CN108283509A - A kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture - Google Patents

A kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture Download PDF

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Publication number
CN108283509A
CN108283509A CN201810012859.2A CN201810012859A CN108283509A CN 108283509 A CN108283509 A CN 108283509A CN 201810012859 A CN201810012859 A CN 201810012859A CN 108283509 A CN108283509 A CN 108283509A
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CN
China
Prior art keywords
strut
fixing sleeve
minimally invasive
extension fixture
invasive surgery
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN201810012859.2A
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Chinese (zh)
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CN108283509B (en
Inventor
张艳梅
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Shandong Institute of Cancer Prevention and Treatment
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张艳梅
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Publication date
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Priority to CN201810012859.2A priority Critical patent/CN108283509B/en
Publication of CN108283509A publication Critical patent/CN108283509A/en
Application granted granted Critical
Publication of CN108283509B publication Critical patent/CN108283509B/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • A61B2017/0256Joint distractors for the spine

Abstract

The invention discloses a kind of orthopaedics Minimally Invasive Surgeries to adjust extension fixture, including fixing sleeve, first evacuation chamber, fixing axle, supporting plate, first spring, strut, limit touch panel, second evacuation chamber, pressing plate, second spring, capping, adjusting screw rod, blanket gas washer, regulating valve, air injection pipe, syringe, a kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture, clever structure, it is powerful, pass through rotary expansion and the mutually matched effect of supporting mechanism, it can be while facilitating medical staff to operate, also reach very well and corrective surgery position is strutted, expand visual area space, finally bring great convenience to subsequent surgical procedure, utilize clinical popularization and application.

Description

A kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture
Technical field
The present invention relates to equipment technology fields more particularly to a kind of orthopaedics Minimally Invasive Surgery to adjust extension fixture.
Background technology
Neck and shoulder ache, pain in waist and lower extremities are symptoms common in clinic, and most of is caused by spinal disease, and part severe patient needs to perform the operation Treatment.Since backbone is the important physiological structure of human body, minimally invasive or non-invasive therapy has become spinal surgery doctor pursuit Ideal state.Minimally invasive spine surgical achieves fast development in terms for the treatment of spinal disease, but since spinal anatomy is multiple Miscellaneous and individual there are certain specificity, surgical procedure, which will accurately reach lesion region, has larger difficulty, therefore vertebral column minimally invasive Operation has certain risk and limitation.
According to above-mentioned, in Present clinical operation, need effectively to expand operative site visual area, that is, reach raising hand Art operates purpose, but traditional expander at present, and common configuration is simple, has a single function, and has the following disadvantages, and 1, because of existing expansion Device is mostly hard drawing expansion structure, is easy to generate damage to patient's wound tissue in process of expansion, improves patient's hand The risk of art, 2, can not by simple rotation process to operative site carry out well expansion support, reduce visual area space, Strong influence finally is brought to subsequent surgical procedure, is unfavorable for clinical popularization and application, in view of disadvantages described above, it is really necessary to Design a kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture.
Invention content
Technical problem to be solved by the present invention lies in:A kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture is provided, to solve The problem of background technology proposes.
In order to solve the above technical problems, the technical scheme is that:A kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture, packet Include fixing sleeve, the first evacuation chamber, fixing axle, supporting plate, the first spring, strut, limit touch panel, the second evacuation chamber, pressing plate, the second bullet Spring, capping, adjusting screw rod, blanket gas washer, regulating valve, air injection pipe, syringe, the described first evacuation chamber are located in fixing sleeve Subordinate end, the described first evacuation chamber is hollow cavity, and the fixing axle is described at left and right sides of fixing sleeve interior lower end Fixing axle be connected with fixing sleeve close-fitting, the supporting plate is rotatedly connected through fixing axle, the supporting plate with fixing axle, institute For the first spring stated between supporting plate and fixing sleeve inner wall, first spring welds phase with supporting plate and fixing sleeve respectively Even, the strut is located at fixing sleeve interior lower end, and the strut is connected with fixing sleeve sliding, and the strut is column Shape, the limit touch panel are located at left and right sides of strut middle-end, and the limit touch panel is integrally connected with strut, and described second Evacuation chamber is located at fixing sleeve inner upper end, and the described second evacuation chamber is circular groove, and the pressing plate is located at the top of strut, institute The pressing plate stated is connected with strut screw thread, and the second spring is welded through strut upper end, the second spring with pressing plate It is connected, the capping is located at fixing sleeve outer wall upper end, and the capping is connected with fixed external threading, and the adjusting screw rod passes through The internal middle-end of capping is worn, the adjusting screw rod is connected with closure threads, and the blanket gas washer is through fixing sleeve outer wall Upper end, the blanket gas washer are connected with fixing sleeve glue, and the regulating valve is located at upper end on the left of blanket gas washer, described Regulating valve be connected with blanket gas washer glue, the air injection pipe is located on the left of regulating valve, the air injection pipe and regulating valve Screw thread is connected, and the syringe is located on the left of air injection pipe, and the syringe is connected with air injection pipe glue.
Further, evacuation opening is additionally provided at left and right sides of the fixing sleeve interior lower end, evacuation opening is square Shape through-hole.
Further, the fixing sleeve lower end outer wall shape is in wide at the top and narrow at the bottom.
Further, the strut bottom is additionally provided with neonychium, and the neonychium is connected with strut glue.
Further, the supporting plate bottom is arc fillet.
Further, it is additionally provided with handle at the top of the adjusting screw rod, the handle is integrally connected with adjusting screw rod.
Further, the strut, pressing plate, adjusting screw rod and handle inner are also equipped with operating walk way, the operation Channel cross-sectional shape is circular through hole.
Further, side opening is additionally provided at left and right sides of the strut interior lower end, the side opening is rectangular through-hole.
Compared with prior art, which adjusts extension fixture, and when operation, medical staff will consolidate first Fixed set is inserted into from corrective surgery wound site, then rotating handle, i.e. handle drives adjusting screw rod to make from top to bottom along capping Movement, the effect pushed down at this time by adjusting screw rod make pressing plate that strut be driven to overcome the screen resilience of second spring along the Two evacuation chambers move from top to bottom, i.e., strut drives downwards neonychium to be supported expansion, at this time by the effect of strut, expand Big visual area space, meanwhile, in strut drives downwards limit touch panel moving process, when limiting touch panel contact supporting plate, pass through Limit touch panel overcomes downwards the screen resilience of the first spring, so that supporting plate is rotated by the center of circle of fixing axle, i.e. subordinate in fixing sleeve Hold both sides supporting plate Unscrew outward, i.e., the effect opened by supporting plate, so as to reach expansion wound inner wall both sides skin The effect of valve tissue improves the convenient of subsequent operation, and then medical staff can be by corresponding surgical instrument insertion operation channel, such as Drainage tube, i.e. drainage tube enter patient's body by side opening, eventually by above-mentioned, to facilitate the insertion behaviour of medical instrument Make, a kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture, clever structure is powerful, passes through rotary expansion and supporting mechanism phase The effect mutually coordinated also can very well reach and strutted to corrective surgery position while facilitating medical staff to operate, and expand Visual area space, finally brings great convenience to subsequent surgical procedure, using clinical popularization and application, meanwhile, medical care people Member can be as needed, is first turned on regulating valve, then by pushing syringe, make syringe inner air pass through air injection pipe enter it is close It seals inside airfilled ring, i.e., the effect flowed by air passes through blanket gas washer at this time to realize the expansion of blanket gas washer Expansion, can reach at the top of patient's wound covering sealing, effectively avoid the excessive of blood, improve operation The safety of operation, neonychium material are silica gel, have good flexibility, can with patient body is soft contacts, patient is risen To protective effect, because fixing sleeve lower end shape facilitates the minimally invasive insertion of the device in wide at the top and narrow at the bottom, evacuation opening be for Facilitate supporting plate Unscrew.
Description of the drawings
Fig. 1 is a kind of front view of orthopaedics Minimally Invasive Surgery adjusting extension fixture;
Fig. 2 is a kind of sectional view of orthopaedics Minimally Invasive Surgery adjusting extension fixture;
Fig. 3 is supporting plate receiving state figure;
Fig. 4 is a kind of stereogram of orthopaedics Minimally Invasive Surgery adjusting extension fixture;
Fig. 5 is blanket gas washer position enlarged drawing;
Fig. 6 is blanket gas washer position cutaway view Amplified image;
Fig. 7 is side opening position cutaway view Amplified image.
Fixing sleeve 1, first avoids chamber 2, fixing axle 3, supporting plate 4, the first spring 5, strut 6, limit touch panel 7, second and avoids Chamber 8, pressing plate 9, second spring 10, capping 11, adjusting screw rod 12, blanket gas washer 13, regulating valve 14, air injection pipe 15, syringe 16, evacuation opening 101, neonychium 601, side opening 602, handle 1201, operating walk way 1202.
Following specific implementation mode will be further illustrated in conjunction with above-mentioned attached drawing.
Specific implementation mode
Hereinafter, a variety of specific details are elaborated, in order to provide the saturating of the concept to constituting described embodiment basis Thorough understanding, however, it will be apparent to those skilled in the art that described embodiment can be in these no specific details In the practice of getting off of some or all situations do not specifically describe well-known processing step in other cases.
As shown in Figure 1, Figure 2, shown in Fig. 3, Fig. 4, Fig. 5, Fig. 6, Fig. 7, a kind of orthopaedics Minimally Invasive Surgery adjusting extension fixture, including it is solid Surely set 1, first evacuation chamber 2, fixing axle 3, supporting plate 4, the first spring 5, strut 6, limit touch panel 7, second avoid chamber 8, pressing plate 9, Second spring 10, capping 11, adjusting screw rod 12, blanket gas washer 13, regulating valve 14, air injection pipe 15, syringe 16, described the One evacuation chamber 2 is located at 1 interior lower end of fixing sleeve, and the described first evacuation chamber 2 is hollow cavity, and the fixing axle 3 is through solid Surely it covers at left and right sides of 1 interior lower end, the fixing axle 3 is connected with 1 close-fitting of fixing sleeve, and the supporting plate 4 is through fixing axle 3, the supporting plate 4 is rotatedly connected with fixing axle 3, and first spring 6 is located between 1 inner wall of supporting plate 4 and fixing sleeve, described The first spring 6 be weldingly connected respectively with supporting plate 4 and fixing sleeve 1, the strut 6 is located at 1 interior lower end of fixing sleeve, described Strut 6 is connected with the sliding of fixing sleeve 1, and the strut 6 is cylindricality, and the limit touch panel 7 is located at 6 middle-end of strut or so two Side, the limit touch panel 7 are integrally connected with strut 6, and the described second evacuation chamber 8 is located at 1 inner upper end of fixing sleeve, described Second evacuation chamber 8 is circular groove, and the pressing plate 9 is located at 6 top of strut, and the pressing plate 9 is connected with 6 screw thread of strut, institute The second spring 10 stated is weldingly connected through 6 upper end of strut, the second spring 10 with pressing plate 9, the capping 11 In 1 outer wall upper end of fixing sleeve, the capping 11 is connected with 1 screw thread of fixing sleeve, and the adjusting screw rod 12 is in capping 11 Portion's middle-end, the adjusting screw rod 12 are connected with 11 screw threads of capping, and the blanket gas washer 13 is through on 1 outer wall of fixing sleeve End, the blanket gas washer 13 are connected with 1 glue of fixing sleeve, and the regulating valve 14 is located on 13 left side of blanket gas washer End, the regulating valve 14 are connected with 13 glue of blanket gas washer, and the air injection pipe 15 is located at 14 left side of regulating valve, described Air injection pipe 15 is connected with 14 screw thread of regulating valve, and the syringe 16 is located at 15 left side of air injection pipe, the syringe 16 and note 15 glue of tracheae is connected.Evacuation opening 101, evacuation opening are additionally provided at left and right sides of 1 interior lower end of fixing sleeve 101 be rectangular through-hole, and the 1 lower end outer wall shape of fixing sleeve is in wide at the top and narrow at the bottom, and 6 bottom of strut is additionally provided with neonychium 601, the neonychium 601 is connected with 6 glue of strut, and 4 bottom of supporting plate is arc fillet, the adjusting screw rod 12 Top is additionally provided with handle 1201, and the handle 1201 is integrally connected with adjusting screw rod 12, and the strut 6, is adjusted pressing plate 9 Operating walk way 1202 is also equipped with inside screw rod 12 and handle 1201,1202 cross sectional shape of operating walk way is round logical Hole, 6 interior lower end of the strut left and right sides are additionally provided with side opening 602, and the side opening 602 is rectangular through-hole.
A kind of orthopaedics Minimally Invasive Surgery adjusts extension fixture, and when operation, medical staff is first by fixing sleeve 1 from corrective surgery Wound site is inserted into, then rotating handle 1201, i.e., handle 1201 drives adjusting screw rod 12 to be transported from top to bottom along capping 11 Dynamic, the effect pushed down at this time by adjusting screw rod 12 makes pressing plate 9 that strut 6 be driven to overcome the screen resilience of second spring 10 suitable It the second evacuation chamber 8 to move from top to bottom, i.e., strut 6 drives neonychium 601 to be supported expansion downwards, passes through strut at this time 6 effect expands visual area space, meanwhile, in strut 6 drives downwards limit 7 moving process of touch panel, when limit touch panel 7 connects When touching supporting plate 4, overcomes the screen resilience of the first spring 5 downwards by limiting touch panel 7, supporting plate 4 is made to be turned for the center of circle with fixing axle 3 It is dynamic, i.e. 1 interior lower end both sides supporting plate 4 of fixing sleeve Unscrew outward, i.e., the effect opened by supporting plate 4, so as to reach To the effect of expansion wound inner wall both sides skin flap tissues, the convenient of subsequent operation is improved, then medical staff can be by corresponding hand Art instrument insertion operation channel 1202, such as drainage tube, i.e., drainage tube enters patient's body by side opening 602, eventually by above-mentioned, To facilitate the insertion operation of medical instrument, meanwhile, medical staff can be as needed, is first turned on regulating valve 14, then pass through Syringe 16 is pushed, so that 16 inner air of syringe is passed through air injection pipe 15 and enters inside blanket gas washer 13, that is, pass through air stream The effect entered, at this time by the expansion of blanket gas washer 13, can reach pair to realize the expansion of blanket gas washer 13 Covering sealing at the top of patient's wound, effectively avoids the excessive of blood, improves the safety of surgical procedure, neonychium 601 materials are silica gel, have good flexibility, can with patient body is soft contacts, play a protective role to patient, because of fixation 1 lower end shape is covered in wide at the top and narrow at the bottom to facilitate the minimally invasive insertion of the device, and evacuation opening 101 is that supporting plate 4 revolves for convenience Turn to open.
The present invention is not limited to above-mentioned specific embodiment, those skilled in the art from above-mentioned design, Without performing creative labour, the various transformation made are within the scope of the present invention.

Claims (8)

1. a kind of orthopaedics Minimally Invasive Surgery adjusts extension fixture, it is characterised in that including fixing sleeve, the first evacuation chamber, fixing axle, support Plate, the first spring, strut, limit touch panel, second evacuation chamber, pressing plate, second spring, capping, adjusting screw rod, blanket gas washer, Regulating valve, air injection pipe, syringe, the described first evacuation chamber are located at fixing sleeve interior lower end, and the described first evacuation chamber is sky Chambers of the heart body, the fixing axle is at left and right sides of fixing sleeve interior lower end, and the fixing axle is connected with fixing sleeve close-fitting, institute The supporting plate stated is rotatedly connected through fixing axle, the supporting plate with fixing axle, and first spring is located at supporting plate and fixation Between covering inner wall, first spring is weldingly connected with supporting plate and fixing sleeve respectively, and the strut is located inside fixing sleeve Lower end, the strut is connected with fixing sleeve sliding, and the strut is cylindricality, and the limit touch panel is located at strut middle-end The left and right sides, the limit touch panel are integrally connected with strut, and the described second evacuation chamber is located at fixing sleeve inner upper end, described Second evacuation chamber be circular groove, the pressing plate be located at strut top, the pressing plate is connected with strut screw thread, described Second spring is weldingly connected through strut upper end, the second spring with pressing plate, and the capping is located at fixing sleeve outer wall Upper end, the capping are connected with fixed external threading, and the adjusting screw rod is through the internal middle-end of capping, the adjusting screw rod It is connected with closure threads, the blanket gas washer is through fixing sleeve outer wall upper end, the blanket gas washer and fixing sleeve Glue is connected, and the regulating valve is located at upper end on the left of blanket gas washer, and the regulating valve is connected with blanket gas washer glue, The air injection pipe is located on the left of regulating valve, and the air injection pipe is connected with regulating valve screw thread, and the syringe is located at gas injection On the left of pipe, the syringe is connected with air injection pipe glue.
2. a kind of orthopaedics Minimally Invasive Surgery as described in claim 1 adjusts extension fixture, it is characterised in that in the fixing sleeve Evacuation opening is additionally provided at left and right sides of subordinate end, evacuation opening is rectangular through-hole.
3. a kind of orthopaedics Minimally Invasive Surgery as described in claim 1 adjusts extension fixture, it is characterised in that under the fixing sleeve Hold outer wall shape in wide at the top and narrow at the bottom.
4. a kind of orthopaedics Minimally Invasive Surgery as described in claim 1 adjusts extension fixture, it is characterised in that the strut bottom It is additionally provided with neonychium, the neonychium is connected with strut glue.
5. a kind of orthopaedics Minimally Invasive Surgery as described in claim 1 adjusts extension fixture, it is characterised in that the supporting plate bottom For arc fillet.
6. a kind of orthopaedics Minimally Invasive Surgery as described in claim 1 adjusts extension fixture, it is characterised in that the adjusting screw rod Top is additionally provided with handle, and the handle is integrally connected with adjusting screw rod.
7. a kind of orthopaedics Minimally Invasive Surgery as claimed in claim 6 adjusts extension fixture, it is characterised in that the strut, pressure Plate, adjusting screw rod and handle inner are also equipped with operating walk way, and the operating walk way cross sectional shape is circular through hole.
8. a kind of orthopaedics Minimally Invasive Surgery as described in claim 1 adjusts extension fixture, it is characterised in that inside the strut Side opening is additionally provided at left and right sides of lower end, the side opening is rectangular through-hole.
CN201810012859.2A 2018-01-06 2018-01-06 Adjusting and expanding device for orthopedic minimally invasive surgery Expired - Fee Related CN108283509B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201810012859.2A CN108283509B (en) 2018-01-06 2018-01-06 Adjusting and expanding device for orthopedic minimally invasive surgery

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Application Number Priority Date Filing Date Title
CN201810012859.2A CN108283509B (en) 2018-01-06 2018-01-06 Adjusting and expanding device for orthopedic minimally invasive surgery

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CN108283509A true CN108283509A (en) 2018-07-17
CN108283509B CN108283509B (en) 2020-01-10

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110338851A (en) * 2019-07-10 2019-10-18 杭州市第三人民医院 A kind of prostatic fluid acquisition device
CN111603210A (en) * 2020-06-03 2020-09-01 上海市浦东新区公利医院(第二军医大学附属公利医院) Surgical field expander for minimally invasive orthopedic surgery

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EP0531710A2 (en) * 1991-08-05 1993-03-17 United States Surgical Corporation Endoscopic dilator
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CN2820090Y (en) * 2005-08-24 2006-09-27 申屠裕华 Side way intervertebral discs dilator
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CN103202719A (en) * 2012-01-17 2013-07-17 广西大学 Spindly non-pneumoperitoneum device for single-port laparoscopy
CN203195722U (en) * 2013-04-21 2013-09-18 王建卿 Pelvic cavity drag hook with adjustable width
CN203662878U (en) * 2013-12-27 2014-06-25 李万里 Cervical vertebra plate door opener
CN204274604U (en) * 2014-12-05 2015-04-22 邹孝军 A kind of orthopaedics retractor
CN105310733A (en) * 2015-12-12 2016-02-10 王振华 Endoscope lower thoracic vertebra body expander
CN205697875U (en) * 2016-05-06 2016-11-23 高宏 Stamp card balloon dilatation catheter
CN106606367A (en) * 2016-11-23 2017-05-03 浙江省肿瘤医院 Percutaneous skin-puncture traction retractor axially externally-unfolded in visual endoscopy
CN106974684A (en) * 2017-05-05 2017-07-25 王建玲 A kind of orthopaedics Minimally Invasive Surgery bellows extension fixture

Patent Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0531710A2 (en) * 1991-08-05 1993-03-17 United States Surgical Corporation Endoscopic dilator
US6464690B1 (en) * 2000-10-11 2002-10-15 Popcab, Llc Port off-pump beating heart coronary artery bypass heart stabilization system
CN2820090Y (en) * 2005-08-24 2006-09-27 申屠裕华 Side way intervertebral discs dilator
CN202136391U (en) * 2011-07-03 2012-02-08 桐庐洲济医疗器械有限公司 Quinquefoliolate fan-shaped pliers
CN103202719A (en) * 2012-01-17 2013-07-17 广西大学 Spindly non-pneumoperitoneum device for single-port laparoscopy
CN203195722U (en) * 2013-04-21 2013-09-18 王建卿 Pelvic cavity drag hook with adjustable width
CN203662878U (en) * 2013-12-27 2014-06-25 李万里 Cervical vertebra plate door opener
CN204274604U (en) * 2014-12-05 2015-04-22 邹孝军 A kind of orthopaedics retractor
CN105310733A (en) * 2015-12-12 2016-02-10 王振华 Endoscope lower thoracic vertebra body expander
CN205697875U (en) * 2016-05-06 2016-11-23 高宏 Stamp card balloon dilatation catheter
CN106606367A (en) * 2016-11-23 2017-05-03 浙江省肿瘤医院 Percutaneous skin-puncture traction retractor axially externally-unfolded in visual endoscopy
CN106974684A (en) * 2017-05-05 2017-07-25 王建玲 A kind of orthopaedics Minimally Invasive Surgery bellows extension fixture

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110338851A (en) * 2019-07-10 2019-10-18 杭州市第三人民医院 A kind of prostatic fluid acquisition device
CN111603210A (en) * 2020-06-03 2020-09-01 上海市浦东新区公利医院(第二军医大学附属公利医院) Surgical field expander for minimally invasive orthopedic surgery
CN111603210B (en) * 2020-06-03 2022-09-13 上海市浦东新区公利医院(第二军医大学附属公利医院) Surgical field expander for minimally invasive orthopedic surgery

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Inventor after: Cong Ning

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