CN111658963A - Guide wire marking method and application in ureteral sheath implantation - Google Patents
Guide wire marking method and application in ureteral sheath implantation Download PDFInfo
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- CN111658963A CN111658963A CN202010502336.3A CN202010502336A CN111658963A CN 111658963 A CN111658963 A CN 111658963A CN 202010502336 A CN202010502336 A CN 202010502336A CN 111658963 A CN111658963 A CN 111658963A
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- 238000000034 method Methods 0.000 title claims abstract description 58
- 238000002513 implantation Methods 0.000 title description 10
- 230000008569 process Effects 0.000 claims abstract description 16
- 238000003384 imaging method Methods 0.000 claims abstract description 9
- 206010066901 Treatment failure Diseases 0.000 claims abstract description 3
- 230000006378 damage Effects 0.000 claims description 7
- 239000000049 pigment Substances 0.000 claims description 6
- 238000000576 coating method Methods 0.000 claims description 5
- 208000027418 Wounds and injury Diseases 0.000 claims description 3
- 239000011248 coating agent Substances 0.000 claims description 3
- 208000014674 injury Diseases 0.000 claims description 3
- 238000002604 ultrasonography Methods 0.000 claims description 3
- 239000003086 colorant Substances 0.000 claims description 2
- 239000002184 metal Substances 0.000 claims description 2
- 210000000056 organ Anatomy 0.000 claims description 2
- 230000007704 transition Effects 0.000 claims description 2
- 201000004569 Blindness Diseases 0.000 abstract description 3
- 230000036541 health Effects 0.000 abstract description 3
- 230000002285 radioactive effect Effects 0.000 abstract description 3
- 230000008816 organ damage Effects 0.000 abstract 1
- 210000000244 kidney pelvis Anatomy 0.000 description 5
- 230000005855 radiation Effects 0.000 description 4
- 210000000626 ureter Anatomy 0.000 description 4
- 238000003745 diagnosis Methods 0.000 description 3
- 238000012544 monitoring process Methods 0.000 description 3
- 238000005516 engineering process Methods 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000001635 urinary tract Anatomy 0.000 description 2
- 241001164374 Calyx Species 0.000 description 1
- 208000000913 Kidney Calculi Diseases 0.000 description 1
- 206010029148 Nephrolithiasis Diseases 0.000 description 1
- 206010040047 Sepsis Diseases 0.000 description 1
- 208000012931 Urologic disease Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 238000002682 general surgery Methods 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 230000001050 lubricating effect Effects 0.000 description 1
- 238000013507 mapping Methods 0.000 description 1
- 238000005507 spraying Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 208000014001 urinary system disease Diseases 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 238000009736 wetting Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M2025/0008—Catheters; Hollow probes having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M2025/0177—Introducing, guiding, advancing, emplacing or holding catheters having external means for receiving guide wires, wires or stiffening members, e.g. loops, clamps or lateral tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M2025/09175—Guide wires having specific characteristics at the distal tip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/10—Trunk
- A61M2210/1078—Urinary tract
- A61M2210/1089—Urethra
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Radiation-Therapy Devices (AREA)
Abstract
The invention relates to the technical field of medical instruments, in particular to a guide wire marking method and application thereof in implanting into a ureteral sheath, which can effectively reduce or even completely avoid the use of radioactive rays and overcome the subjectivity and blindness of operation, thereby greatly reducing the operation risk and effectively protecting the health of doctors and patients; under the guidance of imaging means such as direct vision or ultrasonic/X rays and the like, the guide wire is placed in a correct position in a human body, and in the subsequent process, instruments such as a puncture needle, a catheter or an endoscope and the like are placed into the guide wire to the tail end to be overlapped with the annular marked line set on the guide wire body, so that the instrument placing process under the guide wire guidance can be completed, and the treatment failure caused by over-shallow instrument placing and the adjacent organ damage caused by over-deep instrument placing are effectively avoided.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a guide wire marking method and application thereof in implanting of a ureteral sheath.
Background
The medical guide wire is used for guiding instruments such as a catheter, a stent and the like to a specific position in a blood vessel or other cavities so as to continue subsequent medical operations, thereby achieving the purpose of diagnosis or treatment. Widely used in department of cardiology, neurology, general surgery, urology surgery, interventional therapy department, and the like.
In the medical practice, once the indwelling of the guide wire is completed, a catheter, a stent or the like needs to be guided to a required position under the limitation of the guide wire. However, this procedure generally does not allow viewing of the position of the instrument in the body under direct vision. Currently, the following two methods are mainly used for the instrument implantation process guided along the guide wire: first, for operations with strict requirements on operation precision, such as cardiac and vascular intervention operations, precise delivery of instruments is achieved by intermittent or continuous monitoring of imaging means such as radiation. The method is difficult to avoid radiation damage to medical staff and patients. How to reduce the radiation dose used in medical treatment as much as possible becomes an urgent problem to be solved; secondly, for operations with slightly low requirements on operation precision, such as the placement of a drainage tube in a body cavity, the placement of a catheter in a urological surgery and the like, although the operations can also be carried out under the monitoring of imaging means such as ultrasound/X rays and the like to achieve the accurate placement of instruments, most operators rely on hand feeling and experience in consideration of the problems of large equipment investment, long learning curve, ray exposure damage and the like. The method has the defects that the application precision of the instrument cannot be accurately controlled, the pushing of the instrument is too shallow, and the treatment purposes of drainage, support and the like cannot be achieved. Too deep pushing of the instrument will lose the guidance and restriction of the guide wire and even damage surrounding tissues, causing serious complications. How to improve the application precision of the instrument becomes a problem to be solved urgently.
In the last two decades, with the progress of manufacturing level and imaging technology and the continuous improvement of auxiliary calculus removing baskets and calculus crushing laser equipment, ureter soft lenses are increasingly applied to the diagnosis and treatment process of upper urinary tract diseases, and are written in the diagnosis and treatment guidelines of China, Europe and America as a first-line treatment scheme of kidney stones smaller than 2 cm.
The ureteral sheath is recommended to be used in the transurethral ureteroscope operation, and the functions of protecting surgical instruments, continuously draining the renal pelvis liquid and gravels, effectively reducing the internal pressure of the renal pelvis and reducing the complications in the perioperative period can be achieved. The proper placement of the ureteral sheath along the guidewire into the urinary tract is a critical step in determining the success or failure of subsequent procedures. Under X-ray fluoroscopy, this method has the following problems: a special operation room is needed, the equipment investment is large, and radiation damage is brought to medical staff and patients; the method is widely adopted in clinical practice depending on the hand feeling and experience of an operator, but cannot realize accurate application, and serious complications such as perioperative bleeding, ureter or renal pelvis and renal calyx injury, high-pressure related infection in the renal pelvis and even sepsis can be caused by too deep or too shallow insertion of a ureteral sheath.
Disclosure of Invention
In order to solve the technical problems, the invention provides a guide wire marking method which can effectively reduce or even completely avoid the use of radioactive rays, overcomes the subjectivity and blindness of operation, greatly reduces the operation risk, and effectively protects the health of doctors and patients, and an application of the guide wire marking method in the implantation of a ureteral sheath.
The invention relates to a guide wire marking method and application thereof in implanting a ureteral sheath, comprising an annular marking near the head end of a guide wire, which represents the head end position of an apparatus to be implanted, and an annular marking at the specific length of the guide wire body part which represents the tail end position of the apparatus to be implanted.
The invention relates to a guide wire marking method and application in the placement of a ureteral sheath, wherein the selected basic guide wire does not use a guide wire with a hydrophilic lubricating coating in the whole length, because the guide wire is difficult to fix at a specific position in a patient body.
According to the guide wire marking method and the application of the guide wire marking method in the process of being placed into the ureteral sheath, the annular guide wire can be realized through ultrathin pigment coatings with different colors, and can also be realized through nicking on the metal guide wire on the premise of not influencing the stability and the smoothness of the guide wire.
According to the guide wire marking method and the application of the guide wire marking method in the placement of the ureteral sheath, on the same guide wire, a plurality of instruments can be marked respectively through different characteristics of the width, the number, the color and the like of the annular marked line.
According to the guide wire marking method and the application of the guide wire marking method in the placement of the ureteral sheath, smooth and uninterrupted outer surface transition is formed between the annular marked line and the guide wire.
According to the guide wire marking method and the application of the guide wire marking method in the implantation of the ureteral sheath, the annular marking line close to the head end of the guide wire is positioned at the junction of the soft wire part and the hard wire part of the guide wire.
The guide wire marking method and the application thereof in the implantation of the ureteral sheath are characterized in that the width of the annular mark line close to the head end of the guide wire is equal to the length of the sharp head end of an apparatus to be implanted.
The invention relates to a guide wire marking method and application in the implantation of a ureteral sheath, wherein the first guide wire marking method comprises the guide wire required by claims 1-7, the guide wire is implanted into a correct position in a human body under the guidance of imaging means such as direct vision or ultrasonic/X rays, and in the subsequent process, instruments such as a puncture needle, a catheter or an endoscope are implanted into the tail end along the guide wire to be overlapped with an annular mark line set on the body part of the guide wire, so that the instrument implantation process under the guide wire guidance can be completed, and the treatment failure caused by the over-shallow implantation of the instruments and the adjacent organ injury caused by the over-deep implantation of the instruments are effectively avoided.
The invention relates to a guide wire marking method and application in the placement of a ureteral sheath, and a second method for applying guide wire marking, which comprises the guide wire claimed in the claims 1 to 7, wherein under the guidance of imaging means such as direct vision or ultrasonic/X-ray and the like, instruments such as a puncture needle, a catheter or an endoscope and the like are placed in a correct position in a human body, at the moment, the guide wire is inserted along a working channel of the instrument until the tail end of the instrument is superposed with an annular marking line set on the body part of the guide wire, and then the placement of the guide wire can be completed, so that the subsequent instrument replacement process can be safely and effectively guided.
The invention has the beneficial effects that: the invention relates to a special marking method for a guide wire in a medical treatment process, which is designed by mapping the full length of an appliance to be placed to a specific position of the guide wire and marking. On the basis of the existing guide wire, the medical guide wire can be processed simply, the manufacturing process and cost cannot be greatly increased, and the technical index parameters of the medical guide wire are not influenced. The operation is simple and easy to operate in clinical use, the use of radioactive rays can be effectively reduced or even completely avoided in the process of implanting the instrument guided by the medical guide wire marked by the technology, and the subjectivity and blindness of the operation are overcome, so that the operation risk can be greatly reduced, and the health of doctors and patients can be effectively protected.
Drawings
FIG. 1 is a schematic illustration of the design concept of the present invention;
FIG. 2 is a schematic illustration of a marked guidewire in comparison to different sized ureteral sheaths;
fig. 3 is a schematic view of an embodiment of intraoperative placement of a ureteral sheath along a guidewire.
Detailed Description
The following detailed description of embodiments of the present invention is provided in connection with the accompanying drawings and examples. The following examples are intended to illustrate the invention but are not intended to limit the scope of the invention.
As shown in fig. 1, the entire length of the puncture instrument is mapped to a specific position of the guide wire and marked with a ring-shaped marking. The special-shaped guide wire comprises an annular marking near the head end of the guide wire, which represents the head end position of an appliance to be placed, and an annular marking at the specific length position of the guide wire body, which represents the tail end position of the appliance to be placed. In clinical practice, firstly, under the guidance of imaging means such as direct vision or ultrasonic/X-ray, the guide wire is placed in a correct position in a human body, and in the subsequent operation process, instruments such as a puncture needle, a catheter or an endoscope are placed into the guide wire until the tail end of the instruments is overlapped with the set annular marked line on the guide wire, so that the instrument placing process under the guide wire guidance can be completed.
The embodiment of the technique for marking the guide wire is shown in fig. 2 by taking the mixed guide wire with different sizes and ureteral sheath of boston scientific as an example.
And spraying a plurality of continuous ultrathin pigment annular marked lines at the position 3cm away from the head end of the guide wire, wherein the total width is 2.7cm, the combined ureteral sheath is represented, and the inner core extends out of the tip part of the outer sheath.
2 ultrathin pigment ring-shaped marked lines are sprayed at a position 37.3cm away from the head end of the guide wire, and the position represents the tail end position of the combined 28 cm-sized ureteral sheath.
And 3 ultrathin pigment ring-shaped marked lines are sprayed at a position 45.3cm away from the head end of the guide wire, wherein the marked lines represent the tail end position of the combined 36 cm-sized ureteral sheath.
4 ultrathin pigment ring-shaped marked lines are sprayed at a position 55.3cm away from the head end of the guide wire, and represent the tail end position of the combined 46 cm-sized ureteral sheath.
As shown in fig. 3, the operation is implemented as follows: under the direct vision of ureteroscope or the monitoring of image learning procedures such as ultrasonic/X-ray, the guide wire is placed in the correct position in the ureter, the head end of the guide wire is positioned in the affected side kidney collecting system, and the annular marking line at the head end of the guide wire is positioned at the connecting part of the renal pelvis ureter. Keeping the position of the guide wire relatively fixed with a human body, wetting a 36 cm-sized ureteral sheath to activate a hydrophilic coating, combining the inner core and the outer sheath, inserting the ureteral sheath into the urinary tract of the human body under the guide of the guide wire until the tail end of the ureteral sheath is superposed with a set annular marking on the guide wire, completing the catheterization sheath inserting process under the guide of the guide wire, removing the inner core and the guide wire, and inserting a ureteroscope to complete subsequent operation.
The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and variations can be made without departing from the technical principle of the present invention, and these modifications and variations should also be regarded as the protection scope of the present invention.
Claims (9)
1. A guide wire marking method and application in implanting a ureteral sheath are characterized by comprising an annular marking line close to the head end of a guide wire, representing the head end position of an apparatus to be implanted, and an annular marking line at a specific length position of a guide wire body, representing the tail end position of the apparatus to be implanted.
2. A guidewire marking method and use in the placement of a ureteral sheath according to claim 1 wherein the base guidewire is selected such that a full length guidewire with a hydrophilic lubricious coating is not used because such guidewires are difficult to secure in a particular location in a patient.
3. The guide wire marking method and use in the placement of a ureteral sheath of claim 2, wherein the annular marking can be achieved by ultra-thin pigment coatings of different colors, or by scoring the metal guide wire without affecting the stability and smoothness of the guide wire.
4. The guide wire marking method and the application thereof in the placement of the ureteral sheath according to claim 3, wherein a plurality of instruments can be marked on the same guide wire respectively through different characteristics of the width, the number, the color and the like of the annular marked lines.
5. The method of claim 4, wherein the annular marking forms a smooth, uninterrupted outer surface transition with the guidewire.
6. The guide wire marking method and use in implanting a ureteral sheath of claim 5, wherein the annular marking near the tip end of the guide wire is located at the intersection of the soft wire portion and the hard wire portion of the guide wire.
7. The guide wire marking method and use in inserting a ureteral sheath of claim 6, wherein the annular marking near the tip end of the guide wire has a width equal to the length of the sharp tip end of the device to be inserted.
8. The guide wire marking method and the application in the placement of the ureteral sheath as claimed in claim 7, wherein the first method for applying the guide wire marking comprises the guide wire claimed in claims 1 to 7, the guide wire is placed in a correct position in a human body under the guidance of imaging means such as direct vision or ultrasound/X rays, and in the subsequent process, a puncture needle, a catheter or an endoscope and other instruments are placed to the tail end along the guide wire to be overlapped with the annular marked line set on the guide wire body, so that the instrument placement process under the guide wire guidance can be completed, and therefore treatment failure caused by over-shallow instrument placement and adjacent organ injury caused by over-deep instrument placement are effectively avoided.
9. The guide wire marking method and the application in the placement of the ureteral sheath as claimed in claim 8, the second method for applying the guide wire marking comprises the guide wire claimed in claims 1 to 7, under the guidance of imaging means such as direct vision or ultrasound/X-ray, a puncture needle, a catheter or an endoscope and the like are placed in the right position in a human body, at the moment, the guide wire is inserted along the working channel of the device until the tail end of the device is overlapped with the annular marking line set on the guide wire body, and then the placement of the guide wire can be completed, so that the subsequent device replacing process can be guided safely and effectively.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010502336.3A CN111658963A (en) | 2020-06-05 | 2020-06-05 | Guide wire marking method and application in ureteral sheath implantation |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010502336.3A CN111658963A (en) | 2020-06-05 | 2020-06-05 | Guide wire marking method and application in ureteral sheath implantation |
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| CN111658963A true CN111658963A (en) | 2020-09-15 |
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Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6074367A (en) * | 1997-10-01 | 2000-06-13 | Scimed Life Systems, Inc. | Preinsertion measurement of catheters |
| CN1997412A (en) * | 2004-07-19 | 2007-07-11 | 阿罗国际公司 | Guide wire bearing markings simplifying catheter selection |
| CN101687087A (en) * | 2007-04-16 | 2010-03-31 | C.R.巴德有限公司 | Guidewire-assisted catheter placement system |
| CN108261598A (en) * | 2016-12-30 | 2018-07-10 | 先健科技(深圳)有限公司 | Measure seal wire |
| CN207755627U (en) * | 2017-07-04 | 2018-08-24 | 安瑞医疗器械(杭州)有限公司 | A kind of measurable seal wire |
| CN208114911U (en) * | 2017-12-29 | 2018-11-20 | 徐晓峰 | A kind of ureteroscope seal wire with a scale |
| CN109481828A (en) * | 2018-12-27 | 2019-03-19 | 肖恒军 | A kind of novel seal wire and its application |
-
2020
- 2020-06-05 CN CN202010502336.3A patent/CN111658963A/en active Pending
Patent Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6074367A (en) * | 1997-10-01 | 2000-06-13 | Scimed Life Systems, Inc. | Preinsertion measurement of catheters |
| CN1997412A (en) * | 2004-07-19 | 2007-07-11 | 阿罗国际公司 | Guide wire bearing markings simplifying catheter selection |
| CN101687087A (en) * | 2007-04-16 | 2010-03-31 | C.R.巴德有限公司 | Guidewire-assisted catheter placement system |
| CN108261598A (en) * | 2016-12-30 | 2018-07-10 | 先健科技(深圳)有限公司 | Measure seal wire |
| CN207755627U (en) * | 2017-07-04 | 2018-08-24 | 安瑞医疗器械(杭州)有限公司 | A kind of measurable seal wire |
| CN208114911U (en) * | 2017-12-29 | 2018-11-20 | 徐晓峰 | A kind of ureteroscope seal wire with a scale |
| CN109481828A (en) * | 2018-12-27 | 2019-03-19 | 肖恒军 | A kind of novel seal wire and its application |
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Application publication date: 20200915 |
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