Daalụ maka ileta Nature.com.Ị na-eji ụdị ihe nchọgharị nwere oke nkwado CSS.Maka ahụmịhe kachasị mma, anyị na-akwado ka ị jiri ihe nchọgharị emelitere (ma ọ bụ gbanyụọ ọnọdụ ndakọrịta na Internet Explorer).Na mgbakwunye, iji hụ na nkwado na-aga n'ihu, anyị na-egosi saịtị na-enweghị ụdị na Javascript.
Ihe mmịfe na-egosi akụkọ atọ kwa slide.Jiri bọtịnụ azụ na nke na-esote ịkwaga na slides, ma ọ bụ bọtịnụ njikwa slide na njedebe ka ịgafe na slide ọ bụla.
Centrifugation ọgwụ a pụrụ ịdabere na ya chọrọ n'akụkọ ihe mere eme iji ngwa azụmaahịa dị oke ọnụ, buru ibu na ọkụ eletrik, nke anaghị adị na ntọala nwere oke akụrụngwa.Ọ bụ ezie na a kọwawo ọtụtụ centrifuges dị obere, dị ọnụ ala, na-abụghị moto, ihe ngwọta ndị a bụ nke e bu n'obi maka ngwa nyocha nke na-achọ obere mpempe akwụkwọ sedimentation.Tụkwasị na nke ahụ, nhazi nke ngwaọrụ ndị a na-achọkarị iji ihe pụrụ iche na ngwá ọrụ ndị na-adịghị adị na mpaghara ndị a na-ejighị n'aka.N'ebe a, anyị na-akọwa nhazi, mgbakọ, na nnwale nnwale nke CentREUSE, ọnụ ahịa dị oke ala, nke mmadụ na-arụ ọrụ, centrifuge na-ekpofu ihe na-ebugharị maka ngwa ọgwụgwọ.CentREUSE na-egosipụta nkezi centrifugal ike nke 10.5 ikwu centrifugal Force (RCF) ± 1.3.Idozi 1.0 ml vitreous nkwusioru nke triamcinolone mgbe nkeji 3 nke centrifugation na CentREUSE dị ka nke ahụ mgbe awa iri na abụọ nke ike ndọda na-agbapụta agbaze (0.41 ml ± 0.04 vs 0.38 ml ± 0.03, p = 0.14).Sedimenti siri ike mgbe CentREUSE centrifugation gasịrị maka nkeji 5 na 10 ma e jiri ya tụnyere nke a hụrụ mgbe centrifugation na 10 RCF (0.31 ml ± 0.02 vs. 0.32 ml ± 0.03, p = 0.20) na 50 RCF (0.20 ml) maka nkeji 5 na-eji ngwá ọrụ azụmahịa Simi. 0.02 vs. 0.19 ml ± 0.01, p = 0.15).Agụnyere ndebiri na ntuziaka ụlọ maka CentREUSE na post isi mmalite a.
Centrifugation bụ nzọụkwụ dị mkpa n'ọtụtụ nyocha nyocha na ọgwụgwọ ọgwụgwọ1,2,3,4.Otú ọ dị, imezu centrifugation zuru oke na akụkọ ihe mere eme chọrọ iji ngwá ahịa azụmahịa dị oke ọnụ, nnukwu na ọkụ eletrik, nke na-adịghị adị na ntọala nwere oke akụ2,4.N'afọ 2017, ndị otu Prakash webatara obere akwụkwọ ntuziaka centrifuge (nke a na-akpọ “puffer akwụkwọ”) nke emere site na ihe eji arụ ọrụ na ọnụ ahịa $0.20 ($)2.Kemgbe ahụ, etinyela fugue akwụkwọ na ntọala nwere oke akụrụngwa maka ngwa nyocha dị ala (dịka njupụta dabere na nkewa nke ihe mejupụtara ọbara na tubes capillary iji chọpụta nje nje ịba), si otú a na-egosipụta ngwa ọrụ mmadụ nwere ike iji dị oke ọnụ.centrifuge 2 .Kemgbe ahụ, a kọwawo ọtụtụ kọmpat ndị ọzọ kọmpat, ndị dị ọnụ ala, na-abụghị moto centrifugation ngwaọrụ 4,5,6,7,8,9,10.Otú ọ dị, ọtụtụ n'ime ngwọta ndị a, dị ka uzuoku akwụkwọ, ezubere maka nchọpụta nchọpụta na-achọ obere sedimentation mpịakọta na ya mere enweghị ike iji centrifuge nnukwu samples.Tụkwasị na nke ahụ, mgbakọ nke ngwọta ndị a na-achọkarị iji ihe pụrụ iche na ngwá ọrụ ndị na-adịghị adị na mpaghara ndị na-adịghị echekwa 4,5,6,7,8,9,10.
N'ebe a, anyị na-akọwa nhazi, mgbakọ, na nnwale nnwale nke centrifuge (a na-akpọ CentREUSE) nke a rụrụ site na mkpofu fugue akwụkwọ a na-emekarị maka ngwa ọgwụgwọ nke na-achọkarị nnukwu sedimentation mpịakọta.Ikpe 1, 3 Dị ka ihe akaebe nke echiche, anyị nwalere ngwaọrụ ahụ na ezigbo ntinye anya anya: mmiri ozuzo nke nkwusioru nke triamcinolone na acetone (TA) maka ntinye ọgwụ bolus na-esote n'ime ahụ vitreous nke anya.Ọ bụ ezie na centrifugation maka TA ịta bụ ihe a ghọtara dị ọnụ ala ntinye aka maka ọgwụgwọ ogologo oge nke ọnọdụ anya dị iche iche, mkpa maka centrifuges dị n'ahịa n'oge mmepụta ọgwụ bụ nnukwu ihe mgbochi maka iji ọgwụgwọ a mee ihe na ntọala ihe onwunwe1,2, 3.ma e jiri ya tụnyere nsonaazụ ndị e nwetara na centrifuges azụmahịa.Agụnyere ndebiri na ntuziaka maka iwulite CentREUSE na mgbasa ozi mepere emepe na ngalaba “Ozi ndị ọzọ”.
Enwere ike wuo CentREUSE ihe fọrọ nke nta ka ọ bụrụ kpamkpam site na scrap.Ebipụtara mbipụta abụọ nke ndebiri ọkara okirikiri (Ngbakwunye S1) na akwụkwọ ozi carbon US ọkọlọtọ (215.9 mm × 279.4 mm).Ihe ndebiri ọkara okirikiri abụọ jikọtara na-akọwapụta atụmatụ atọ dị mkpa nke ngwaọrụ CentREUSE, gụnyere (1) mpụta mpụta nke 247mm spinning disk, (2) bụ nke e mere iji nabata sirinji 1.0ml (ya na okpu na plọge ebipụrụ).grooves na shank) na (3) akara abụọ na-egosi ebe a ga-akụ oghere ka eriri wee si na diski ahụ gafee.
Jide (dịka ọmụmaatụ na nrapado ma ọ bụ teepu) ndebiri na bọọdụ corrugated (nha kacha nta: 247 mm × 247 mm) (Ọnọdụ mgbakwunye S2a).A na-eji bọọdụ corrugated “A” ọkọlọtọ (oke 4.8 mm) mee ihe n'ọmụmụ ihe a, mana enwere ike iji bọọdụ corrugated yiri ọkpụrụkpụ, dị ka bọọdụ corrugated sitere na igbe mbupu a tụfuru.Iji ngwá ọrụ dị nkọ (dị ka agụba ma ọ bụ mkpa), bee kaadiboodu n'akụkụ nsọtụ nke diski mpụta nke akọwapụtara na ndebiri (Ngbakwunye S2b).Mgbe ahụ, na-eji ngwá ọrụ dị warara, dị nkọ (dị ka ọnụ ọnụ pensụl), mepụta perforations abụọ zuru oke na radius nke 8.5 mm dị ka akara ndị a chọtara na template (Ngbakwunye S2c).A na-ebipụ oghere abụọ maka sirinji 1.0 ml site na template na n'okpuru oyi akwa nke kaadiboodu site na iji ngwá ọrụ a kapịrị ọnụ dị ka agụba;a ga-akpachapụ anya ka ọ ghara imebi oyi akwa corrugated dị n'okpuru ma ọ bụ oyi akwa nke dị n'elu (Mgbakwunye S2d, e) .Mgbe ahụ, tinye otu eriri eriri (dịka ọmụmaatụ, eriri owu esi nri 3mm ma ọ bụ eri ọ bụla nke nha na nha nha) site na oghere abụọ ahụ wee kee akaghị n'akụkụ ọ bụla nke diski ihe dị ka 30cm ogologo (Mgbakwunye Fig. S2f).
Jujuo sirinji 1.0 ml abụọ nwere oke nha nhata (dịka ọmụmaatụ 1.0 ml nke nkwusioru TA) na okpu.E bepụrụ mkpanaka sirinji ahụ n'ogo nke flange gbọmgbọm (Ọnọdụ Mgbakwunye S2g, h).A na-ekpuchikwa flange cylinder ahụ na teepu teepu ka ọ ghara ịpụpụ piston mkpọnwụ n'oge eji ngwá ọrụ.A na-etinye sirinji 1.0 ml nke ọ bụla n'ime sirinji nke ọma na okpu chere ihu n'etiti diski (Nkọwa S2i).A na-etinyezi sirinji ọ bụla na opekata mpe diski ahụ nwere teepu nrapado (Ngbakwunye S2j).N'ikpeazụ, mezue mgbakọ nke centrifuge site n'itinye pensụl abụọ (dị ka pensụl ma ọ bụ ngwaọrụ siri ike yiri osisi) na njedebe ọ bụla nke eriri n'ime loop (Nyocha 1).
Ntuziaka maka iji CentREUSE yiri nke ahụ maka ihe egwuregwu egwuregwu ọdịnala.A na-amalite ntụgharị ahụ site na ijide aka n'aka ọ bụla.Obere ntakịrị na eriri na-eme ka diski ahụ maa jijiji n'ihu ma ọ bụ azụ azụ, na-eme ka diski ahụ tụgharịa n'ihu ma ọ bụ azụ azụ n'otu n'otu.A na-eme nke a ọtụtụ ugboro n'ụzọ dị nwayọọ, na-achịkwa nke mere na eriri ahụ gbakọọ.Mgbe ahụ kwụsị mmegharị ahụ.Ka eriri ahụ na-amalite ịpụpụ, a na-adọta aka ahụ nke ọma ruo mgbe eriri ahụ na-akpụ akpụ, na-eme ka diski ahụ gbanye.Ozugbo eriri ahụ kwụsịrị kpamkpam wee malite ịlaghachi azụ, aka ahụ kwesịrị ịdị nwayọọ nwayọọ nwayọọ.Ka eriri ahụ malitere ịpụpụ ọzọ, tinye otu usoro mmegharị ahụ ka ngwaọrụ ahụ na-agbagharị (vidiyo S1).
Maka ngwa chọrọ sedimentation nke nkwusioru site na centrifugation, ngwaọrụ na-aga n'ihu na-atụgharị ruo mgbe e nwetara granulation na-eju afọ (Nkọwa S3a, b).Ihe mgbagwoju anya ga-etolite na njedebe plunger nke gbọmgbọm sirinji na ihe dị elu ga-elekwasị anya na nsọtụ sirinji ahụ.A na-awụpụ ihe dị elu site n'iwepụ teepu nke na-ekpuchi flange gbọmgbọm na iwebata plunger nke abụọ iji jiri nwayọọ nwayọọ mee ka onye na-agbapụta nwa afọ gaa n'ọnụ sirinji, na-akwụsị mgbe ọ ruru sedimenti mejupụtara (Mgbakwunye S3c, d).
Iji chọpụta ọsọ ntụgharị, ngwaọrụ CentREUSE, nke nwere sirinji abụọ 1.0 ml jupụtara na mmiri, ka ejiri igwefoto vidiyo dị elu (Freek 240 kwa nkeji) dekọọ maka 1 min mgbe ọ rutere n'ọnọdụ oscillation na-adịgide adịgide.A na-eji aka na-enyocha ihe nrịbama dị nso na nsọtụ diski a na-agbagharị agbagharị site n'iji ntule-site-frame nyocha nke ndekọ ahụ iji chọpụta ọnụọgụ mgbanwe n'otu nkeji (rpm) (Njirimara 2a-d).Tinyegharịa n = 10 mgbalị.A na-agbakọ ike centrifugal (RCF) dị n'etiti oghere sirinji site na iji usoro a:
Ntụle ọsọ ntụgharị na CentREUSE.(A–D) Onyonyo nnọchite anya usoro na-egosi oge (nkeji: sekọnd. milliseconds) iji mechaa ntụgharị ngwaọrụ.Àkú na-egosi akara nchọta.(E) ọnụọgụ RPM na-eji CentREUSE.Ahịrị ndị ahụ na-anọchi anya ọntụ (ọbara ọbara) ± ọkọlọtọ ọkọlọtọ (ojii).Akara ndị ahụ na-anọchi anya nnwale nke nkeji 1 n'otu n'otu (n = 10).
sirinji 1.0 ml nke nwere nkwusioru TA maka ịgba ọgwụ (40 mg/ml, Amneal Pharmaceuticals, Bridgewater, NJ, USA) ka ejiri CentREUSE mee ihe maka nkeji 3, 5 na 10.Atụnyere sedimentation site na iji usoro a na nke enwetara mgbe centrifugation na 10, 20, na 50 RCF na-eji A-4-62 rotor maka 5 min na Eppendorf 5810R benchtop centrifuge (Hamburg, Germany).Atụnyere oke mmiri ozuzo na oke mmiri ozuzo enwetara site na iji mmiri ozuzo dabere na ike ndọda n'oge dị iche iche site na 0 ruo 720 nkeji.A na-eme ngụkọta nke n = 9 ugboro ugboro nke onwe maka usoro ọ bụla.
Emere nyocha ndekọ ọnụ ọgụgụ niile site na iji sọftụwia Prism 9.0 (GraphPad, San Diego, USA).A na-egosipụta ụkpụrụ dị ka ± ọkọlọtọ ọkọlọtọ (SD) ọ gwụla ma amataghị ya.Atụnyere ụzọ otu site na iji t-ule agbaziri Welch ọdụdụ abụọ.A kọwapụtara Alfa dị ka 0.05.Maka nkwado ndọda na-adabere n'ike ndọda, a na-etinye ụdị ire ere nke otu nkeji na-eji opekata mpe-squares regression, na-emeso ụkpụrụ y ugboro ugboro maka uru x nyere dị ka otu ebe.
ebe x bụ oge na nkeji.y - olu sedimenti.y0 bụ uru y mgbe x bụ efu.Ala dị larịị bụ uru y maka nkeji na-enweghị ngwụcha.K bụ ọnụego na-adịgide adịgide, gosipụtara dị ka nkeji nkeji.
Ngwaọrụ CentREUSE gosipụtara oscillations na-abụghị nke a na-achịkwa, na-eji sirinji 1.0 ml abụọ jupụtara na 1.0 ml mmiri nke ọ bụla (vidiyo S1).Na n = 10 ule (1 nkeji nke ọ bụla), CentREUSE nwere nkezi ntụgharị ntụgharị nke 359.4 rpm ± 21.63 (oke = 337-398), na-ebute ike centrifugal gbakọọ nke 10.5 RCF ± 1, 3 (oke = 9.2-128). ).(Foto 2a-e).
A tụlere ọtụtụ ụzọ maka pellet TA nkwusioru na sirinji 1.0 ml wee jiri ya tụnyere CentREUSE centrifugation.Mgbe awa 12 nke ndozi ndọda-adabere na ike ndọda, oke sedimenti ruru 0.38 ml ± 0.03 (Foto mgbakwunye S4a,b).Ndobe TA na-adabere na ike ndọda kwekọrọ na ụdị ire ere nke otu nkeji (nke R2 = 0.8582 meziri), na-ebute ọnụ ala dị larịị nke 0.3804 mL (95% oge ntụkwasị obi: 0.3578 ruo 0.4025) (Nkọwa S4c).CentREUSE mepụtara nkezi sedimenti olu nke 0.41 ml ± 0.04 na 3 nkeji, nke yiri uru pụtara 0.38 ml ± 0.03 hụrụ maka sedimentation dabere na ike ndọda na awa 12 (p = 0.14) (Fig. 3a, d, h) .CentREUSE nyere oke kọmpat karịa 0.31 ml ± 0.02 na nkeji 5 ma e jiri ya tụnyere 0.38 ml ± 0.03 hụrụ maka sedimentation dabere na ike ndọda na awa 12 (p = 0.0001) (Fig. 3b, d, h).
Ntụle nke TA pellet density nwetara site na CentREUSE centrifugation na ike ndọda na-adabere na ọkọlọtọ ulo oru centrifugation (A–C).Onyonyo nnọchite anya nke nkwusioru TA agbagoro na sirinji 1.0 ml mgbe nkeji 3 gachara (A), 5 min (B), na 10 min (C) nke ojiji CentREUSE.(D) onyonyo nnọchite anya TA echekwabara mgbe elekere iri na abụọ nke nhazi ike ndọda gachara.(EG) Onyonyo nnọchite anya nke TA precipitated mgbe ọkọlọtọ azụmahịa centrifugation na 10 RCF (E), 20 RCF (F), na 50 RCF (G) maka 5 min.(H) A na-eji CentREUSE (3, 5, na 10 min), nke na-eme ka ike ndọda (12 h), na centrifugation ụlọ ọrụ ọkọlọtọ na 5 min (10, 20, na 50 RCF).Ahịrị ndị ahụ na-anọchi anya ọntụ (ọbara ọbara) ± ọkọlọtọ ọkọlọtọ (ojii).Ntụpọ ahụ na-anọchi anya nkwugharị nọọrọ onwe ya (n = 9 maka ọnọdụ ọ bụla).
CentREUSE rụpụtara ihe dị ka 0.31 ml ± 0.02 mgbe nkeji 5 gachara, nke yiri 0.32 ml ± 0.03 nke a hụrụ na centrifuge azụmahịa ọkọlọtọ na 10 RCF maka nkeji 5 (p = 0.20), ma dịtụ ala karịa ụda pụtara. enwetara na 20 RCF hụrụ na 0.28 ml ± 0.03 maka nkeji 5 (p = 0.03) (Fig. 3b, e, f, h).CentREUSE mepụtara ihe dị ka 0.20 ml ± 0.02 na nkeji 10, nke dị ka kọmpat (p = 0.15) ma e jiri ya tụnyere 0.19 ml ± 0.01 na nkeji 5 na-ahụ maka centrifuge azụmahịa na 50 RCF (Fig 3c, g, h)..
N'ebe a, anyị na-akọwa nhazi, mgbakọ, na nyocha nnwale nke ọnụ ahịa dị oke ọnụ ala, nke a na-ebugharị, nke mmadụ na-arụ ọrụ, centrifuge dabeere na akwụkwọ nke sitere na mkpofu ọgwụgwọ.Nhazi ahụ dabere na centrifuge nke dabere na akwụkwọ (nke a na-akpọ fugue akwụkwọ) nke ndị otu Prakash webatara na 2017 maka ngwa nyocha.Nyere na centrifugation chọrọ n'akụkọ ihe mere eme iji ngwa azụmahịa dị oke ọnụ, nnukwu na ọkụ eletrik dabere, Prakash's centrifuge na-enye ngwọta mara mma maka nsogbu nke enweghị nchebe ịnweta centrifugation na ntọala nwere oke akụ2,4.Kemgbe ahụ, akwụkwọ akụkọ egosila uru bara uru n'ọtụtụ ngwa nyocha dị ala, dị ka njupụta ọbara dabere na njupụta maka ịchọpụta ịba.Otú ọ dị, ruo n'ókè anyị maara, ejibeghị ngwaọrụ centrifuge akwụkwọ dị ọnụ ala dị ọnụ ala maka ebumnuche ọgwụgwọ, ọnọdụ ndị na-achọkarị sedimentation olu.
N'iburu nke a n'uche, ebumnuche CentREUSE bụ ịgbasa ojiji nke centrifugation akwụkwọ na mmemme ọgwụgwọ.Emezuru nke a site n'ime ọtụtụ mgbanwe na nhazi nke mkpughe Prakash.N'ụzọ doro anya, iji mụbaa ogologo nke sirinji ọkọlọtọ 1.0 ml abụọ, CentREUSE nwere diski buru ibu (radius = 123.5 mm) karịa akwụkwọ wringer akwụkwọ Prakash kacha anwale (radius = 85 mm).Na mgbakwunye, iji kwado oke ibu nke sirinji 1.0 ml jupụtara na mmiri mmiri, CentREUSE na-eji kaadiboodu corrugated kama kaadiboodu.Ọnụ, ndị a mgbanwe ekwe centrifugation nke ibu mpịakọta karịa ndị a nwalere na Prakash akwụkwọ Cleaner (ie abụọ 1.0 ml sirinji na capillaries) mgbe ka na-adabere na yiri components: filament na akwụkwọ dabeere ihe onwunwe.N'ụzọ doro anya, a kọwawo ọtụtụ centrifuges ndị ọzọ dị ọnụ ala maka ebumnuche nchọpụta 4,5,6,7,8,9,10.Ndị a na-agụnye spinners, ndị na-akụ salad, ndị na-akụ akwa, na ọkụ aka maka ngwaọrụ ntụgharị5, 6, 7, 8, 9. Otú ọ dị, ọtụtụ n'ime ngwaọrụ ndị a abụghị nke a na-emepụta iji na-edozi mpịakọta ruo 1.0 ml ma mejupụtara ihe ndị na-adịkarị ọnụ karịa ọnụ. na enweghị ike ịnweta karịa ndị ejiri akwụkwọ centrifuges2,4,5,6,7,8,9,10..N'ezie, a na-ahụkarị ihe mpempe akwụkwọ a tụfuru n'ebe niile;dịka ọmụmaatụ, na United States, akwụkwọ na mpempe akwụkwọ na-enweta ihe karịrị 20% nke mkpofu siri ike nke ime obodo, na-enye ebe dị ukwuu, dị ọnụ ala, ma ọ bụ ọbụna n'efu maka ịmepụta centrifuges akwụkwọ.dịka CentREUSE11.Ọzọkwa, tụnyere ọtụtụ ndị ọzọ dị ọnụ ala ngwọta e bipụtara, CentREUSE adịghị achọ pụrụ iche ngwaike (dị ka 3D obibi ngwaike na software, laser ọnwụ ngwaike na software, wdg) ike, na-eme ka ngwaike ọzọ akụ ike..Ndị a nọ na gburugburu 4, 8, 9, 10.
Dị ka ihe akaebe nke uru bara uru nke centrifuge akwụkwọ anyị maka ebumnuche ọgwụgwọ, anyị na-egosipụta nzizi ngwa ngwa na nke a pụrụ ịdabere na ya nke nkwusioru triamcinolone na acetone (TA) maka injection bolus vitreous - ntinye aka dị ọnụ ala maka ọgwụgwọ ogologo oge nke ọrịa anya dị iche iche. ,3.Idozi nsonaazụ ka nkeji 3 gachara ya na CentREUSE tụrụnyere nsonaazụ ka awa iri na abụọ nke nzizi nzizi ndọda gachara.Na mgbakwunye, nsonaazụ CentREUSE mgbe centrifugation gachara maka nkeji 5 na 10 gafere nsonaazụ nke a ga-enweta site na ike ndọda ma yie nke a hụrụ mgbe centrifugation ụlọ ọrụ na-eme na 10 na 50 RCF maka nkeji 5, n'otu n'otu.N'ụzọ doro anya, na ahụmahụ anyị, CentREUSE na-emepụta ihe dị nkọ ma dị nro nke sedimenti-elu karịa ụzọ ndị ọzọ a nwalere;nke a bụ ihe na-achọsi ike ka ọ na-enye ohere maka nleba anya ziri ezi nke dose nke ọgwụ a na-enye, ọ dịkwa mfe iji wepụ ihe dị elu na obere mfu nke urughuru olu.
Nhọrọ nke ngwa a dị ka ihe akaebe nke echiche bụ mkpa na-aga n'ihu iji melite ohere ịnweta steroid intravitreal na-eme ogologo oge na ntọala ndị nwere oke akụ.A na-eji steroid intravitreal eme ihe n'ọtụtụ ebe iji gwọọ ọnọdụ anya dị iche iche, gụnyere ọrịa macular edema na-arịa ọrịa shuga, mmebi macular degeneration nke afọ, occlusion vaskụla retina, uveitis, retinopathy radieshon, na cystic macular edema3,12.N'ime steroid dị maka nchịkwa intravitreal, TA ka bụ nke a na-ejikarị eme ihe n'ụwa niile12.Ọ bụ ezie na nkwadebe na-enweghị TA preservatives (PF-TA) dị (dịka ọmụmaatụ, Triesence [40 mg / mL, Alcon, Fort Worth, USA]), nkwadebe na benzyl mmanya preservatives (dịka, Kenalog-40 [40 mg / mL, Bristol-). Myers Squibb, New York, USA]) na-anọgide na-ewu ewu3,12.Ekwesiri ighota na ndi otu ogwu ndi ozo kwadoro site na US Food and Drug Administration (FDA) maka intramuscular na intraarticular were naanị, ya mere a na-ewere nchịkwa intraocular na-edebanyeghị aha 3, 12.Ọ bụ ezie na ọgwụ intravitreal TA injectable dịgasị iche dabere na ngosipụta na usoro, usoro a na-akọkarị bụ 4.0 mg (ya bụ, olu injection nke 0.1 ml sitere na ngwọta 40 mg / ml), nke na-enyekarị oge ọgwụgwọ ihe dịka ọnwa 3 Mmetụta 1. , 12, 13, 14, 15.
Iji mee ka ọrụ steroid nke intravitreal dị ogologo na ọrịa anya na-adịghị ala ala, nke siri ike ma ọ bụ na-alọghachi, ewebatala ọtụtụ ngwaọrụ steroid na-arụ ọrụ ogologo oge, gụnyere dexamethasone 0.7 mg (Ozurdex, Allergan, Dublin, Ireland), Relax fluoride acetonide 0.59 mg (Retisert). , Bausch na Lomb, Laval, Canada) na fluocinolone acetonide 0.19 mg (Iluvien, Alimera Sciences, Alpharetta, Georgia, USA) 3,12.Agbanyeghị, ngwaọrụ ndị a nwere ọtụtụ ihe ndọghachi azụ.Na United States, a kwadoro ngwaọrụ ọ bụla naanị maka ihe ngosi ole na ole, na-amachi mkpuchi mkpuchi.Na mgbakwunye, ụfọdụ ngwaọrụ chọrọ ntinye ịwa ahụ ma nwee ike ịkpata nsogbu pụrụ iche dị ka mbugharị ngwaọrụ n'ime ụlọ ihu3,12.Tụkwasị na nke a, ngwaọrụ ndị a na-adịchaghị adị ngwa ngwa ma dị oke ọnụ karịa TA3,12;na ọnụ ahịa US ugbu a, Kenalog-40 na-efu ihe dịka $20 kwa 1.0 ml nke nkwusioru, ebe Ozurdex, Retisert, na Iluvien na-akọwa.Ọnụ ụzọ mbata bụ ihe dịka $1400., $20,000 na $9,200 n'otu n'otu.Ọnụ, ihe ndị a na-egbochi ohere ịnweta ngwaọrụ ndị a maka ndị mmadụ nọ na ntọala ejiri akụrụngwa.
Emeela mgbalị ịgbatị mmetụta nke intravitreal TA1,3,16,17 n'ihi ọnụ ala ya dị ala, nkwụghachi ụgwọ n'ụba, yana nnweta dị ukwuu.Nyere ya ala mmiri solubility, TA na-anọgide na anya dị ka ebe nchekwa, ikwe nwayọọ nwayọọ na dịtụ mgbe nile ọgwụ mgbasa, otú mmetụta a na-atụ anya na-adịru ogologo oge na ibu depots1,3.Iji mezuo nke a, e mepụtala ọtụtụ ụzọ iji tinye uche na nkwụsị TA tupu ịgbanye n'ime vitreous.Ọ bụ ezie na a kọwawo ụzọ dabere na ngafe (ntụgharị ike ndọda) nhazi ma ọ bụ microfiltration, ụzọ ndị a na-ewe oge ma na-enye nsonaazụ mgbanwe15,16,17.N'ụzọ megidere nke ahụ, nchọpụta ndị gara aga egosiwo na TA nwere ike ịdị ngwa ngwa na ịdabere na ya (ma si otú a na-eme ogologo oge) site na centrifugation-enyere aka ọdịda1,3.N'ikpeazụ, ịdị mma, ọnụ ala, ogologo oge, na ịdị irè nke centrifugalally TA na-eme ka ntinye aka a bụrụ nhọrọ mara mma maka ndị ọrịa nọ na ntọala ndị nwere oke akụ.Otú ọ dị, enweghị ohere ịnweta centrifugation a pụrụ ịdabere na ya nwere ike ịbụ nnukwu ihe mgbochi iji mejuputa ntinye aka a;Site n'ịkwado okwu a, CentREUSE nwere ike inye aka mee ka ohere ọgwụgwọ steroid dị ogologo oge maka ndị ọrịa na ntọala ndị nwere oke akụ.
Enwere oke ụfọdụ na ọmụmụ ihe anyị, gụnyere ndị metụtara arụrụ ọrụ nke ngwa CentREUSE.Ngwaọrụ ahụ bụ oscillator na-abụghị nke kwụ ọtọ, nke na-adịghị agbanwe agbanwe nke na-adabere na ntinye mmadụ na ya mere enweghị ike ịnye ọnụego ntụgharị ziri ezi na mgbe niile n'oge eji;Ọsọ ntụgharị na-adabere n'ọtụtụ mgbanwe dị iche iche, dị ka mmetụta onye ọrụ na ọkwa nke ngwaọrụ, ihe ndị a kapịrị ọnụ ejiri na mgbakọ akụrụngwa, yana àgwà njikọ ndị a na-agbagharị.Nke a dị iche na akụrụngwa azụmahịa ebe enwere ike itinye ọsọ ntụgharị n'otu oge na nke ọma.Na mgbakwunye, enwere ike ịtụle ọsọ nke CentREUSE nwetara dị ka ọ dị ntakịrị ma e jiri ya tụnyere ọsọ nke ngwaọrụ centrifuge ndị ọzọ nwetara2.Ọ dabara nke ọma, ọsọ (na ike centrifugal metụtara) nke ngwaọrụ anyị mepụtara zuru ezu iji nwalee echiche zuru ezu na ọmụmụ anyị (ya bụ, ntinye TA).Enwere ike ịbawanye ọsọ ntụgharị site n'ịkwalite oke nke diski etiti 2;Enwere ike ime nke a site na iji ihe dị ọkụ (dị ka kaadiboodu dị gịrịgịrị) ma ọ bụrụ na ọ siri ike ijide sirinji abụọ jupụtara na mmiri mmiri.N'ọnọdụ anyị, mkpebi iji ọkọlọtọ ọkọlọtọ "A" slotted cardboard (4.8 mm thick) bụ nke a kpachapụrụ anya, ebe ọ bụ na a na-ahụkarị ihe a na igbe mbupu ya mere a na-achọta ya ngwa ngwa dị ka ihe a na-emegharị.Enwere ike ịbawanye ọsọ ntụgharị site na ibelata radius nke diski etiti 2.Agbanyeghị, radius nke ikpo okwu anyị ejiri ụma mee ka ọ buru ibu ka ọ nabata sirinji 1.0 ml.Ọ bụrụ na onye ọrụ nwere mmasị n'ịkọba ụgbọ mmiri dị mkpụmkpụ, radius nwere ike ibelata-mgbanwe nke na-ebu amụma na-ebute ọsọ ọsọ dị elu (na ikekwe ndị agha centrifugal dị elu).
Na mgbakwunye, anyị enyochabeghị nke ọma mmetụta ike ọgwụgwụ nke onye ọrụ na arụ ọrụ akụrụngwa.N'ụzọ na-akpali mmasị, ọtụtụ ndị òtù anyị nwere ike iji ngwaọrụ ahụ maka nkeji 15 n'enweghị ike ọgwụgwụ pụtara ìhè.Ihe ngwọta maka ike ọgwụgwụ onye ọrụ mgbe achọrọ ogologo centrifuges bụ ịtụgharị ndị ọrụ abụọ ma ọ bụ karịa (ọ bụrụ na ọ ga-ekwe omume).Na mgbakwunye, anyị enyochaghị ịdịte ngwaọrụ ahụ nke ọma, n'otu akụkụ n'ihi na akụkụ nke ngwaọrụ ahụ (dịka kaadiboodu na eriri) nwere ike dochie ngwa ngwa n'obere obere ma ọ bụ na-efu ma ọ bụrụ na ọ na-eyi ma ọ bụ mebie ya.N'ụzọ na-akpali mmasị, n'oge ule pilot anyị, anyị ji otu ngwaọrụ mee ihe karịrị nkeji 200.Mgbe oge a gachara, naanị ihe a na-ahụ anya mana obere akara nke iyi bụ perforation n'akụkụ eriri.
Mgbochi ọzọ nke ọmụmụ ihe anyị bụ na anyị atụleghị oke ma ọ bụ njupụta nke TA echekwabara, nke a na-enweta na ngwaọrụ CentREUSE na ụzọ ndị ọzọ;kama, nkwenye nnwale anyị nke ngwaọrụ a dabere na nha njupụta sedimenti (na ml).na-apụtachaghị ìhè nha nke njupụta.Na mgbakwunye, anyị anwalebeghị CentREUSE Concentrated TA na ndị ọrịa, Otú ọ dị, ebe ọ bụ na ngwaọrụ anyị na-emepụta pellet TA yiri nke a na-emepụta site na iji centrifuge azụmahịa, anyị chere na CentREUSE Concentrated TA ga-adị irè ma dị mma dị ka ejiri na mbụ.na akwụkwọ.akọwara maka ngwaọrụ centrifuge nkịtị1,3.Ọmụmụ ihe ndị ọzọ na-akọwapụta ọnụ ọgụgụ TA nke a na-enye mgbe nchekwa CentREUSE gachara nwere ike inye aka nyochaa uru ngwaọrụ anyị dị na ngwa a.
Dị ka anyị maara, CentREUSE, ngwaọrụ enwere ike ịrụ ngwa ngwa site na mkpofu dị adị, bụ centrifuge mbụ nke mmadụ na-arụ ọrụ, nke a na-ebugharị ebugharị, dị ọnụ ala dị ọnụ ala nke a ga-eji mee ihe na nhazi ọgwụgwọ.Na mgbakwunye na inwe ike centrifuge dịtụ nnukwu mpịakọta, CentREUSE achọghị iji ihe ndị pụrụ iche na ihe owuwu ihe eji atụnyere centrifuges ndị ọzọ dị ọnụ ala ebipụtara.Ngosipụta arụmọrụ nke CentREUSE na mmiri ozuzo TA ngwa ngwa na ntụkwasị obi nwere ike inye aka melite ọnụnọ steroid intravitreal ogologo oge na ndị mmadụ na ntọala nwere oke akụ, nke nwere ike inye aka na-emeso ọnọdụ dị iche iche anya.Na mgbakwunye, uru nke centrifuges anyị nwere ike ibugharị na-ebu amụma ga-eru ebe ndị nwere akụrụngwa dịka nnukwu ụlọ akwụkwọ ahụike na quaternary na mba ndị mepere emepe.N'okpuru ọnọdụ ndị a, nnweta ngwaọrụ centrifuging nwere ike ịga n'ihu na-ejedebe na ụlọ ọgwụ na nyocha nyocha, yana ihe ize ndụ nke imetọ sirinji na mmiri ahụ mmadụ, ngwaahịa anụmanụ na ihe ndị ọzọ dị ize ndụ.Na mgbakwunye, ụlọ nyocha ndị a na-anọkarị ebe dị anya site na nlekọta ndị ọrịa.Nke a, n'aka nke ya, nwere ike bụrụ ihe mgbochi ngwa ngwa maka ndị na-ahụ maka ahụike na-achọ ngwa ngwa ịnweta centrifugation;ibuga CentREUSE nwere ike ije ozi dị ka ụzọ bara uru iji kwado ọgwụgwọ ọgwụgwọ n'ime obere oge na-akpaghasịghị nlekọta onye ọrịa.
Ya mere, iji mee ka ọ dịrị onye ọ bụla mfe ịkwadebe maka ọgwụgwọ ọgwụgwọ nke chọrọ centrifugation, template na ntụziaka maka ịmepụta CentREUSE gụnyere n'akwụkwọ a mepere emepe n'okpuru ngalaba Ozi Mgbakwunye.Anyị na-agba ndị na-agụ akwụkwọ ume ka ha chegharịa CentREUSE ka ọ dị mkpa.
Data na-akwado nsonaazụ ọmụmụ a dị site n'aka onye edemede SM dị iche iche na arịrịọ ezi uche dị na ya.
Ober, MD na Valizhan, S. Ogologo oge ọrụ nke triamcinolone acetone na vitreous na ntinye uche centrifugation.Retina 33, 867–872 (2013).
Bhamla, MS na ndị ọzọ.Akwụkwọ ntuziaka ultra-dị ọnụ ala centrifuge maka akwụkwọ.National Biomedical Science.oru ngo.1, 0009. https://doi.org/10.1038/s41551-016-0009 (2017).
Malinovsky SM na Wasserman JA Centrifugal ntinye uche nke nkwusioru intravitreal nke triamcinolone acetonide: ihe dị ọnụ ala, dị mfe ma dị mfe ọzọ maka nchịkwa steroid ogologo oge.J. Vitrain.diss.5. 15–31 (2021).
Huck, a ga m eche.Ihe nkwụnye centrifuge mepere emepe dị ọnụ ala maka ikewapụta nnukwu nlele ọbara ụlọ ọgwụ.PLOS Otu.17.e0266769.https://doi.org/10.1371/journal.pone.0266769 (2022).
Wong AP, Gupta M., Shevkoplyas SS na Whitesides GM whisk dị ka centrifuge: ikewapụ plasma mmadụ na ọbara dum na ntọala nwere oke akụrụngwa.ụlọ nyocha.mgbawa.8, 2032–2037 (2008).
Brown, J. et al.Akwụkwọ ntuziaka, obere, centrifuge dị ọnụ ala maka nchọpụta anaemia na ntọala nwere oke akụrụngwa.Ee.J. Trope.ọgwụ.mmiri mmiri.85, 327–332 (2011).
Liu, K.-H.chere.A na-ekewa Plasma site na iji spinner.ike.Chemical.91, 1247–1253 (2019).
Michael, I. et al.Spinner maka nyocha ngwa ngwa nke ọrịa urinary tract.National Biomedical Science.oru ngo.4, 591–600 (2020).
Lee, E., Larson, A., Kotari, A., na Prakash, M. Handyfuge-LAMP: centrifugation na-enweghị electrolyte dị ọnụ ala maka nchọpụta isothermal nke SARS-CoV-2 na mmiri.https://doi.org/10.1101/2020.06.30.20143255 (2020).
Lee, S., Jeong, M., Lee, S., Lee, SH, na Choi, J. Mag-spinner: Ọgbọ na-abịa nke adaba, ọnụ ọnụ, mfe na obere (ngwa ngwa) magnetik nkewa nkewa.Nano Ọganihu 4, 792–800 (2022).
Ụlọ ọrụ nchekwa gburugburu US.Ịga n'ihu njikwa ihe eji eme ihe: Akwụkwọ akụkọ 2018 na-enyocha usoro na mmepụta na njikwa ihe na United States.(2020).https://www.epa.gov/sites/default/files/2021-01/documents/2018_ff_fact_sheet_dec_2020_fnl_508.pdf.
Sarao, V., Veritti, D., Boschia, F. na Lanzetta, P. Steroid maka ọgwụgwọ intravitreal nke ọrịa retina.sayensị.Akwụkwọ akụkọ Mir 2014, 1–14 (2014).
Beer, tii ehihie, wdg. Intraocular concentrations na pharmacokinetics nke triamcinolone acetonide mgbe otu intravitreal injection.Ophthalmology 110, 681-686 (2003).
Audren, F. et al.Pharmacokinetic-pharmacodynamic nlereanya nke mmetụta nke triamcinolone acetonide na etiti macular ọkpụrụkpụ na ndị ọrịa nwere ọrịa shuga macular edema.itinye ego.ophthalmology.anya.sayensị.45, 3435–3441 (2004).
Ober, MD et al.A tụrụ dose triamcinolone acetone n'ezie site na usoro ịgba ọgwụ mgbochi intravitreal.Ee.J. Ophthalmol.142, 597–600 (2006).
Chin, HS, Kim, TH, Ọnwa, YS na Oh, JH Concentrated triamcinolone acetonide usoro maka ịgba ọgwụ intravitreal.Retina 25, 1107–1108 (2005).
Tsong, JW, Persaud, TO & Mansour, SE Quantitative analysis of triamcinolone echekwabara maka ntụtụ.Retina 27, 1255–1259 (2007).
A na-akwado SM n'akụkụ ụfọdụ site na onyinye e nyere Mukai Foundation, Massachusetts Eye and Ear Hospital, Boston, Massachusetts, USA.
Ngalaba Ophthalmology, Ụlọ Akwụkwọ Ahụike Harvard, Massachusetts Anya na Ntị, 243 Charles St, Boston, Massachusetts, 02114, USA