probe-based LAMP method allows the simultaneous detection of the target Vibrio parahaemolyticus DNA and the internal amplification control in a one-pot reaction, demonstrating its potential for multiplexed detection.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨使用高频超声检查作为检测早期和长期RA患者手足关节炎症和破坏性变化的工具。
    方法:本研究采用前瞻性队列设计,纳入162例符合美国风湿病学会/欧洲抗风湿联盟(ACR/EULAR)分类标准的类风湿关节炎(RA)患者。根据疾病持续时间将患者分为两组:第1组(n=74)包括疾病持续时间长达2年的患者,或早期式(ERA;),第2组(n=88)由病程超过2年的患者组成,或长期持久的351(LtRA)。所有患者都接受了关节的临床评估,以及射线照相和关节超声检查,在研究开始时,在6个月和12个月后再次。
    结果:在一般患者组中,与临床检查相比,超声检查显示手部关节滑膜炎的征象更频繁(66%)(56%的关节肿胀[NSJ]和55%的关节疼痛[NPJ],P<.01)。经过6个月的治疗,12%的患者实现了US完全缓解,24%实现了US部分缓解。
    结论:在RA综合诊断范围内,手和脚关节的关节超声检查,利用灰度和功率多普勒的组合,在检测早期RA方面可能超过射线照相术。该方法允许更准确地评估疾病活动性和进展率。
    OBJECTIVE: This study aims to investigate the use of high-frequency sonography as a tool for detecting inflammatory and destructive changes in the hand and foot joints of patients with early and long-term RA.
    METHODS: This study employs a prospective cohort design involving 162 patients diagnosed with Rheumatoid arthritis (RA) who meet the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria. Patients were divided into two groups based on disease duration: Group 1 (n = 74) included patients with a disease duration of up to 2 years, or early РА (ERA;), Group 2 (n = 88) consisted of patients with a disease duration exceeding 2 years, or long-term persistent РА (LtRA). All patients underwent a clinical assessment of their joints, as well as radiography and arthrosonography, at the beginning of the study and again at 6 and 12 months later.
    RESULTS: In the general group of patients, ultrasound examination revealed signs of synovitis in the joints of the hands more frequently (66%) compared with clinical examination (56% by a number of swollen joints [NSJ] and 55% by a number of painful joints [NPJ], P < .01). After 6 months of treatment, 12% of the patients achieved full US remission and 24% achieved partial US remission.
    CONCLUSIONS: Within the scope of comprehensive RA diagnostics, arthrosonography of the joints of the hands and feet, utilizing a combination of greyscale and power Doppler, may surpass radiography in detecting early RA. This method allows for a more accurate assessment of disease activity and progression rates.
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  • 文章类型: Journal Article
    生物标志物是宿主体内重要的生理和病理指标。多年来,已经开发了许多生物标志物的检测方法,考虑到它们在各种生物和生物医学应用中的巨大潜力。其中,基于功能化DNA折纸的检测系统由于其对传感模块的精确控制而成为一种有前途的方法,启用敏感,具体,和可编程生物标志物检测。我们总结了使用功能化DNA折纸进行生物标志物检测的进展,专注于DNA折纸功能化的策略,生物标志物识别的机制,以及在疾病诊断和监测中的应用。这些应用根据生物标志物的类型-核酸被组织成部分,蛋白质,小分子,和离子-最后讨论了与使用功能化DNA折纸系统进行生物标志物检测相关的优势和挑战。
    Biomarkers are crucial physiological and pathological indicators in the host. Over the years, numerous detection methods have been developed for biomarkers, given their significant potential in various biological and biomedical applications. Among these, the detection system based on functionalized DNA origami has emerged as a promising approach due to its precise control over sensing modules, enabling sensitive, specific, and programmable biomarker detection. We summarize the advancements in biomarker detection using functionalized DNA origami, focusing on strategies for DNA origami functionalization, mechanisms of biomarker recognition, and applications in disease diagnosis and monitoring. These applications are organized into sections based on the type of biomarkers - nucleic acids, proteins, small molecules, and ions - and concludes with a discussion on the advantages and challenges associated with using functionalized DNA origami systems for biomarker detection.
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  • 文章类型: Journal Article
    细胞外囊泡(EV),对于促进细胞间通讯的不同分子货物的运输至关重要,在诊断方面显示出巨大的潜力,治疗学,和药物输送。电动汽车的内在异质性和复杂性加剧了开发有效制备方法的挑战。这里,通过利用EV亲和改性的纤维素纳米原纤维开发了一种高EV富集的新策略。具体来说,富含羧基的改性纤维素具有突出的分散性能,能够在溶液中分散到纤维素纳米原纤维中。这些纤维素纳米原纤维被用作支架,用于通过化学缀合固定CD63的EV亲合抗体。与其他报道的方法相比,CD63修饰的纳米原纤维表现出86.4%的优异EV捕获效率。通过从生物血浆中有效捕获电动汽车,进一步验证了该系统的高性能,允许从EV衍生的miRNA和蛋白质中检测生物活性标志物。作者设想这些具有增强EV富集能力的改性纤维素纳米原纤维将在各种生物医学应用中开辟新的途径。
    Extracellular vesicles (EVs), crucial in facilitating the transport of diverse molecular cargoes for intercellular communication, have shown great potential in diagnostics, therapeutics, and drug delivery. The challenge of developing effective preparation methods for EVs is heightened by their intrinsic heterogeneity and complexity. Here, a novel strategy for high EV enrichment is developed by utilizing EV-affinitive-modified cellulose nanofibrils. Specifically, modified cellulose with rich carboxyl groups has outstanding dispersing properties, able to be dispersed into cellulose nanofibrils in solution. These cellulose nanofibrils are utilized as scaffolds for the immobilization of EV-affinitive antibody of CD63 by chemical conjugation. The CD63-modified nanofibrils demonstrate a superior EV capture efficiency of 86.4% compared with other reported methods. The high performance of this system is further validated by the efficient capture of EVs from biological blood plasma, allowing the detection of bioactive markers from EV-derived miRNAs and proteins. The authors envision that these modified cellulose nanofibrils of enhanced capability on EV enrichment will open new avenues in various biomedical applications.
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  • 文章类型: Journal Article
    癌症是主要的非传染性疾病之一,每年造成全球数百万人死亡。尽管目前有各种癌症检测和治疗方式,由于其晚期检测和转移性质,许多死亡发生。使用基于发光的成像工具的非侵入性检测由于其低成本而被认为是有前途的技术之一,高灵敏度,和亮度。此外,这些工具是独特和有价值的,因为它们甚至可以检测到细胞微环境中最微小的变化。为了实现这一点,具有强肿瘤摄取和高时空分辨率的荧光探针,特别是水溶性高,要求很高。最近,几个在可见光(400-700nm)具有发射窗口的水溶性分子,第一近红外(NIR-I,700-1000nm),和第二近红外(NIR-II,1000-1700nm)窗口已在文献中报道。这篇综述重点介绍了最近报道的水溶性小有机荧光团/染料在癌症诊断和治疗中的应用。我们系统地突出和描述了关键概念,荧光团的结构类别,赋予水溶性的策略,以及在癌症治疗和诊断中的应用,即,Theragnostics.我们讨论了基于香豆素的水溶性荧光探针的例子,黄吨,硼-二吡咯亚甲基(BODIPY),和花青岩心。还讨论了基于碳环和杂环核的其他新兴类型的染料。此外,讨论了获得此类荧光团的新兴分子工程方法。最后,还描述了该研究领域的机遇和挑战。
    Cancer is one of the major noncommunicable diseases, responsible for millions of deaths every year worldwide. Though various cancer detection and treatment modalities are available today, many deaths occur owing to its late-stage detection and metastatic nature. Noninvasive detection using luminescence-based imaging tools is considered one of the promising techniques owing to its low cost, high sensitivity, and brightness. Moreover, these tools are unique and valuable as they can detect even the slightest changes in the cellular microenvironment. To achieve this, a fluorescent probe with strong tumor uptake and high spatial and temporal resolution, especially with high water solubility, is highly demanded. Recently, several water-soluble molecules with emission windows in the visible (400-700 nm), first near-infrared (NIR-I, 700-1000 nm), and second near-infrared (NIR-II, 1000-1700 nm) windows have been reported in literature. This review highlights recently reported water-soluble small organic fluorophores/dyes with applications in cancer diagnosis and therapeutics. We systematically highlight and describe the key concepts, structural classes of fluorophores, strategies for imparting water solubility, and applications in cancer therapy and diagnosis, i.e., theragnostics. We discuss examples of water-soluble fluorescent probes based on coumarin, xanthene, boron-dipyrromethene (BODIPY), and cyanine cores. Some other emerging classes of dyes based on carbocyclic and heterocyclic cores are also discussed. Besides, emerging molecular engineering methods to obtain such fluorophores are discussed. Finally, the opportunities and challenges in this research area are also delineated.
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  • 文章类型: Journal Article
    压力导线血流储备分数(FFR)及其衍生物,如定量流量比(QFR),计算压力流量导出FFR(caFFR),冠状动脉造影衍生的FFR(FFRangio),和计算机断层扫描得出的FFR(FFRCT),已被验证用于识别功能显著狭窄和指导血运重建策略。使用这些方法的局限性包括充血诱导剂的副作用,额外费用,和微血管阻力的脆弱性。FFR与狭窄冠状动脉的程度及其对向心肌区域有关。冠状动脉树描述和病变评估(CatLet)评分(也称为Hexu)是狭窄程度和受影响冠状动脉(心肌区域)权重的乘积。因此,我们假设CatLet评分可以预测血流动力学显著的冠状动脉狭窄.
    我们回顾性纳入了连续的稳定型冠状动脉疾病患者。他们在四川科学城医院就诊,在2毫米或更大的冠状动脉中至少有一个直径狭窄50-90%的病变。FFR测量是在侵入性冠状动脉造影期间获得的。通过将固定值2.0(对于非闭塞性病变)乘以受影响的冠状动脉的重量来获得CatLet评分。主要终点是CatLet评分在确定血流动力学显著冠状动脉狭窄方面的诊断准确性,使用压力线FFR≤0.80作为参考。
    我们分析了175例稳定型冠状动脉疾病和中度冠状动脉病变患者206条血管的FFR和CatLet评分。每血管分析显示,CatLet评分与FFR之间总体上具有良好的相关性[r=-0.61;95%置信区间(95%CI):-0.69至-0.52;P<0.01]。我们还注意到每个左前降支动脉(LAD)的CatLet评分-FFR相关性,左回旋(LCX),和右冠状动脉(RCA)。当CatLet评分≥10作为FFR≤0.80的预测因子时,总体诊断准确性包括78.80%的敏感性(95%CI:67.00-87.90%),特异性为85.00%(95%CI:78.00-90.50%),正似然比为5.25,负似然比为0.25,曲线下面积为0.90(95%CI:0.85-0.94).每个LAD也获得了等效的血管特异性结果,LCX,和RCA。
    CatLet得分,仅基于对冠状动脉造影结果的视觉估计,在心肌缺血方面表现出良好的诊断性能。其指导血运重建的临床价值值得进一步研究。
    UNASSIGNED: Pressure wire fractional flow reserve (FFR) and its derivatives, such as quantitative flow ratio (QFR), computational pressure flow-derived FFR (caFFR), coronary angiography-derived FFR (FFRangio), and computed tomography-derived FFR (FFRCT), have been validated for identifying functionally significant stenosis and guiding revascularization strategy. The limitations of using these methods include the side effects of hyperemia-induced agents, additional costs, and vulnerability to microvascular resistance. FFR is related both to the degree of a stenotic coronary artery and to its subtended myocardial territory. Coronary Artery Tree Description and Lesion Evaluation (CatLet) score (also known as Hexu) is a product of the degree of a stenosis and the weighting of the affected coronary artery (myocardial territory). Hence, we hypothesized that the CatLet score could predict hemodynamically significant coronary stenosis.
    UNASSIGNED: We retrospectively enrolled consecutive patients with stable coronary artery disease. They attended Sichuan Science City Hospital with at least one lesion of 50-90% diameter stenosis in a coronary artery of 2 mm or larger. FFR measurement was obtained during invasive coronary angiography. The CatLet score was obtained by multiplying a fixed value of 2.0 (for non-occlusive lesions) and the weight of the affected coronary artery. The primary endpoint was the CatLet score\'s diagnostic accuracy in identifying hemodynamically significant coronary stenosis, with a pressure wire FFR of ≤0.80 being used as reference.
    UNASSIGNED: We analyzed the FFR and CatLet scores from 206 vessels in 175 patients with stable coronary disease and intermediate coronary lesions. The per-vessel analysis revealed an overall good correlation between the CatLet score and the FFR [r=-0.61; 95% confidence interval (95% CI): -0.69 to -0.52; P<0.01]. We also noted a significant CatLet score-FFR correlation for each of the left anterior descending artery (LAD), left circumflex (LCX), and right coronary artery (RCA). With a CatLet score ≥10 as a predictor of FFR ≤0.80, the overall diagnostic accuracy included a sensitivity of 78.80% (95% CI: 67.00-87.90%), a specificity of 85.00% (95% CI: 78.00-90.50%), a positive likelihood ratio of 5.25, a negative likelihood ratio of 0.25, and an area under the curve of 0.90 (95% CI: 0.85-0.94). Equivalent vessel-specific results were also achieved for each of the LAD, LCX, and RCA.
    UNASSIGNED: The CatLet score, solely based on visual estimation of the results of coronary angiography, demonstrated good diagnostic performance with respect to myocardial ischemia. Its clinical values in guiding revascularization warrant further investigation.
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  • 文章类型: Journal Article
    背景:对以神经母细胞瘤表现为神经母细胞瘤的神经阵挛性肌阵挛性共济失调综合征(OMAS)患者进行早期精确诊断和有效治疗可以预防严重的神经系统预后。
    目的:评估18F-氟代脱氧葡萄糖(FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)成像在小儿OMAS合并神经母细胞瘤中的诊断价值。
    方法:对45例诊断为OMAS且接受18F-FDGPET/CT检查的患者进行回顾性评估。进行单变量分析以比较有和没有神经母细胞瘤的OMAS之间的临床特征。应用单变量和多变量逻辑回归分析来确定OMAS合并神经母细胞瘤的独立危险因素并建立临床模型。最后,对独立危险因素和PET/CT进行拟合,以建立诊断OMAS合并神经母细胞瘤的联合模型,并显示为列线图.接收机工作特性曲线,决策曲线,和校准曲线分析进行评估模型的性能。
    结果:在45名患者中,27例PET/CT阳性,23/27病灶为神经母细胞瘤,四个是假阳性。其中1例假阳性患者经术后病理证实为肾上腺反应性增生,其余3例患者在临床随访中OMAS症状消失。PET/CT阳性病灶的平均最大标准化摄取值为2.6。敏感性,特异性,正预测值,负预测值,PET/CT的准确率为100%,81.8%,85.2%,100%,91.1%,分别。诊断时的年龄,乳酸脱氢酶,和神经元特异性烯醇化酶在有和没有神经母细胞瘤的OMAS之间显示出统计学上的显着差异。乳酸脱氢酶被确定为建立临床模型的独立危险因素,并且临床模型显示出0.82的曲线下面积(AUC)用于诊断OMAS伴神经母细胞瘤,当与PET/CT结合时,AUC高达0.91。决策曲线分析和校准曲线表明,列线图具有良好的一致性和临床实用性。
    结论:在OMAS患者中,18F-FDGPET/CT对神经母细胞瘤的诊断准确率高,尤其是合并血清乳酸脱氢酶的独立危险因素。
    Early precision diagnosis and effective treatment of opsoclonus myoclonus ataxia syndrome (OMAS) patients presenting with neuroblastoma can prevent serious neurological outcomes.
    To assess the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging in pediatric OMAS with neuroblastoma.
    A retrospective evaluation of 45 patients diagnosed with OMAS who underwent 18F-FDG PET/CT was performed. A univariate analysis was performed to compare clinical characteristics between OMAS with and without neuroblastoma. Univariate and multivariate logistic regression analyses were applied to identify independent risk factors for OMAS with neuroblastoma and to develop the clinical model. Finally, independent risk factors and PET/CT were fitted to build the combined model for the diagnosis of OMAS with neuroblastoma and presented as a nomogram. Receiver operating characteristic curve, decision curve, and calibration curve analyses were conducted to evaluate the performance of the models.
    Among 45 patients, 27 were PET/CT-positive, 23/27 lesions were neuroblastoma, and four were false positives. One of the false positive patients was confirmed to be adrenal reactive hyperplasia by postoperative pathology, and the symptoms of OMAS disappeared in the remaining three cases during clinical follow-up. The average maximal standardized uptake value of PET/CT-positive lesions was 2.6. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT were 100%, 81.8%, 85.2%, 100%, and 91.1%, respectively. Age at diagnosis, lactate dehydrogenase, and neuron-specific enolase showed statistically significant differences between OMAS with and without neuroblastoma. Lactate dehydrogenase was identified as the independent risk factor to develop the clinical model, and the clinical model demonstrated an area under the curve (AUC) of 0.82 for the diagnosis of OMAS with neuroblastoma, with an AUC as high as 0.91 when combined with PET/CT. The decision curve analysis and calibration curve demonstrated that the nomogram had good consistency and clinical usefulness.
    In patients with OMAS, 18F-FDG PET/CT has a high diagnostic accuracy in detecting tumors of the neuroblastoma, especially when combined with the independent risk factor serum lactate dehydrogenase.
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  • 文章类型: Journal Article
    本研究旨在验证常规非侵入性评分在预测代谢相关脂肪性肝病(MAFLD)显着纤维化中的功效,并开发MAFLD的非侵入性预测模型。
    这项横断面研究是在2018年8月至2023年12月的7701名MAFLD参与者中进行的。将所有参与者分为训练队列和验证队列。这项研究比较了不同的亚组人口统计学,人体测量学,和实验室检查指标,并进行logistic回归分析,评估自变量与肝纤维化的相关性。使用逻辑回归模型创建列线图。使用受试者工作特征(ROC)曲线分析和决策曲线分析(DCA)评估非侵入性模型和列线图的预测值。
    根据多变量逻辑回归分析结果,开发了四个列线图,用于定量分析显着的肝纤维化风险。总体MAFLD的列线图ROC曲线下面积(AUC)分别为0.710、0.714、0.748和0.715,OW-MAFLD,精益MAFLD,和T2DM-MAFLD,分别。所有MAFLD参与者和OW-MAFLD的列线图AUC高于其他非侵入性评分。DCA曲线显示各列线图的净获益均高于APRI和FIB-4。在验证队列中,列线图的AUC分别为0.722,0.750,0.719和0.705.
    APRI,FIB-4和NFS对MAFLD患者的显著纤维化预测效果不佳。新模型在识别MAFLD中的显著纤维化方面显示出改进的诊断准确性和临床适用性。
    UNASSIGNED: This study aims to validate the efficacy of the conventional non-invasive score in predicting significant fibrosis in metabolic-associated fatty liver disease (MAFLD) and to develop a non-invasive prediction model for MAFLD.
    UNASSIGNED: This cross-sectional study was conducted among 7701 participants with MAFLD from August 2018 to December 2023. All participants were divided into a training cohort and a validation cohort. The study compared different subgroups\' demographic, anthropometric, and laboratory examination indicators and conducted logistic regression analysis to assess the correlation between independent variables and liver fibrosis. Nomograms were created using the logistic regression model. The predictive values of noninvasive models and nomograms were evaluated using receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA).
    UNASSIGNED: Four nomograms were developed for the quantitative analysis of significant liver fibrosis risk based on the multivariate logistic regression analysis results. The nomogram\'s area under ROC curves (AUC) was 0.710, 0.714, 0.748, and 0.715 in overall MAFLD, OW-MAFLD, Lean-MAFLD, and T2DM-MAFLD, respectively. The nomogram had a higher AUC in all MAFLD participants and OW-MAFLD than the other non-invasive scores. The DCA curve showed that the net benefit of each nomogram was higher than that of APRI and FIB-4. In the validation cohort, the AUCs of the nomograms were 0.722, 0.750, 0.719, and 0.705, respectively.
    UNASSIGNED: APRI, FIB-4, and NFS performed poorly predicting significant fibrosis in patients with MAFLD. The new model demonstrated improved diagnostic accuracy and clinical applicability in identifying significant fibrosis in MAFLD.
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