Ua tsaug rau koj tuaj xyuas Nature.com.Koj siv lub browser version nrog kev txhawb nqa CSS tsawg.Rau qhov kev paub zoo tshaj plaws, peb xav kom koj siv qhov browser tshiab (lossis lov tes taw Compatibility Hom hauv Internet Explorer).Tsis tas li ntawd, txhawm rau xyuas kom muaj kev txhawb nqa tsis tu ncua, peb qhia lub vev xaib tsis muaj qauv thiab JavaScript.
Sliders qhia peb kab lus rau ib tus swb.Siv cov nyees khawm rov qab thiab tom ntej kom txav mus los ntawm cov slides, lossis cov khawm tswj swb thaum kawg kom txav mus los ntawm txhua tus swb.
Txhim khu kev kho mob centrifugation muaj keeb kwm xav tau kev siv cov khoom kim heev, loj, thiab cov khoom siv hluav taws xob ua lag luam, uas feem ntau tsis muaj nyob rau hauv cov chaw muaj kev txwv.Txawm hais tias ob peb portable, pheej yig, tsis yog lub cev muaj zog centrifuges tau piav qhia, cov kev daws teeb meem no yog tsim los rau kev kuaj mob uas xav tau me me ntawm cov sedimentation.Tsis tas li ntawd, kev tsim cov khoom siv no feem ntau yuav tsum tau siv cov ntaub ntawv tshwj xeeb thiab cov cuab yeej uas tsis tshua muaj nyob hauv cov chaw tsis muaj kev pab.Ntawm no peb piav qhia txog kev tsim, sib dhos, thiab kev sim ua kom pom tseeb ntawm CentREUSE, tus nqi qis qis, tib neeg ua haujlwm, portable khib nyiab centrifuge rau kev siv kho mob.CentREUSE nthuav tawm qhov nruab nrab centrifugal quab yuam ntawm 10.5 txheeb ze centrifugal force (RCF) ± 1.3.Kev daws teeb meem ntawm 1.0 ml vitreous ncua kev kawm ntawm triamcinolone tom qab 3 feeb ntawm centrifugation hauv CentREUSE yog piv rau tom qab 12 teev ntawm lub ntiajteb txawj nqus-mediated sedimentation (0.41 ml ± 0.04 vs 0.38 ml ± 0.03, p = 0.14).Sediment thickening tom qab CentREUSE centrifugation rau 5 thiab 10 feeb piv rau qhov pom tom qab centrifugation ntawm 10 RCF (0.31 ml ± 0.02 vs. 0.32 ml ± 0.03, p = 0.20) thiab 50 RCF (0.20 ml) coj mus muag khoom siv 5 feeb 0.02 vs. 0.19 ml ± 0.01, p = 0.15).Cov qauv thiab cov lus qhia hauv tsev rau CentREUSE suav nrog hauv qhov qhib qhov chaw tshaj tawm no.
Centrifugation yog ib kauj ruam tseem ceeb hauv ntau qhov kev kuaj mob thiab kev kho mob 1,2,3,4.Txawm li cas los xij, kev ua tiav cov centrifugation tsim nyog muaj keeb kwm xav tau kev siv cov khoom kim heev, loj, thiab cov khoom siv hluav taws xob ua lag luam, uas feem ntau tsis muaj nyob rau hauv cov chaw muaj kev txwv 2,4.Hauv xyoo 2017, Prakash pawg tau qhia txog daim ntawv me me-raws li phau ntawv centrifuge (hu ua "paper puffer") ua los ntawm cov ntaub ntawv prefabricated ntawm tus nqi ntawm $0.20 ($)2.Txij thaum ntawd los, daim ntawv fugue tau raug xa mus rau hauv cov chaw muaj kev txwv rau cov ntawv siv tshuaj ntsuam xyuas tsawg (xws li kev sib cais ntawm cov ntshav hauv cov hlab ntsha capillary txhawm rau txheeb xyuas cov kab mob malaria), yog li ua kom pom cov khoom siv hluav taws xob pheej yig uas siv tib neeg lub zog.centrifugal twj 2.Txij thaum ntawd los, ob peb lwm yam compact, pheej yig, tsis-motorized centrifugation li tau piav qhia 4,5,6,7,8,9,10.Txawm li cas los xij, feem ntau ntawm cov kev daws teeb meem no, zoo li daim ntawv fumes, yog npaj rau kev kuaj mob uas xav tau cov sedimentation me me thiab yog li tsis tuaj yeem siv los centrifuge cov qauv loj.Tsis tas li ntawd, kev sib sau ua ke ntawm cov kev daws teeb meem no feem ntau yuav tsum tau siv cov ntaub ntawv tshwj xeeb thiab cov cuab yeej uas feem ntau tsis muaj nyob rau hauv cov chaw tsis muaj kev pabcuam 4,5,6,7,8,9,10.
Ntawm no peb piav qhia txog kev tsim, sib dhos, thiab kev sim ua kom pom tseeb ntawm lub centrifuge (hu ua CentREUSE) tsim los ntawm cov ntaub ntawv fugue pov tseg rau cov kev siv kho mob uas feem ntau xav tau cov sedimentation ntau.Case 1, 3 Raws li cov ntaub ntawv pov thawj ntawm lub tswv yim, peb tau sim cov cuab yeej nrog kev cuam tshuam ophthalmic tiag tiag: nag lossis daus ntawm kev ncua ntawm triamcinolone hauv acetone (TA) rau tom qab txhaj tshuaj bolus rau hauv lub cev vitreous ntawm lub qhov muag.Txawm hais tias centrifugation rau TA concentration yog ib qho kev lees paub tus nqi qis rau kev kho mob mus sij hawm ntev ntawm ntau lub qhov muag, qhov xav tau rau kev lag luam centrifuges thaum lub sij hawm tsim tshuaj yog ib qho teeb meem loj rau kev siv cov kev kho no hauv cov chaw muaj kev txwv 1,2, 3.piv nrog cov txiaj ntsig tau nrog cov khoom lag luam centrifuges.Cov qauv thiab cov lus qhia rau lub tsev CentREUSE muaj nyob rau hauv qhov qhib qhov chaw tshaj tawm no nyob rau hauv seem "Cov Lus Qhia Ntxiv".
CentREUSE tuaj yeem tsim yuav luag tag nrho los ntawm cov khoom seem.Ob daim ntawv theej ntawm daim duab ib nrab voj voog (Cov Duab Ntxiv S1) tau luam tawm ntawm cov ntawv luam ntawv US carbon (215.9 hli × 279.4 hli).Cov ntawv txuas ob lub voj voog ib ntus txhais tau peb qhov tseem ceeb tsim qauv ntawm CentREUSE ntaus ntawv, suav nrog (1) sab nrauv ntawm 247mm spinning disk, (2) yog tsim los kom haum rau 1.0ml syringe (nrog cap thiab amputated plunger).grooves nyob rau hauv lub shank) thiab (3) ob lub cim qhia qhov twg yuav punch qhov kom cov hlua tuaj yeem hla lub disk.
Adhere (xws li nrog tag nrho cov hom phiaj nplaum los yog daim kab xev) tus qauv rau lub rooj tsavxwm corrugated (qhov tsawg kawg nkaus: 247 mm × 247 mm) (Cov duab ntxiv S2a).Standard "A" corrugated board (4.8 hli tuab) tau siv nyob rau hauv txoj kev tshawb no, tab sis corrugated board ntawm tuab tuab yuav siv tau, xws li corrugated board los ntawm pov tseg shipping thawv.Siv cov cuab yeej ntse (xws li cov hniav lossis txiab), txiav cov duab los qhia rau ntawm ntug ntawm cov disc sab nraud uas tau teev tseg rau ntawm tus qauv (Cov duab ntxiv S2b).Tom qab ntawd, siv cov cuab yeej nqaim, ntse (xws li lub taub ntawm tus cwj mem ballpoint), tsim ob qhov tuab tuab perforations nrog lub vojvoog ntawm 8.5 hli raws li cov cim tau taug qab ntawm tus qauv (Cov duab ntxiv S2c).Ob lub qhov rau 1.0 ml syringes raug txiav los ntawm cov qauv thiab cov txheej txheem saum npoo ntawm cov duab los qhia siv cov cuab yeej taw tes xws li rab chais hniav;Kev saib xyuas yuav tsum tsis txhob ua kom cov txheej txheem corrugated hauv qab lossis cov txheej txheem seem (S2d, e).Tom qab ntawd, xov ib txoj hlua (xws li 3 hli ua cov paj rwb hlua los yog ib qho xov uas zoo sib xws thiab elasticity) los ntawm ob lub qhov thiab khi ib lub voj nyob ib ncig ntawm txhua sab ntawm ib daim disc ntev txog 30cm (Ntxiv Fig. S2f).
Sau ob 1.0 ml syringes nrog kwv yees li qhov sib npaug (piv txwv li 1.0 ml ntawm TA suspension) thiab cap.Tom qab ntawd lub syringe plunger pas nrig raug txiav tawm ntawm theem ntawm flange flange (Ntxiv daim duab S2g, h).Lub tog raj kheej flange yog ces npog nrog ib txheej ntawm daim kab xev los tiv thaiv lub ejection ntawm truncated piston thaum siv cov khoom.Tom qab ntawd txhua 1.0 ml syringe tau muab tso rau hauv lub koob txhaj tshuaj zoo nrog lub hau uas tig mus rau qhov chaw ntawm lub disc (Ntxiv daim duab S2i).Tom qab ntawd txhua lub koob txhaj tshuaj tau txuas rau yam tsawg kawg ntawm lub disc nrog cov nplaum nplaum (Cov Duab Ntxiv S2j).Thaum kawg, ua kom tiav qhov sib dhos ntawm cov centrifuge los ntawm kev tso ob lub cwj mem (xws li xaum lossis cov cuab yeej zoo sib xws zoo li cov nplaum nplaum) ntawm txhua qhov kawg ntawm txoj hlua hauv lub voj (Daim duab 1).
Cov lus qhia rau kev siv CentREUSE zoo ib yam li cov khoom ua si spinning.Kev sib hloov yog pib los ntawm kev tuav ib txhais tes ntawm txhua txhais tes.Lub slack me ntsis hauv cov hlua ua rau lub disc txav mus rau pem hauv ntej los yog rov qab, ua rau lub disc tig mus rau pem hauv ntej los yog rov qab.Qhov no yog ua ob peb zaug hauv ib qho qeeb, tswj kom cov hlua khi tuaj.Ces nres lub zog.Raws li cov hlua pib unwind, tus kov yog rub nyuaj kom txog thaum cov hlua taut, ua rau lub disc tig.Thaum txoj hlua tsis muaj qhov txhab thiab pib rov qab, tus kov yuav tsum tau maj mam so.Raws li txoj hlua pib rov qab ua dua, siv tib cov lus tsa suab kom lub cuab yeej tig (video S1).
Rau cov ntawv thov uas yuav tsum tau muaj kev cuam tshuam ntawm kev ncua los ntawm centrifugation, cov cuab yeej tau hloov mus tas li kom txog thaum ua tiav cov granulation txaus siab (Cov duab ntxiv S3a, b).Complex particles yuav tsim nyob rau hauv lub plunger kawg ntawm lub syringe chim thiab lub supernatant yuav tsom mus rau lub ntsis ntawm lub syringe.Lub supernatant tau muab tshem tawm los ntawm kev tshem cov kab xev npog lub flange flange thiab qhia lub plunger thib ob kom maj mam thawb tus neeg plunger mus rau lub koob txhaj tshuaj, nres thaum nws mus txog qhov sib xyaw ua ke (Cov duab ntxiv S3c, d).
Txhawm rau txiav txim siab qhov kev sib hloov ceev, CentREUSE ntaus ntawv, nruab nrog ob lub 1.0 ml syringes ntim nrog dej, tau kaw nrog lub koob yees duab ceev ceev (240 ntas ib ob) rau 1 min tom qab mus txog lub xeev khov kho ntawm oscillation.Cov cim nyob ze ntawm ntug ntawm cov spinning disk tau taug qab manually siv cov ncej-los-nruab kev tsom xam ntawm cov ntaub ntawv kaw tseg los txiav txim siab tus naj npawb ntawm cov kiv puag ncig ib feeb (rpm) (Daim duab 2a-d).Rov ua dua n = 10 sim.Tus txheeb ze centrifugal quab yuam (RCF) ntawm qhov nruab nrab ntawm lub syringe chim yog xam nrog cov qauv hauv qab no:
Kev sib hloov ceev kom muaj nuj nqis nrog CentREUSE.(A–D) Cov duab sawv cev ua ntu zus qhia lub sijhawm (feeb: vib nas this. milliseconds) kom ua tiav cov cuab yeej tig.Cov xib xub qhia cov cim cim.(E) RPM quantification siv CentREUSE.Cov kab sawv cev qhov nruab nrab (liab) ± tus qauv sib txawv (dub).Cov qhab nia sawv cev rau tus kheej 1-feeb sim (n = 10).
Ib 1.0 ml syringe uas muaj TA ncua kev txhaj tshuaj (40 mg / ml, Amneal Pharmaceuticals, Bridgewater, NJ, USA) tau centrifuged rau 3, 5 thiab 10 feeb siv CentREUSE.Sedimentation siv cov txheej txheem no tau muab piv nrog qhov ua tiav tom qab centrifugation ntawm 10, 20, thiab 50 RCF siv A-4-62 rotor rau 5 min ntawm Eppendorf 5810R benchtop centrifuge (Hamburg, Lub teb chaws Yelemees).Cov nag lossis daus kuj tau muab piv nrog cov nag lossis daus uas tau siv los ntawm lub ntiajteb txawj nqus los ntawm ntau lub sijhawm los ntawm 0 txog 720 feeb.Tag nrho ntawm n = 9 kev rov ua dua tshiab tau ua rau txhua tus txheej txheem.
Txhua qhov kev txheeb cais tau ua tiav siv Prism 9.0 software (GraphPad, San Diego, USA).Cov txiaj ntsig tau nthuav tawm raws li txhais tau tias ± tus qauv sib txawv (SD) tshwj tsis yog sau tseg.Pab pawg txhais tau tias tau muab piv nrog ob-tailed Welch-corrected t-test.Alpha txhais tau tias yog 0.05.Rau lub ntiajteb txawj nqus-dependent subsidence, ib-theem exponential decay qauv tau haum siv tsawg-squares regression, kho dua y qhov tseem ceeb rau ib tug muab x tus nqi raws li ib tug taw tes.
qhov twg x yog lub sijhawm hauv feeb.y - sediment ntim.y0 yog tus nqi ntawm y thaum x yog xoom.Lub toj siab yog tus nqi y rau infinite feeb.K yog tus nqi tas li, qhia raws li qhov sib txuam ntawm feeb.
Cov cuab yeej CentREUSE tau pom kev txhim khu kev qha, tswj tsis tau cov kab hluav taws xob siv ob tus qauv 1.0 ml syringes ntim nrog 1.0 ml dej txhua (video S1).Hauv n = 10 qhov kev sim (1 feeb txhua), CentREUSE muaj qhov nruab nrab kev sib hloov ceev ntawm 359.4 rpm ± 21.63 (ntau = 337-398), uas ua rau xam qhov nruab nrab centrifugal quab yuam ntawm 10.5 RCF ± 1, 3 (ntau = 9.2–12. ).(Daim duab 2a-e).
Ntau txoj hauv kev rau pelleting TA ncua kev kawm ntawv hauv 1.0 ml syringes raug soj ntsuam thiab muab piv nrog CentREUSE centrifugation.Tom qab 12 teev ntawm lub ntiajteb txawj nqus-raws li kev daws teeb meem, cov sediment ntim tau mus txog 0.38 ml ± 0.03 (Ntxiv daim duab S4a,b).Lub ntiajteb txawj nqus-dependent TA deposition yog zoo ib yam nrog ib-theem exponential decay qauv (kho los ntawm R2 = 0.8582), uas ua rau ib qho kev kwv yees ntawm toj siab ntawm 0.3804 mL (95% kev ntseeg siab ncua sij hawm: 0.3578 txog 0.4025) (Ntxiv daim duab S4c).CentREUSE tsim ib qho nruab nrab sediment ntim ntawm 0.41 ml ± 0.04 ntawm 3 feeb, uas zoo ib yam li tus nqi nruab nrab ntawm 0.38 ml ± 0.03 pom rau lub ntiajteb txawj nqus-dependent sedimentation ntawm 12 teev (p = 0.14) (Fig. 3a, d, h) .CentREUSE muab qhov ntim ntau dua ntawm 0.31 ml ± 0.02 ntawm 5 feeb piv rau qhov nruab nrab ntawm 0.38 ml ± 0.03 pom rau kev nqus-raws li sedimentation ntawm 12 teev (p = 0.0001) (Fig. 3b, d, h).
Kev sib piv ntawm TA pellet ntom tau ua tiav los ntawm CentREUSE centrifugation nrog lub ntiajteb txawj nqus sib piv piv rau cov qauv kev lag luam centrifugation (A-C).Cov duab sawv cev ntawm precipitated TA suspensions hauv 1.0 ml syringes tom qab 3 min (A), 5 min (B), thiab 10 min (C) ntawm CentREUSE siv.(D) Cov duab sawv cev ntawm tso TA tom qab 12 teev ntawm lub ntiajteb txawj nqus.(EG) Cov duab sawv cev ntawm precipitated TA tom qab tus qauv coj mus muag centrifugation ntawm 10 RCF (E), 20 RCF (F), thiab 50 RCF (G) rau 5 min.(H) Sediment ntim tau quantified siv CentREUSE (3, 5, thiab 10 min), lub ntiajteb txawj nqus-mediated sedimentation (12 h), thiab standard industrial centrifugation ntawm 5 min (10, 20, thiab 50 RCF).Cov kab sawv cev qhov nruab nrab (liab) ± tus qauv sib txawv (dub).Cov dots sawv cev rau kev rov ua dua tshiab (n = 9 rau txhua yam).
CentREUSE tsim ib lub ntim nruab nrab ntawm 0.31 ml ± 0.02 tom qab 5 feeb, uas zoo ib yam li qhov nruab nrab ntawm 0.32 ml ± 0.03 pom nyob rau hauv tus qauv coj mus muag centrifuge ntawm 10 RCF rau 5 feeb (p = 0.20), thiab me ntsis qis dua qhov nruab nrab ntim. tau nrog 20 RCF tau pom ntawm 0.28 ml ± 0.03 rau 5 feeb (p = 0.03) (Fig. 3b, e, f, h).CentREUSE tsim ib lub ntim nruab nrab ntawm 0.20 ml ± 0.02 ntawm 10 feeb, uas yog ib yam li compact (p = 0.15) piv rau qhov nruab nrab ntim ntawm 0.19 ml ± 0.01 ntawm 5 feeb pom nrog kev lag luam centrifuge ntawm 50 RCF (Fig. 3c, g, h)..
Ntawm no peb piav qhia txog kev tsim, sib dhos, thiab kev sim ua pov thawj ntawm tus nqi qis qis, nqa tau yooj yim, tib neeg ua haujlwm, ntawv-raws li centrifuge ua los ntawm cov khoom siv kho mob pov tseg.Tus qauv tsim yog feem ntau raws li daim ntawv centrifuge (hu ua "paper fugue") qhia los ntawm Prakash pawg hauv 2017 rau kev kuaj mob.Muab hais tias centrifugation muaj keeb kwm xav tau kev siv cov khoom kim heev, loj, thiab cov khoom siv hluav taws xob ua lag luam, Prakash's centrifuge muab cov kev daws teeb meem zoo nkauj rau cov teeb meem ntawm kev nkag mus rau centrifugation tsis ruaj ntseg hauv cov chaw muaj kev txwv 2,4.Txij thaum ntawd los, paperfuge tau pom cov txiaj ntsig siv tau hauv ntau daim ntawv thov kev kuaj mob qis, xws li cov ntshav raws li qhov ntom ntom rau kev kuaj mob malaria.Txawm li cas los xij, rau qhov zoo tshaj plaws ntawm peb txoj kev paub, zoo ib yam li cov ntawv pheej yig tshaj plaws-raws li cov khoom siv centrifuge tsis tau siv los kho cov hom phiaj, cov xwm txheej uas feem ntau xav tau cov ntim loj dua.
Nrog rau qhov no hauv siab, CentREUSE lub hom phiaj yog kom nthuav dav kev siv cov ntawv centrifugation hauv kev kho mob.Qhov no tau ua tiav los ntawm kev ua ntau yam kev hloov kho rau tus tsim ntawm Prakash qhia.Qhov tseem ceeb, txhawm rau ua kom ntev ntawm ob tus qauv 1.0 ml koob txhaj tshuaj, CentREUSE muaj cov disk loj dua (voj vojvoog = 123.5 hli) dua li qhov loj tshaj plaws Prakash ntawv wringer kuaj (voj = 85 mm).Tsis tas li ntawd, txhawm rau txhawb nqa qhov hnyav ntxiv ntawm 1.0 ml syringe uas muaj cov kua dej, CentREUSE siv corrugated cardboard es tsis txhob cardboard.Ua ke, cov kev hloov kho no tso cai rau centrifugation ntawm cov ntim loj dua li cov kev sim hauv Prakash daim ntawv ntxuav (piv txwv li ob lub 1.0 ml syringes nrog capillaries) thaum tseem cia siab rau cov khoom zoo sib xws: filament thiab ntawv-raws li cov ntaub ntawv.Tshwj xeeb, ob peb lwm yam pheej yig tib neeg-powered centrifuges tau piav qhia rau kev kuaj mob 4,5,6,7,8,9,10.Cov no muaj xws li spinners, zaub xam lav beaters, qe beaters, thiab tes torches rau rotating devices5, 6, 7, 8, 9. Txawm li cas los xij, feem ntau ntawm cov khoom siv no tsis yog tsim los tuav ntim txog li 1.0 ml thiab muaj cov khoom siv uas feem ntau kim dua. thiab siv tsis tau ntau dua li cov ntawv siv centrifuges2,4,5,6,7,8,9,10..Qhov tseeb, cov ntaub ntawv pov tseg feem ntau pom nyob txhua qhov chaw;Piv txwv li, nyob rau hauv lub tebchaws United States, daim ntawv thiab cov ntawv sau nyiaj rau ntau tshaj 20% ntawm cov khoom pov tseg hauv nroog, muab ntau, pheej yig, lossis txawm tias dawb los tsim cov ntawv centrifuges.eg CentREUSE11.Tsis tas li ntawd, piv rau ntau lwm yam kev daws teeb meem uas tsis tshua muaj nqi luam tawm, CentREUSE tsis tas yuav tsum muaj cov cuab yeej tshwj xeeb (xws li 3D luam ntawv kho vajtse thiab software, laser txiav hardware thiab software, thiab lwm yam) los tsim, ua rau cov khoom siv ntau dua..Cov neeg no nyob ib puag ncig 4, 8, 9, 10.
Raws li cov ntaub ntawv pov thawj ntawm qhov muaj txiaj ntsig zoo ntawm peb cov ntawv centrifuge rau kev kho mob lub hom phiaj, peb ua kom pom qhov ceev thiab txhim khu kev qha ntawm triamcinolone ncua kev kawm ntawv hauv acetone (TA) rau kev txhaj tshuaj vitreous bolus - tsim kev cuam tshuam tus nqi qis rau kev kho mob mus sij hawm ntev ntawm ntau yam kab mob ocular1 ,3.Kev daws cov txiaj ntsig tom qab 3 feeb nrog CentREUSE tau muab piv rau cov txiaj ntsig tom qab 12 teev ntawm lub ntiajteb txawj nqus-mediated settling.Tsis tas li ntawd, CentREUSE tau txais txiaj ntsig tom qab centrifugation rau 5 thiab 10 feeb tshaj cov txiaj ntsig uas yuav tau txais los ntawm lub ntiajteb txawj nqus thiab zoo ib yam li cov tau pom tom qab kev lag luam centrifugation ntawm 10 thiab 50 RCF rau 5 feeb, feem.Qhov tseem ceeb, hauv peb qhov kev paub dhau los, CentREUSE ua rau lub ntsej muag ntse thiab smoother sediment-supernatant interface dua li lwm txoj kev sim;Qhov no yog qhov tsim nyog raws li nws tso cai rau kev ntsuam xyuas ntau dua ntawm cov tshuaj siv tshuaj, thiab nws yooj yim dua kom tshem tawm cov supernatant nrog tsawg tsawg ntawm cov khoom ntim.
Qhov kev xaiv ntawm daim ntawv thov no ua pov thawj ntawm lub tswv yim tau tsav los ntawm qhov kev xav tau txuas ntxiv los txhim kho kev nkag mus rau ntev-ua yeeb yam intravitreal steroids hauv cov chaw muaj kev txwv.Intravitreal steroids tau siv dav los kho ntau yam ntawm qhov muag, suav nrog mob ntshav qab zib macular edema, muaj hnub nyoog ntsig txog macular degeneration, retinal vascular occlusion, uveitis, hluav taws xob retinopathy, thiab cystic macular edema3,12.Ntawm cov tshuaj steroids muaj rau kev tswj hwm intravitreal, TA tseem siv ntau tshaj plaws thoob ntiaj teb12.Txawm hais tias kev npaj tsis muaj TA preservatives (PF-TA) muaj (piv txwv li, Triesence [40 mg/mL, Alcon, Fort Worth, USA]), kev npaj nrog benzyl cawv preservatives (xws li, Kenalog-40 [40 mg/mL, Bristol- Myers Squibb, New York, USA]) tseem yog qhov nrov tshaj plaws3,12.Nws yuav tsum raug sau tseg tias cov tshuaj tom kawg tau pom zoo los ntawm US Food and Drug Administration (FDA) rau kev siv tshuaj intramuscular thiab intraarticular nkaus xwb, yog li kev tswj hwm intraocular raug suav tias tsis tau sau npe 3, 12.Txawm hais tias qhov koob tshuaj ntawm intravitreal TA sib txawv raws li kev qhia thiab cov txheej txheem, feem ntau tshaj tawm koob tshuaj yog 4.0 mg (xws li txhaj tshuaj ntim ntawm 0.1 ml los ntawm 40 mg / ml), uas feem ntau muab kev kho mob ntev li ntawm 3 lub hlis 1. , 12, 13, 14, 15.
Txhawm rau ncua qhov kev txiav txim ntawm intravitreal steroids nyob rau hauv cov mob ntev, mob hnyav lossis rov tshwm sim qhov muag, ntau qhov kev ua haujlwm ntev los yog txhaj tshuaj steroid cov cuab yeej tau qhia, suav nrog dexamethasone 0.7 mg (Ozurdex, Allergan, Dublin, Ireland), So fluoride acetonide 0.59 mg (Retisert , Bausch and Lomb, Laval, Canada) thiab fluocinolone acetonide 0.19 mg (Iluvien, Alimera Sciences, Alpharetta, Georgia, USA) 3,12.Txawm li cas los xij, cov khoom siv no muaj ob peb qhov tsis zoo.Hauv Tebchaws Meskas, txhua lub cuab yeej tsuas yog pom zoo rau qee qhov qhia, txwv kev pov hwm kev pov hwm.Tsis tas li ntawd, qee cov khoom siv yuav tsum tau muab kev phais thiab yuav ua rau muaj teeb meem tshwj xeeb xws li kev tsiv teb tsaws chaw mus rau hauv lub anterior chamber3,12.Tsis tas li ntawd, cov khoom siv no zoo li tsis tshua muaj khoom siv thiab kim dua TA3,12;ntawm tus nqi tam sim no hauv Teb Chaws Asmeskas, Kenalog-40 raug nqi txog $ 20 ib 1.0 ml ntawm kev ncua, thaum Ozurdex, Retisert, thiab Iluvien explants.Tus nqi nkag yog txog $1400., $20,000 thiab $9,200 feem.Ua ke, cov xwm txheej no txwv kev nkag mus rau cov cuab yeej no rau tib neeg hauv cov chaw muaj kev txwv.
Kev sim tau ua kom ncua ntev ntawm cov txiaj ntsig ntawm intravitreal TA1,3,16,17 vim nws cov nqi qis dua, kev them nyiaj rov qab ntau dua, thiab muaj ntau dua.Muab nws cov dej solubility tsawg, TA tseem nyob rau hauv lub qhov muag raws li ib tug depot, tso cai rau maj mam thiab kuj cov tshuaj diffusion, yog li ntawd cov nyhuv yuav tsum kav ntev dua nrog loj depots1,3.Txog qhov kawg no, ntau txoj hauv kev tau tsim los ua kom pom tseeb TA ncua kev kawm ua ntej txhaj tshuaj rau hauv vitreous.Txawm hais tias cov txheej txheem raws li kev ua haujlwm tsis zoo (xws li lub ntiajteb txawj nqus nyob ntawm) tau piav qhia los yog microfiltration, cov txheej txheem no siv sijhawm ntev thiab muab cov txiaj ntsig sib txawv15,16,17.Ntawm qhov tsis sib xws, cov kev tshawb fawb yav dhau los tau pom tias TA tuaj yeem ua kom muaj zog sai thiab ntseeg tau (thiab yog li ua haujlwm ntev) los ntawm centrifugation-pab nag lossis daus 1,3.Hauv kev xaus, qhov yooj yim, tus nqi qis, lub sijhawm, thiab kev ua tau zoo ntawm centrifugally concentrated TA ua rau qhov kev cuam tshuam no yog qhov kev xaiv txaus nyiam rau cov neeg mob hauv cov chaw muaj kev txwv.Txawm li cas los xij, tsis muaj kev nkag tau mus rau kev txhim khu kev qha centrifugation tuaj yeem yog qhov cuam tshuam loj rau kev siv qhov kev cuam tshuam no;Los ntawm kev hais txog qhov teeb meem no, CentREUSE tuaj yeem pab ua kom muaj kev kho mob ntev ntev rau cov neeg mob hauv cov chaw muaj kev txwv.
Muaj qee qhov kev txwv hauv peb txoj kev tshawb fawb, suav nrog cov cuam tshuam txog kev ua haujlwm ib txwm muaj rau CentREUSE cov khoom siv.Cov cuab yeej yog non-linear, tsis-conservative oscillator uas tso siab rau tib neeg cov tswv yim thiab yog li tsis tuaj yeem muab qhov tseeb thiab qhov kev sib hloov tas li thaum siv;Kev sib hloov ceev yog nyob ntawm ntau qhov sib txawv, xws li cov neeg siv cuam tshuam rau qib ntawm cov tswv cuab ntawm cov cuab yeej, cov khoom siv tshwj xeeb siv hauv kev sib dhos ntawm cov khoom siv, thiab qhov zoo ntawm cov kev sib txuas tau spun.Qhov no txawv ntawm cov cuab yeej ua lag luam uas qhov kev sib hloov ceev tuaj yeem siv tau zoo thiab raug.Tsis tas li ntawd, qhov ceev tau ua tiav los ntawm CentREUSE tuaj yeem suav tias yog qhov qis dua piv rau qhov nrawm ua tiav los ntawm lwm cov khoom siv centrifuge2.Hmoov zoo, qhov ceev (thiab cuam tshuam centrifugal quab yuam) tsim los ntawm peb lub cuab yeej tau txaus los ntsuas lub tswv yim ntxaws hauv peb txoj kev tshawb fawb (piv txwv li, TA deposition).Kev sib hloov ceev tuaj yeem nce los ntawm kev ua kom pom qhov loj ntawm lub hauv paus disk 2;Qhov no tuaj yeem ua tiav los ntawm kev siv cov khoom sib zog (xws li cov duab los qhia nyias) yog tias nws muaj zog txaus los tuav ob lub koob txhaj tshuaj uas muaj kua.Hauv peb cov ntaub ntawv, kev txiav txim siab siv tus qauv "A" slotted cardboard (4.8 mm tuab) yog txhob txwm tshaj tawm, vim tias cov khoom no feem ntau pom hauv cov thawv xa khoom thiab yog li pom tau yooj yim raws li cov khoom siv rov ua dua tshiab.Kev sib hloov ceev kuj tuaj yeem nce ntxiv los ntawm kev txo lub vojvoog ntawm lub hauv paus disk 2 .Txawm li cas los xij, lub vojvoog ntawm peb lub platform tau txhob txwm ua kom loj kom haum rau 1.0 ml syringe.Yog tias tus neeg siv txaus siab rau centrifuging cov hlab ntsha luv, lub vojvoog tuaj yeem raug txo qis - qhov kev hloov pauv uas kwv yees ua rau muaj kev sib hloov ceev dua (thiab tej zaum yuav siab dua centrifugal rog).
Tsis tas li ntawd, peb tsis tau ua tib zoo ntsuas qhov cuam tshuam ntawm tus neeg teb xov tooj qaug zog ntawm cov khoom siv ua haujlwm.Qhov zoo siab, ntau tus tswv cuab ntawm peb pab pawg tau siv lub cuab yeej rau 15 feeb yam tsis muaj kev qaug zog.Ib qho kev daws teeb meem rau cov neeg ua haujlwm qaug zog thaum xav tau centrifuges ntev dua yog tig ob lossis ntau tus neeg siv (yog tias ua tau).Tsis tas li ntawd, peb tsis tau ntsuas qhov ua tau zoo ntawm lub cuab yeej, vim tias cov khoom siv ntawm cov khoom siv (xws li cov duab los qhia thiab cov hlua) tuaj yeem hloov tau yooj yim ntawm me me lossis tsis muaj nqi thaum hnav lossis puas.Qhov zoo siab, thaum peb sim sim, peb siv ib lub cuab yeej rau tag nrho ntau dua 200 feeb.Tom qab lub sijhawm no, tsuas yog pom tau tab sis me me ntawm kev hnav yog perforation raws cov xov.
Lwm qhov kev txwv ntawm peb txoj kev tshawb fawb yog tias peb tsis tau ntsuas qhov loj lossis qhov ceev ntawm qhov tso TA, ua tiav nrog CentREUSE ntaus ntawv thiab lwm txoj hauv kev;Hloov chaw, peb qhov kev sim tshuaj ntsuam xyuas ntawm cov cuab yeej no yog ua raws li kev ntsuas ntawm sediment ceev (hauv ml).indirect ntsuas qhov ntom.Tsis tas li ntawd, peb tsis tau sim CentREUSE Concentrated TA rau cov neeg mob, txawm li cas los xij, txij li thaum peb lub cuab yeej tsim cov TA pellets zoo ib yam li cov khoom siv ua lag luam centrifuge, peb xav tias CentREUSE Concentrated TA yuav ua tau zoo thiab muaj kev nyab xeeb zoo li yav dhau los siv.hauv ntawv.Tshaj tawm rau cov khoom siv centrifuge pa 1,3.Cov kev tshawb fawb ntxiv uas txheeb xyuas qhov tseeb ntawm TA tswj hwm tom qab CentREUSE fortification tuaj yeem pab ntsuas ntxiv qhov txiaj ntsig ntawm peb lub cuab yeej hauv daim ntawv thov no.
Rau peb txoj kev paub, CentREUSE, ib qho khoom siv uas tuaj yeem tsim tau yooj yim los ntawm cov khoom pov tseg yooj yim, yog thawj tus tib neeg-powered, portable, ultra-qis-nqi ntawv centrifuge siv rau hauv qhov chaw kho mob.Ntxiv nrog rau qhov muaj peev xwm centrifuge cov ntim loj, CentREUSE tsis tas yuav siv cov khoom tshwj xeeb thiab cov cuab yeej tsim kho piv rau lwm cov centrifuges uas tsis muaj nqi luam tawm.Qhov kev ua tau zoo ntawm CentREUSE hauv TA nag lossis daus ceev thiab txhim khu kev qha tuaj yeem pab txhim kho kev muaj peev xwm mus ntev intravitreal steroid nyob rau hauv cov neeg hauv cov chaw muaj kev txwv, uas yuav pab kho ntau yam ntawm qhov muag.Tsis tas li ntawd, cov txiaj ntsig ntawm peb cov centrifuges portable human-powered centrifuges tau kwv yees mus rau qhov chaw muaj peev xwm nplua nuj xws li loj tertiary thiab quaternary chaw kho mob hauv cov teb chaws tsim.Raws li cov xwm txheej no, qhov muaj cov khoom siv centrifuging tuaj yeem txuas ntxiv rau cov chaw kuaj mob thiab tshawb fawb, nrog rau kev pheej hmoo ntawm cov kab mob sib kis nrog tib neeg lub cev cov kua dej, cov khoom tsiaj, thiab lwm yam khoom siv phom sij.Tsis tas li ntawd, cov chaw kuaj mob no feem ntau nyob deb ntawm qhov chaw saib xyuas cov neeg mob.Qhov no, nyob rau hauv lem, yuav ua tau ib tug logistical teeb meem rau cov kws kho mob uas xav tau ceev mus rau centrifugation;Kev xa tawm CentREUSE tuaj yeem ua txoj hauv kev los npaj cov kev pabcuam khomob hauv lub sijhawm luv luv yam tsis muaj kev cuam tshuam loj rau kev saib xyuas neeg mob.
Yog li ntawd, txhawm rau ua kom yooj yim rau txhua tus los npaj rau kev kho mob uas yuav tsum tau muaj centrifugation, cov qauv thiab cov lus qhia rau kev tsim CentREUSE suav nrog hauv qhov qhib qhov chaw tshaj tawm nyob rau hauv Cov Lus Qhia Ntxiv.Peb txhawb cov neeg nyeem kom rov tsim CentREUSE raws li xav tau.
Cov ntaub ntawv txhawb nqa cov txiaj ntsig ntawm txoj kev tshawb fawb no muaj los ntawm tus kws sau ntawv SM raws li kev thov tsim nyog.
Ober, MD thiab Valizhan, S. Lub sijhawm ua haujlwm ntawm triamcinolone acetone hauv vitreous ntawm centrifugation concentration.Retina 33, 867–872 (2013).
Bhamla, MS thiab lwm yam.Phau ntawv ultra-cheap centrifuge rau ntawv.National Biomedical Science.qhov project.1, 0009. https://doi.org/10.1038/s41551-016-0009 (2017).
Malinovsky SM thiab Wasserman JA Centrifugal concentration ntawm ib qho intravitreal ncua kev kawm ntawv ntawm triamcinolone acetonide: ib qho pheej yig, yooj yim thiab ua tau lwm txoj rau kev tswj hwm steroid mus sij hawm ntev.J. Vitrain.diss.5. 15–31 (2021).
Huck, kuv mam tos.Pheej yig qhib qhov chaw centrifuge adapter rau cais cov ntshav kuaj ntshav loj.PLOS Ib.17 e0266769.https://doi.org/10.1371/journal.pone.0266769 (2022).
Wong AP, Gupta M., Shevkoplyas SS thiab Whitesides GM Lub nplawm yog zoo li lub centrifuge: cais tib neeg cov ntshav los ntawm tag nrho cov ntshav hauv cov chaw muaj kev txwv.chav kuaj.nti.8, 2032–2037 (2008).
Brown, J. et al.Phau ntawv, portable, tus nqi qis centrifuge rau kev kuaj mob ntshav qab zib hauv cov chaw muaj kev txwv.Yog lawm.J. Trope.tshuaj kho mob.ya raws.85, 327–332 (2011).
Liu, K.-H.tos.Plasma raug cais los ntawm kev siv lub spinner.qhov quav.Tshuaj.91, 1247–1253 (2019).
Michael, I. et al.Spinner rau kev kuaj mob tam sim ntawm cov kab mob urinary ib ntsuj av.National Biomedical Science.qhov project.4, 591–600 (2020).
Lee, E., Larson, A., Kotari, A., and Prakash, M. Handyfuge-LAMP: Pheej yig electrolyte-free centrifugation for isothermal detection of SARS-CoV-2 in salva.https://doi.org/10.1101/2020.06.30.20143255 (2020).
Lee, S., Jeong, M., Lee, S., Lee, SH, thiab Choi, J. Mag-spinner: Cov tiam tom ntej ntawm kev yooj yim, pheej yig, yooj yim thiab portable (FAST) sib nqus sib nqus tshuab.Nano Advances 4, 792–800 (2022).
US Environmental Protection Agency.Advancing Sustainable Materials Management: Daim ntawv qhia tseeb 2018 txheeb xyuas cov ncauj lus hauv kev tsim khoom thiab kev tswj hwm hauv Tebchaws Meskas.(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. thiab Lanzetta, P. Steroids rau intravitreal kev kho mob ntawm retinal kab mob.kev kawm.Phau ntawv Journal Mir 2014, 1–14 (2014).
Npias, yav tav su tshuaj yej, thiab lwm yam. Intraocular concentrations thiab pharmacokinetics ntawm triamcinolone acetonide tom qab txhaj ib zaug intravitreal.Ophthalmology 110, 681–686 (2003).
Audren, F. et al.Pharmacokinetic-pharmacodynamic qauv ntawm cov nyhuv ntawm triamcinolone acetonide ntawm central macular thickness hauv cov neeg mob ntshav qab zib macular edema.nqis peev.ophthalmology.pom.kev kawm.45, 3435–3441 (2004).
Ober, MD et al.Qhov koob tshuaj tiag tiag ntawm triamcinolone acetone tau ntsuas los ntawm txoj kev niaj hnub ntawm kev txhaj tshuaj intravitreal.Yog lawm.J. Ophthalmol.142, 597–600 (2006).
Chin, HS, Kim, TH, Moon, YS and Oh, JH Concentrated triamcinolone acetonide method for intravitreal injection.Retina 25, 1107–1108 (2005).
Tsong, JW, Persaud, TO & Mansour, SE Quantitative analysis of deposited triamcinolone for injection.Retina 27, 1255–1259 (2007).
SM tau txais kev txhawb nqa los ntawm ib qho khoom plig rau Mukai Foundation, Massachusetts Qhov Muag thiab Pob Ntseg Tsev Kho Mob, Boston, Massachusetts, USA.
Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles St, Boston, Massachusetts, 02114, USA