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centrifugation ea bongaka e tšepahalang esale e hloka tšebeliso ea lisebelisoa tsa khoebo tse theko e boima, tse ngata, le tse itšetlehileng ka motlakase, tseo hangata li sa fumaneheng maemong a fokolang a lisebelisoa.Leha ho hlalositsoe li-centrifuge tse nkehang habonolo, tse theko e tlaase, tse se nang motor, litharollo tsena li etselitsoe lits'ebetso tsa tlhahlobo tse hlokang hore ho be le meqolo e nyane ea sedimentation.Ho phaella moo, ho qaptjoa ha lisebelisoa tsena hangata ho hloka hore ho sebelisoe lisebelisoa tse khethehileng le lisebelisoa tseo ka tloaelo li sa fumaneheng libakeng tse sa bolokehang.Mona re hlalosa moralo, kopano, le netefatso ea liteko ea CentREUSE, theko e tlase haholo, e sebelisoang ke batho, e nkehang habonolo ea litšila bakeng sa lits'ebetso tsa kalafo.CentREUSE e bonts'a matla a mahareng a centrifugal a matla a 10.5 a amanang le centrifugal (RCF) ± 1.3.Ho emisa 1.0 ml vitreous suspension ea triamcinolone ka mor'a metsotso ea 3 ea centrifugation ho CentREUSE e ne e bapisoa le ka mor'a lihora tse 12 tsa sedimentation ea matla a khoheli (0.41 ml ± 0.04 vs 0.38 ml ± 0.03, p = 0.14).Sediment thickening ka mor'a CentREUSE centrifugation bakeng sa metsotso e 5 le 10 ha e bapisoa le e hlokometsoeng ka mor'a centrifugation ho 10 RCF (0.31 ml ± 0.02 vs. 0.32 ml ± 0.03, p = 0.20) le 50 RCF (0.20 ml) bakeng sa lisebelisoa tse tšoanang tsa ± 5 metsotso e tšoanang 0.02 vs. 0.19 ml ± 0.01, p = 0.15).Lithempleite le litaelo tsa moaho tsa CentREUSE li kenyellelitsoe posong ena ea mohloli o bulehileng.
Centrifugation ke mohato oa bohlokoa litekong tse ngata tsa tlhahlobo le mekhoa ea phekolo1,2,3,4.Leha ho le joalo, ho finyella centrifugation e lekaneng ho 'nile ha hlokahala hore ho sebelisoe lisebelisoa tsa khoebo tse theko e boima, tse ngata, le tse itšetlehileng ka motlakase, tseo hangata li sa fumaneheng ka mokhoa o fokolang oa lisebelisoa2,4.Ka 2017, sehlopha sa Prakash se ile sa hlahisa centrifuge e nyenyane ea pampiri e entsoeng ka pampiri (e bitsoang "puffer ea pampiri") e entsoeng ka thepa e entsoeng esale pele ka theko ea $ 0.20 ($)2.Ho tloha ka nako eo, pampiri ea fugue e 'nile ea sebelisoa maemong a fokolang a lisebelisoa bakeng sa lisebelisoa tsa tlhahlobo ea boemo bo tlaase (mohlala, karohano ea likarolo tsa mali ka har'a li-capillary tubes ho lemoha likokoana-hloko tsa malaria), kahoo e bontša sesebelisoa se nkehang habonolo se sebelisoang ke motho.centrifuge 2 .Ho tloha ka nako eo, lisebelisoa tse ling tse 'maloa tsa compact, tse theko e tlaase, tse se nang motlakase li hlalositsoe 4,5,6,7,8,9,10.Leha ho le joalo, boholo ba litharollo tsena, joalo ka mosi oa pampiri, li etselitsoe merero ea tlhahlobo e hlokang melumo e nyane ea sedimentation mme ka hona e ke ke ea sebelisoa ho kenya lisampole tse kholo.Ho phaella moo, ho bokelloa ha litharollo tsena hangata ho hloka hore ho sebelisoe lisebelisoa tse khethehileng le lisebelisoa tseo hangata li sa fumaneheng libakeng tse sa bolokehang4,5,6,7,8,9,10.
Mona re hlalosa moralo, kopano, le netefatso ea liteko ea centrifuge (e bitsoang CentREUSE) e hahiloeng ka litšila tse tloaelehileng tsa pampiri bakeng sa lits'ebetso tsa kalafo tseo hangata li hlokang melumo e phahameng ea sedimentation.Taba ea 1, 3 E le bopaki ba khopolo, re ile ra leka sesebelisoa ka ho kenella ha 'nete ka mahlo: ho na le pula ea ho emisoa ha triamcinolone ka acetone (TA) bakeng sa ente e latelang ea moriana oa bolus ka har'a 'mele oa vitreous oa leihlo.Le hoja centrifugation bakeng sa mahloriso a TA ke ts'ebetso e amohelehang ea theko e tlaase bakeng sa phekolo ea nako e telele ea maemo a sa tšoaneng a mahlo, tlhokahalo ea li-centrifuges tse fumanehang khoebong nakong ea ho etsoa ha lithethefatsi ke tšitiso e kholo ea tšebeliso ea phekolo ena maemong a fokolang a mehloli1,2, 3.ha e bapisoa le liphetho tse fumanoeng ka li-centrifuges tse tloaelehileng tsa khoebo.Lithempleite le litaelo tsa ho haha ​​CentREUSE li kenyelelitsoe mohloling ona o bulehileng oa poso karolong ea "More Information".
CentREUSE e ka hahuoa hoo e batlang e le ho tsoa ho sekhechana.Ka bobeli likopi tsa template ea semi-circle (Supplementary Figure S1) li ile tsa hatisoa pampiring e tloaelehileng ea tlhaku ea carbon ea US (215.9 mm × 279.4 mm).Li-template tse peli tse khomaretsoeng li hlalosa likarolo tse tharo tsa moralo oa sesebelisoa sa CentREUSE, ho kenyelletsa le (1) moqomo o ka ntle oa 247mm spinning disk, (2) e etselitsoe ho amohela seringe ea 1.0ml (e nang le cap le plunger e khaotsoeng).li-grooves ka shank) le (3) matšoao a mabeli a bontšang moo ho lokelang ho phunngoa masoba e le hore thapo e ka feta har'a disk.
Khomarela (mohlala, ka sekhomaretsi sa merero eohle kapa theipi) thempleite ho boto ea masenke (bonyane boholo: 247 mm × 247 mm) (Figumentary Figure S2a).Boto e tloaelehileng ea "A" (botenya ba 4.8 mm) e ne e sebelisoa thutong ena, empa boto ea masenke ea botenya bo tšoanang e ka sebelisoa, joalo ka boto ea masenke ho tloha mabokoseng a likepe a lahliloeng.U sebelisa sesebelisoa se nchocho (joaloka lehare kapa sekere), seha khateboto lehlakoreng la disc e ka ntle e bontšitsoeng template (Supplementary Figure S2b).Ebe, ho sebelisa sesebelisoa se moqotetsane, se bohale (joalo ka ntlha ea pene), etsa li-perforations tse peli tse teteaneng tse nang le radius ea 8.5 mm ho ea ka matšoao a lateloang template (Supplementary Figure S2c).Li-slots tse peli tsa li-syringe tsa 1.0 ml li khaoloa ho tloha thempleiteng le bokaholimo ba k'hateboto ho sebelisoa sesebelisoa se nchocho joalo ka lehare;tlhokomelo e tlameha ho nkoa e le hore e se ke ea senya lesela le ka tlaase la masenke kapa karolo e setseng ea holim'a metsi (Supplementary Figure S2d, e) .Ebe, thaepa sekotoana sa khoele (mohlala, khoele ea 3mm e phehang k'hothone kapa khoele efe kapa efe e botenya le botenya bo ts'oanang) ka har'a masoba a mabeli, 'me u tlamelle lupi ho potoloha letlapa le ka bang bolelele ba 30cm (Supplementary Fig. S2f).
Tlatsa lisyringe tse peli tsa 1.0 ml ka boholo bo lekanang (mohlala 1.0 ml ea suspension TA) le cap.Molamu oa syringe plunger o ile oa khaoloa boemong ba moqomo (Setšoantšo sa Tlatsetso S2g, h).Joale cylinder flange e koaheloa ka lera la theipi ho thibela ejection ea truncated piston nakong ea tšebeliso ea thepa.Seringe e 'ngoe le e' ngoe ea 1.0 ml e ne e kenngoa ka har'a sering hantle le cap e shebaneng le bohareng ba disc (Supplementary Figure S2i).Ka nako eo seringe e 'ngoe le e' ngoe e ne e khomaretsoe bonyane disc e nang le tepi e khomarelang (Supplementary Figure S2j).Qetellong, tlatsa kopano ea centrifuge ka ho beha lipene tse peli (tse kang lipensela kapa lisebelisoa tse tšoanang tse tiileng tse nang le sebōpeho sa thupa) karolong e 'ngoe le e' ngoe ea khoele ka hare ho lupu (Setšoantšo sa 1).
Litaelo tsa ho sebelisa CentREUSE li tšoana le tsa lintho tsa ho bapala tsa setso.Ho potoloha ho qalisoa ka ho tšoara mofeng letsohong ka leng.Ho fokotseha ho fokolang ha likhoele ho etsa hore disc e fetohele pele kapa morao, e leng se etsang hore disc e fetohele pele kapa morao ka ho latellana.Sena se etsoa ka makhetlo a 'maloa ka mokhoa o liehang, o laoloang e le hore likhoele li kobehe.Ebe o emisa motsamao.Ha likhoele li qala ho phutholoha, mofeng o huloa ka thata ho fihlela likhoele li kokobela, e leng ho etsang hore disc e bilike.Hang ha khoele e se e lokolohile ka ho feletseng 'me e qala ho khutlela morao, molamu o lokela ho phutholoha butle-butle.Ha thapo e qala ho phutholoha hape, sebelisa letoto le ts'oanang la ho sisinyeha ho boloka sesebelisoa se ntse se bilika (video S1).
Bakeng sa lits'ebetso tse hlokang sedimentation ea ho emisoa ka centrifugation, sesebelisoa se ne se ntse se potoloha ho fihlela granulation e khotsofatsang e finyelloa (Supplementary Figure S3a,b).Likaroloana tse rarahaneng li tla theha pheletsong ea seringe 'me matla a phahametseng a tla tsepamisa maikutlo ntlheng ea serinji.Ka mor'a moo, supernatant e ile ea ntšoa ka ho tlosa theipi e koahelang moqomo le ho kenya plunger ea bobeli ho sutumelletsa butle-butle plunger ea matsoalloa ho ea ntlheng ea seringe, e emisa ha e fihla sediment sa motsoako (Supplementary Figure S3c,d).
Ho fumana lebelo la ho potoloha, sesebelisoa sa CentREUSE, se nang le li-syringe tse peli tsa 1.0 ml tse tletseng metsi, se ngotsoe ka k'hamera ea video e potlakileng (liforeimi tsa 240 ka motsotsoana) bakeng sa 1 min ka mor'a hore e fihle boemong bo tsitsitseng ba oscillation.Li-marker tse haufi le moeli oa "spinning disk" li ile tsa lateloa ka letsoho ho sebelisoa tlhahlobo ea foreimi-by-frame ea lirekoto ho fumana palo ea liphetoho ka motsotso (rpm) (Lipalo 2a-d).Pheta n = 10 liteko.Matla a lekanyelitsoeng a centrifugal (RCF) bohareng ba moqomo oa syringe joale a baloa ka mokhoa o latelang:
Tekanyetso ea lebelo la potoloho ka CentREUSE.(A–D) Litšoantšo tse latellanang tse bontšang nako (metsotso: metsotsoana. milliseconds) ho qetela ho potoloha ha sesebelisoa.Metsu e bontša matšoao a morao.(E) RPM quantification sebelisa CentREUSE.Mela e emela moelelo (khubelu) ± kheloha e tloaelehileng (e ntšo).Lintlha li emela liteko tsa motsotso o le mong (n = 10).
Seringe ea 1.0 ml e nang le ho emisoa ha TA bakeng sa ente (40 mg / ml, Amneal Pharmaceuticals, Bridgewater, NJ, USA) e ne e le centrifuged bakeng sa 3, 5 le metsotso ea 10 ho sebelisa CentREUSE.Sedimentation e sebelisang mokhoa ona e ile ea bapisoa le e fihletsoeng ka mor'a centrifugation ho 10, 20, le 50 RCF ho sebelisa rotor ea A-4-62 metsotso e 5 holim'a benchtop centrifuge ea Eppendorf 5810R (Hamburg, Jeremane).Palo ea lipula le eona e bapisitsoe le boholo ba pula e fumanoeng ka lipula tse itšetlehileng ka matla a khoheli ka linako tse fapaneng ho tloha ho metsotso e 0 ho isa ho e 720.Kakaretso ea n = 9 e pheta-pheta e ikemetseng e ile ea etsoa bakeng sa mokhoa o mong le o mong.
Litlhahlobo tsohle tsa lipalo li entsoe ho sebelisoa software ea Prism 9.0 (GraphPad, San Diego, USA).Litekanyetso li hlahisoa e le ± tšitiso e tloaelehileng (SD) ntle le ha ho boletsoe ka tsela e 'ngoe.Mekhoa ea sehlopha e ile ea bapisoa ho sebelisoa tlhahlobo ea t-corrected ea Welch e nang le mehatla e 'meli.Alpha e hlalosoa e le 0.05.Bakeng sa ho theoha ho itšetlehileng ka matla a khoheli, mokhoa o le mong oa ho bola oa exponential o ne o kentsoe ka mokhoa o fokolang oa lisekoere, ho tšoara litekanyetso tsa y bakeng sa boleng bo fanoeng ka x e le ntlha e le 'ngoe.
moo x ke nako ka metsotso.y - bophahamo ba sediment.y0 ke boleng ba y ha x e le lefela.Sehlabeng ke boleng ba y bakeng sa metsotso e sa feleng.K ke tekanyo e tsitsitseng, e hlalosoang e le ho lumellana ha metsotso.
Sesebelisoa sa CentREUSE se bonts'itse li-oscillations tse tšepahalang, tse laoloang tse se nang moeli li sebelisa li-syringe tse peli tse tloaelehileng tsa 1.0 ml tse tlatsitsoeng ka 1.0 ml ea metsi ka 'ngoe (video S1).Ho n = liteko tsa 10 (metsotso e 1 ka 'ngoe), CentREUSE e ne e e-na le lebelo le potolohang la 359.4 rpm ± 21.63 (range = 337-398), e leng se hlahisang matla a lekaneng a centrifugal a 10.5 RCF ± 1, 3 (range = 9.2-12.8. ).(Setšoantšo sa 2a-e).
Ho ile ha hlahlojoa mekhoa e 'maloa ea ho fanyeha ho emisoa ha TA ka li-syringe tsa 1.0 ml mme ha bapisoa le CentREUSE centrifugation.Ka mor'a lihora tsa 12 tsa ho rarolla ho itšetlehile ka matla a khoheli, molumo oa sediment o fihlile 0.38 ml ± 0.03 (Supplementary Fig. S4a,b).Taelo ea TA e itšetlehileng ka matla a khoheli e lumellana le mokhoa o le mong oa ho senyeha ha exponential (o lokisitsoeng ke R2 = 0.8582), ho fella ka sebaka se hakantsoeng sa 0.3804 mL (95% nako ea tšepo: 0.3578 ho 0.4025) (Supplementary Figure S4c).CentREUSE e hlahisitse palo e tloaelehileng ea sediment ea 0.41 ml ± 0.04 ka metsotso e 3, e neng e tšoana le ea boleng ba 0.38 ml ± 0.03 e hlokometsoeng bakeng sa sedimentation e itšetlehileng ka matla a khoheli ka lihora tse 12 (p = 0.14) (Setšoantšo sa 3a, d, h) .CentREUSE e fane ka molumo o hlakileng haholoanyane oa 0.31 ml ± 0.02 metsotsong ea 5 ha e bapisoa le moelelo oa 0.38 ml ± 0.03 o hlokometsoeng bakeng sa sedimentation e thehiloeng ho matla a khoheli ka lihora tsa 12 (p = 0.0001) (Setšoantšo sa 3b, d, h).
Papiso ea TA pellet density e fihlelletsoeng ke CentREUSE centrifugation le matla a khoheli a rarollang khahlano le standard industrial centrifugation (A-C).Lits'oants'o tse emetseng tsa ho emisoa ha TA ka li-syringe tsa 1.0 ml ka mor'a metsotso e 3 (A), 5 min (B), le 10 min (C) ea tšebeliso ea CentREUSE.(D) Litšoantšo tse emetseng tsa TA e behiloeng ka mor'a lihora tse 12 tsa matla a khoheli.(EG) Litšoantšo tse emetseng tsa precipitated TA ka mor'a hore ho be le centrifugation e tloaelehileng ea khoebo ho 10 RCF (E), 20 RCF (F), le 50 RCF (G) bakeng sa 5 min.(H) Bophahamo ba sediment bo ile ba lekanyetsoa ho sebelisoa CentREUSE (3, 5, le 10 min), sedimentation ea matla a khoheli (12 h), le centrifugation e tloaelehileng ea indasteri ka metsotso e 5 (10, 20, le 50 RCF).Mela e emela moelelo (khubelu) ± kheloha e tloaelehileng (e ntšo).Matheba a emela ho pheta-pheta ho ikemetseng (n = 9 bakeng sa boemo bo bong le bo bong).
CentREUSE e hlahisitse palo e lekaneng ea 0.31 ml ± 0.02 ka mor'a metsotso e 5, e ts'oanang le moelelo oa 0.32 ml ± 0.03 o hlokometsoeng ka centrifuge e tloaelehileng ea khoebo ho 10 RCF metsotso e 5 (p = 0.20), 'me e tlaase hanyenyane ho feta tekanyo e tloaelehileng. e fumanoeng ka 20 RCF e ile ea hlokomeloa ho 0,28 ml ± 0.03 bakeng sa metsotso ea 5 (p = 0.03) (setšoantšo sa 3b, e, f, h).CentREUSE e hlahisitse palo e lekaneng ea 0.20 ml ± 0.02 ka metsotso e 10, e neng e lekana (p = 0.15) ha e bapisoa le boholo ba 0.19 ml ± 0.01 ka metsotso e 5 e hlokometsoeng ka centrifuge ea khoebo ho 50 RCF (Setšoantšo sa 3c, g, h)..
Mona re hlalosa moralo, kopano, le netefatso ea liteko ea centrifuge e theko e tlase haholo, e nkehang, e sebelisoang ke motho, e entsoeng ka pampiri e entsoeng ka litšila tse tloaelehileng tsa kalafo.Moralo ona o ipapisitse le centrifuge e thehiloeng pampiring (e bitsoang "fugue ea pampiri") e hlahisitsoeng ke sehlopha sa Prakash ka 2017 bakeng sa lits'ebetso tsa tlhahlobo.Ka lebaka la hore histori ea centrifugation e ne e hloka tšebeliso ea lisebelisoa tsa khoebo tse theko e boima, tse ngata, le tse itšetlehileng ka motlakase, centrifuge ea Prakash e fana ka tharollo e ntle ea bothata ba ho se sireletsehe ho fihlella centrifugation maemong a fokolang a lisebelisoa2,4.Ho tloha ka nako eo, paperfuge e bonts'itse ts'ebeliso e sebetsang lits'ebetsong tse 'maloa tsa tlhahlobo ea boemo bo tlase, joalo ka ho arola mali ka bongata bakeng sa ho lemoha malaria.Leha ho le joalo, ho ea ka tsebo ea rona, lisebelisoa tse tšoanang tsa centrifuge tsa pampiri tse theko e tlaase haholo ha li e-s'o sebelisetsoe merero ea phekolo, maemo ao hangata a hlokang sedimentation e kholoanyane ea molumo.
Ka sena kelellong, sepheo sa CentREUSE ke ho atolosa tšebeliso ea pampiri ea centrifugation mekhoeng ea phekolo.Sena se ile sa finyelloa ka ho etsa liphetoho tse 'maloa moralong oa Prakash senola.Ka ho hlakileng, ho eketsa bolelele ba li-syringe tse peli tse tloaelehileng tsa 1.0 ml, CentREUSE e na le disk e kholoanyane (radius = 123.5 mm) ho feta wringer e kholo ka ho fetisisa ea pampiri ea Prakash e lekiloeng (radius = 85 mm).Ho feta moo, ho tšehetsa boima bo eketsehileng ba syringe ea 1.0 ml e tlatsitsoeng ka mokelikeli, CentREUSE e sebelisa karete ea masenke sebakeng sa khateboto.Hammoho, liphetoho tsena li lumella centrifugation ea meqolo e kholoanyane ho feta e lekiloeng ho Prakash paper cleaner (ke hore li-syringe tse peli tsa 1.0 ml tse nang le li-capillaries) ha li ntse li itšetlehile ka likarolo tse tšoanang: filament le thepa e entsoeng ka pampiri.Haholo-holo, li-centrifuge tse ling tse ngata tse theko e tlaase tse tsamaisoang ke batho li hlalositsoe bakeng sa merero ea ho hlahloba4,5,6,7,8,9,10.Tsena li akarelletsa li-spinners, li-salate beater, li-egg beater, le litoche tsa letsoho bakeng sa lisebelisoa tse bilikang5, 6, 7, 8, 9. Leha ho le joalo, boholo ba lisebelisoa tsena ha lia etsetsoa ho sebetsana le melumo e fihlang ho 1.0 ml ’me li na le thepa eo hangata e bitsang chelete e ngata. le tse sa fihlelleheng ho feta tse sebelisoang pampiring ea centrifuges2,4,5,6,7,8,9,10..Ha e le hantle, hangata thepa ea pampiri e lahliloeng e fumanoa hohle;mohlala, United States, pampiri le liboto tsa pampiri li etsa karolo e fetang 20% ​​ea litšila tse tiileng tsa masepala, tse fanang ka mohloli o mongata, o theko e tlaase, kapa esita le oa mahala bakeng sa li-centrifuge tsa pampiri.mohlala CentREUSE11.Hape, ha ho bapisoa le litharollo tse ling tse ngata tse theko e tlase tse hatisitsoeng, CentREUSE ha e hloke lisebelisoa tse khethehileng (tse kang 3D printing hardware le software, laser cutting hardware le software, joalo-joalo) ho theha, ho etsa hore hardware e be matla haholoanyane..Batho bana ba tikolohong ea 4, 8, 9, 10.
E le bopaki ba molemo o sebetsang oa pampiri ea rona ea centrifuge bakeng sa merero ea phekolo, re bonts'a ho rarolla ka potlako le ho ts'epahala ha triamcinolone ho emisoa ka acetone (TA) bakeng sa ente ea vitreous bolus-e leng mokhoa o thehiloeng oa theko e tlaase bakeng sa phekolo ea nako e telele ea mafu a sa tšoaneng a mahlo. ,3.Ho lokisa liphetho kamora metsotso e 3 le CentREUSE li ne li bapisoa le liphetho kamora lihora tse 12 tsa ho rarolla mathata a khoheli.Ho phaella moo, liphetho tsa CentREUSE ka mor'a hore centrifugation ea metsotso e 5 le 10 e fetise liphello tse neng li tla fumanoa ka matla a khoheli 'me li ne li tšoana le tse hlokometsoeng ka mor'a centrifugation ea indasteri ho 10 le 50 RCF bakeng sa metsotso ea 5, ka ho latellana.Haholo-holo, phihlelong ea rona, CentREUSE e hlahisa sebopeho se hlakileng le se boreleli sa sediment-supernatant ho feta mekhoa e meng e lekiloeng;sena se lakatseha kaha se lumella tlhahlobo e nepahetseng haholoanyane ea lethal dose ea sethethefatsi se tsamaisoang, 'me ho bonolo ho tlosa matla a phahametseng tlhaho ka tahlehelo e fokolang ea molumo oa likaroloana.
Khetho ea kopo ena e le bopaki ba khopolo e ne e khannoa ke tlhokahalo e tsoelang pele ea ho ntlafatsa phihlelo ea nako e telele ea intravitreal steroids maemong a fokolang a mehloli.Li-Intravitreal steroids li sebelisoa haholo ho phekola maemo a sa tšoaneng a mahlo, ho akarelletsa le lefu la tsoekere la macular edema, ho senyeha ha macular ho amanang le lilemo, retinal vascular occlusion, uveitis, radiation retinopathy, le cystic macular edema3,12.Har'a li-steroid tse fumanehang bakeng sa tsamaiso ea intravitreal, TA e ntse e le eona e sebelisoang ka ho fetisisa lefatšeng ka bophara12.Le hoja litokisetso tse se nang TA preservatives (PF-TA) li fumaneha (mohlala, Triesence [40 mg/mL, Alcon, Fort Worth, USA]), litokisetso tse nang le li-preservatives tsa joala tsa benzyl (mohlala, Kenalog-40 [40 mg/mL, Bristol- Myers Squibb, New York, USA]) e ntse e le eona e tsebahalang haholo3,12.Hoa lokela ho hlokomeloa hore sehlopha sa ho qetela sa lithethefatsi se amoheloa ke US Food and Drug Administration (FDA) bakeng sa tšebeliso ea intramuscular le intraarticular feela, kahoo tsamaiso ea intraocular e nkoa e sa ngolisoa 3, 12.Le hoja tekanyo e nang le ente ea intravitreal TA e fapana ho ea ka pontšo le mokhoa, tekanyo e atisang ho tlalehoa ke 4.0 mg (ke hore bophahamo ba ente ea 0.1 ml ho tsoa ho 40 mg / ml tharollo), eo hangata e fanang ka nako ea phekolo ea likhoeli tse ka bang 3. , 12, 13, 14, 15.
Ho lelefatsa ts'ebetso ea intravitreal steroids ho mafu a mahlo a sa foleng, a matla kapa a iphetang khafetsa, ho hlahisitsoe lisebelisoa tse 'maloa tsa nako e telele tse kentsoeng kapa tse nang le ente, ho kenyelletsa dexamethasone 0.7 mg (Ozurdex, Allergan, Dublin, Ireland), Relax fluoride acetonide 0.59 mg (Retisert). , Bausch le Lomb, Laval, Canada) le fluocinolone acetonide 0.19 mg (Iluvien, Alimera Sciences, Alpharetta, Georgia, USA) 3,12.Leha ho le joalo, lisebelisoa tsena li na le litšitiso tse 'maloa tse ka bang teng.United States, sesebelisoa se seng le se seng se amohetsoe feela bakeng sa matšoao a fokolang, ho fokotsa tšireletso ea inshorense.Ho phaella moo, lisebelisoa tse ling li hloka ho kenngoa ha ho buuoa 'me li ka baka mathata a ikhethang a kang ho falla ha lisebelisoa ka kamoreng e ka pele3,12.Ho phaella moo, lisebelisoa tsena li atisa ho fumaneha habonolo ebile li theko e boima haholo ho feta TA3,12;ka litheko tsa hajoale tsa US, Kenalog-40 e bitsa chelete e ka bang $20 ka 1.0 ml ea ho emisoa, ha Ozurdex, Retisert, le Iluvien li ntse li tsoela pele.Tefiso ea ho kena ke $1400., $20,000 le $9,200 ka ho latellana.Ka kopanelo, lintlha tsena li fokotsa phihlello ea lisebelisoa tsena bakeng sa batho ba maemong a haelloang ke lisebelisoa.
Boiteko bo entsoe ho lelefatsa phello ea intravitreal TA1,3,16,17 ka lebaka la theko ea eona e tlaase, puseletso e ngata ea seatla se bulehileng, le ho fumaneha ho hoholo.Ka lebaka la ho qhibiliha ha eona ka metsi a tlaase, TA e lula e le ka leihlong e le depo, e lumellang ho ata ha lithethefatsi butle-butle le ho sa khaotseng, kahoo phello e lebeletsoe hore e tšoarelle nako e telele ka li-depot tse kholoanyane1,3.Ho fihlela sena, ho entsoe mekhoa e mengata ea ho tsepamisa mohopolo ho emisoa ha TA pele ho ente ka har'a vitreous.Le hoja mekhoa e thehiloeng holim'a mokhoa o sa sebetseng (e leng ho itšetlehile ka matla a khoheli) ho rarolla kapa microfiltration e hlalositsoe, mekhoa ena e batla e ja nako 'me e fana ka liphello tse fapaneng15,16,17.Ho fapana le hoo, liphuputso tse fetileng li bonts'itse hore TA e ka tsepamisoa ka potlako le ka mokhoa o ts'eptjoang (mme ka hona ketso ea nako e telele) ka pula e nang le centrifugation-assisted1,3.Qetellong, boiketlo, litšenyehelo tse tlaase, nako, le katleho ea TA e nang le centrifugally concentrated e etsa hore ts'ebetso ena e be khetho e ntle bakeng sa bakuli ba nang le lisebelisoa tse fokolang.Leha ho le joalo, khaello ea phihlello ea centrifugation e ka tšeptjoang e ka ba tšitiso e kholo ea ho kenya ts'ebetsong ts'ebetso ena;Ka ho rarolla bothata bona, CentREUSE e ka thusa ho eketsa boteng ba phekolo ea nako e telele ea steroid bakeng sa bakuli ba maemong a fokolang a lisebelisoa.
Ho na le mefokolo thutong ea rona, ho kenyeletsoa le e amanang le ts'ebetso ea tlhaho ea sesebelisoa sa CentREUSE.Sesebelisoa ke oscillator e sa tsitsang, e sa bolokehang e itšetlehileng ka ho kenya letsoho ha motho 'me ka hona e ke ke ea fana ka tekanyo e nepahetseng le e tsitsitseng ea ho potoloha nakong ea tšebeliso;lebelo la ho potoloha le ipapisitse le mefuta e mengata, joalo ka tšusumetso ea basebelisi boemong ba botho ba sesebelisoa, lisebelisoa tse ikhethileng tse sebelisoang ho bokelleng lisebelisoa, le boleng ba likhokahano tse ohliloeng.Sena se fapane le thepa ea khoebo moo lebelo la ho potoloha le ka sebelisoang ka mokhoa o tsitsitseng le ka nepo.Ho phaella moo, lebelo le fihletsoeng ke CentREUSE le ka nkoa le le bonolo ha le bapisoa le lebelo le fihletsoeng ke lisebelisoa tse ling tsa centrifuge2.Ka lehlohonolo, lebelo (le matla a centrifugal a amanang) a hlahisoang ke sesebelisoa sa rona a ne a lekane ho leka mohopolo o qaqileng thutong ea rona (ke hore, TA deposition).Lebelo la ho potoloha le ka eketsoa ka ho khantša boima ba disk e bohareng 2;sena se ka finyelloa ka ho sebelisa thepa e bobebe (joaloka khateboto e tšesaane) haeba e le matla ho lekana ho tšoara lisyringe tse peli tse tlatsitsoeng ka mokelikeli.Tabeng ea rona, qeto ea ho sebelisa "A" e tloaelehileng ea "A" e slotted cardboard (4.8 mm thick) e ne e entsoe ka boomo, kaha boitsebiso bona bo atisa ho fumanoa ka mabokoseng a ho romela thepa 'me ka hona ho fumanoa habonolo e le thepa e ka sebelisoang hape.Lebelo la ho potoloha le ka boela la eketseha ka ho fokotsa radius ea disk bohareng 2.Leha ho le joalo, sebaka sa sethala sa rona se entsoe ka boomo hore se be seholo ho amohela serinji ea 1.0 ml.Haeba mosebelisi a thahasella likepe tse khuts'oane tsa centrifuging, radius e ka fokotsoa - phetoho e ka lebisang ho lebelo le phahameng la ho potoloha ('me mohlomong le matla a phahameng a centrifugal).
Ho feta moo, ha rea ​​hlahlobisisa ka hloko phello ea mokhathala oa opareitara tšebetsong ea lisebelisoa.Hoa thahasellisa hore ebe litho tse ’maloa tsa sehlopha sa rōna li ile tsa khona ho sebelisa sesebelisoa ka metsotso e 15 ntle le mokhathala o hlokomelehang.Tharollo e ka bang teng bakeng sa mokhathala oa opareitara ha ho hlokahala li-centrifuge tse telele ke ho potoloha basebelisi ba babeli kapa ho feta (ha ho khoneha).Ho phaella moo, ha rea ​​ka ra hlahloba ka ho teba ho tšoarella ha sesebelisoa, ka karolo e itseng hobane likarolo tsa sesebelisoa (tse kang k'hateboto le khoele) li ka nkeloa sebaka habonolo ka litšenyehelo tse fokolang kapa tse se nang letho ha ho ka senyeha kapa ho senyeha.Ho khahlisang, nakong ea tlhahlobo ea rona ea sefofane, re sebelisitse sesebelisoa se le seng ka kakaretso ea metsotso e fetang 200.Ka mor'a nako ena, letšoao le le leng feela le hlokomelehang empa le le lenyenyane la ho roala ke ho phunyeha ka har'a likhoele.
Moeli o mong oa thuto ea rona ke hore ha rea ​​ka ra lekanya ka ho khetheha boima kapa boima ba TA e behiloeng, e ka finyelloang ka sesebelisoa sa CentREUSE le mekhoa e meng;ho e-na le hoo, tlhahlobo ea rona ea liteko ea sesebelisoa sena e ne e itšetlehile ka tekanyo ea sediment density (in ml).tekanyo e sa tobang ya boimana.Ho phaella moo, ha re e-s'o leke CentREUSE Concentrated TA ho bakuli, leha ho le joalo, kaha sesebelisoa sa rona se hlahisitse li-pellets tsa TA tse tšoanang le tse hlahisoang ho sebelisoa centrifuge ea khoebo, re ne re nahana hore CentREUSE Concentrated TA e tla sebetsa hantle ebile e sireletsehile joalokaha e ne e sebelisoa pele.lingoliloeng.e tlalehiloeng bakeng sa lisebelisoa tse tloaelehileng tsa centrifuge1,3.Lithuto tse ling tse lekanyang palo ea 'nete ea TA e tsamaisoang kamora' CentREUSE fortification e ka thusa ho lekola bohlokoa ba sesebelisoa sa rona ts'ebelisong ena.
Ho ea ka tsebo ea rona, CentREUSE, sesebelisoa se ka etsoang habonolo ka litšila tse fumanehang habonolo, ke mochine oa pele oa pampiri o sebelisoang ke motho, o nkehang, o theko e tlaase haholo o ka sebelisoang sebakeng sa phekolo.Ntle le ho khona ho centrifuge meqolo e batlang e le kholo, CentREUSE ha e hloke tšebeliso ea lisebelisoa tse khethehileng le lisebelisoa tsa kaho ha li bapisoa le li-centrifuge tse ling tse theko e tlaase tse hatisitsoeng.Tšebeliso e bonts'itsoeng ea CentREUSE ka pula e potlakileng le e ka tšeptjoang ea TA e ka thusa ho ntlafatsa ho fumaneha ha intravitreal steroid ka nako e telele ho batho ba nang le lisebelisoa tse fokolang, tse ka thusang ho phekola maemo a sa tšoaneng a mahlo.Ho feta moo, melemo ea li-centrifuge tsa rona tse nkehang habobebe tse tsamaisoang ke batho ka mokhoa o sa lebelloang li atolohela libakeng tse nang le lisebelisoa tse ngata joalo ka litsi tse kholo tsa thuto e phahameng le tsa quaternary linaheng tse tsoetseng pele.Tlas'a maemo ana, ho fumaneha ha lisebelisoa tsa centrifuging ho ka 'na ha tsoela pele ho fella feela lilaboratoring tsa bongaka le tsa lipatlisiso, ka kotsi ea ho silafatsa li-syringe ka maro a' mele oa motho, lihlahisoa tsa liphoofolo le lintho tse ling tse kotsi.Ho feta moo, lilaboratori tsena hangata li fumaneha hole le moo ho hlokomeloang bakuli.Sena, le sona, e ka ba tšitiso ea lisebelisoa bakeng sa bafani ba tlhokomelo ea bophelo ba hlokang ho fihlella kapele ho centrifugation;ho tsamaisa CentREUSE ho ka sebetsa e le mokhoa o sebetsang oa ho lokisetsa mehato ea phekolo ka nako e khutšoanyane ntle le ho senya tlhokomelo ea mokuli ka ho teba.
Ka hona, ho nolofalletsa bohle ho itokisetsa mehato ea phekolo e hlokang centrifugation, template le litaelo tsa ho theha CentREUSE li kenyelelitsoe khatisong ena ea mohloli o bulehileng tlas'a karolo ea Boitsebiso bo Eketsehileng.Re khothaletsa babali ho hlophisa bocha CentREUSE ha ho hlokahala.
Lintlha tse tšehetsang liphetho tsa phuputso ena li fumaneha ho tsoa ho sengoli sa SM ka kopo e utloahalang.
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SM e tšehetsoa ka karolo e 'ngoe ke mpho ho Mukai Foundation, Massachusetts Eye and Ear Hospital, Boston, Massachusetts, USA.
Lefapha la Ophthalmology, Sekolo sa Bongaka sa Harvard, Massachusetts Eye and Ear, 243 Charles St, Boston, Massachusetts, 02114, USA