CN112244995A - Safe intelligent ablation host combined with nerve monitoring - Google Patents
Safe intelligent ablation host combined with nerve monitoring Download PDFInfo
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- CN112244995A CN112244995A CN202011266116.1A CN202011266116A CN112244995A CN 112244995 A CN112244995 A CN 112244995A CN 202011266116 A CN202011266116 A CN 202011266116A CN 112244995 A CN112244995 A CN 112244995A
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- 238000012544 monitoring process Methods 0.000 title claims abstract description 101
- 238000002679 ablation Methods 0.000 title claims abstract description 100
- 210000005036 nerve Anatomy 0.000 title claims abstract description 80
- 230000000638 stimulation Effects 0.000 claims abstract description 18
- 230000001537 neural effect Effects 0.000 claims abstract description 12
- 238000002844 melting Methods 0.000 claims abstract description 8
- 230000008018 melting Effects 0.000 claims abstract description 8
- 239000000155 melt Substances 0.000 claims abstract description 4
- 238000006243 chemical reaction Methods 0.000 claims description 11
- 238000001514 detection method Methods 0.000 claims description 11
- 230000003750 conditioning effect Effects 0.000 claims description 10
- 238000001914 filtration Methods 0.000 claims description 7
- 238000000034 method Methods 0.000 abstract description 10
- 238000007674 radiofrequency ablation Methods 0.000 abstract description 8
- 230000000694 effects Effects 0.000 abstract description 3
- 230000004936 stimulating effect Effects 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 238000003763 carbonization Methods 0.000 description 3
- 230000003902 lesion Effects 0.000 description 2
- 230000007383 nerve stimulation Effects 0.000 description 2
- 210000002416 recurrent laryngeal nerve Anatomy 0.000 description 2
- 208000028389 Nerve injury Diseases 0.000 description 1
- 208000024770 Thyroid neoplasm Diseases 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000012806 monitoring device Methods 0.000 description 1
- 230000008764 nerve damage Effects 0.000 description 1
- 238000013021 overheating Methods 0.000 description 1
- 208000013076 thyroid tumor Diseases 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6848—Needles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00898—Alarms or notifications created in response to an abnormal condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/0091—Handpieces of the surgical instrument or device
- A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
- A61B2018/00958—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device for switching between different working modes of the main function
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
Abstract
The utility model provides a combine neural monitoring's safe intelligence to melt host computer, including melting the needle interface, neural monitoring interface, host system, signal switching module, melt module and neural monitoring module, the output of radio frequency output circuit and stimulus circuit is connected to melting the needle interface through signal switching module, host system connects signal switching module respectively, melt module and neural monitoring module, signal switching module includes the relay, the switching signal end of relay connects respectively melts module and neural monitoring module, the control signal connection host system of relay. The invention uses the ablation electrode of the radio frequency ablation needle as the stimulation electrode for nerve monitoring, does not need to separately additionally arrange the stimulation electrode and produce a special ablation needle, can work intermittently by time division of radio frequency ablation and nerve monitoring, can greatly improve the monitoring effect, and can give an alarm in advance if the nerve is to be damaged in the processes of puncture and ablation when the device is used for ablation, thereby preventing damage.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a safe and intelligent ablation host machine combined with nerve monitoring.
Background
Nerves near the lesion of a patient are easily injured by radiofrequency ablation, so an operation with a complicated nerve distribution near the lesion requires intraoperative nerve monitoring to prevent nerve damage. However, the existing ablation operation needs to be monitored by a separate nerve monitoring host. The stimulation electrode is added in the use, so that the use is inconvenient, and the stimulation electrode are not organically combined. And as such, various approaches have been explored in the industry. For example, utility model patent: the ablation electrode with the nerve detection function (notice number: CN207384320U) takes the nerve monitoring function of the ablation electrode into consideration. However, in this practical application, the doctor needs to manually press the key of the nerve detection module for monitoring, and manually press the key of the ablation module for ablation, so that the nerve monitoring cannot be performed in real time in the ablation process, and the monitoring effectiveness and timeliness are not very high. CN109350222A thyroid tumor radio frequency ablation device based on recurrent laryngeal nerve detection also adopts the arrangement of an ablation key and a detection key on an ablation needle. When the ablation device is used, manual switching is needed, real-time monitoring cannot be carried out in the ablation process, ablation can only be suspended through a manual key in the ablation process, ablation is resumed through the manual key, and the safety is still low.
CN109528297A patent of the invention relates to an ablation needle and a monitoring system capable of monitoring recurrent laryngeal nerves, which adds a nerve monitoring electrode interface on the ablation needle, directly connects a nerve monitoring stimulation circuit with ablation radio frequency output on the ablation needle, and can monitor in real time during the ablation process. However, due to the direct connection, the current in the ablation process can stimulate the nerve, and the stimulation amplitude of the nerve is larger than that output by the nerve monitor, so that the nerve monitor is difficult to measure under the condition.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides a safe and intelligent ablation host combined with nerve monitoring, which comprises the following steps:
the technical scheme of the invention is realized as follows:
the utility model provides a combine neural monitoring's safe intelligence to melt host computer, includes to melt needle interface, nerve monitoring interface, host system, signal switching module, melts module and nerve monitoring module, it includes radio frequency output circuit to melt the module, nerve monitoring module includes amazing circuit, radio frequency output circuit is connected to melting the needle interface with amazing circuit's output through signal switching module, host system connects signal switching module respectively, melts module and nerve monitoring module, signal switching module includes the relay, melting module and nerve monitoring module are connected respectively to the switching signal end of relay, the control signal connection host system of relay.
Preferably, the nerve monitoring module comprises a stimulation circuit and a signal receiving and conditioning circuit, the stimulation circuit is connected with the ablation needle interface through the signal switching module, the ablation needle interface is connected with the ablation electrode loop of the ablation needle, and the signal receiving and conditioning circuit is connected with the external nerve monitoring and recording electrode through the nerve monitoring and receiving interface.
Preferably, the signal receiving and conditioning circuit comprises a signal filtering and amplifying circuit, an AD conversion circuit and an algorithm monitoring circuit which are connected in sequence, the output of the algorithm monitoring circuit is connected with the main control module, and the signal filtering and amplifying circuit, the AD conversion circuit and the algorithm monitoring circuit are respectively connected with the main control module.
Preferably, the ablation module comprises a radio frequency output circuit and a temperature detection circuit, the radio frequency output circuit comprises an external DC power input, a DC-DC voltage regulation and conversion circuit and a DC-AC radio frequency output circuit which are sequentially connected, the DC-AC radio frequency output circuit is connected with an ablation needle interface through a signal switching module, the ablation needle interface is connected with an ablation electrode loop of the ablation needle, and the temperature detection circuit is directly connected with a thermocouple interface of the ablation needle interface without signal switching.
Preferably, the ablation module further comprises an impedance monitoring circuit, and the output of the impedance monitoring circuit is connected with the main control module.
Preferably, the main control module is further connected with an alarm circuit.
Compared with the prior art, the invention has the following beneficial effects:
the safe intelligent ablation host machine combined with nerve monitoring utilizes the ablation electrode of the radio frequency ablation needle as the stimulating electrode of the nerve monitoring, does not need to be additionally provided with the stimulating electrode independently, does not need to produce a special ablation needle independently, can work in a time division intermittent mode through radio frequency ablation and nerve monitoring, can greatly improve the monitoring effect, and can continuously send out intermittent stimulating current to stimulate a patient before the ablation needle punctures a focus when the device is used for ablation, and a signal receiving electrode of the nerve monitoring continuously receives a feedback signal of the patient to monitor the nerve, thereby ensuring that the nerve is not damaged in the puncturing process. When the focus is ablated, the signal switching module continuously works in a time-sharing manner between the ablation module and the nerve monitoring module, so that whether nerves are damaged or not can be monitored in real time, and the safe and smooth operation is ensured.
Drawings
FIG. 1 is a schematic diagram of a safe and intelligent ablation system incorporating nerve monitoring according to the present invention;
FIG. 2 is a schematic structural diagram of an ablation control module of the present invention;
FIG. 3 is a schematic diagram of a nerve monitoring module according to the present invention;
fig. 4 is a schematic structural diagram of a signal switching module according to the present invention.
In the figure: the nerve monitoring device comprises an ablation needle interface 100, a thermocouple interface 110, a nerve monitoring interface 200, a main control module 300, a signal switching module 400, a relay 410, an ablation module 500, an external DC power input 511, a DC-DC voltage regulation and conversion circuit 512, a DC-AC radio frequency output circuit 513, a radio frequency output circuit 510, a temperature detection circuit 530, an impedance monitoring circuit 540, a nerve monitoring module 600, a stimulation circuit 610, a signal receiving and conditioning circuit 620, a filtering and amplifying circuit 621, an AD conversion circuit 622, an algorithm monitoring circuit 623, a nerve monitoring receiving interface 640, an external nerve monitoring recording electrode 650 and an alarm circuit 700.
Detailed Description
The present invention will now be described more fully hereinafter with reference to the accompanying drawings, in which embodiments of the invention are shown.
As shown in fig. 1, a safe intelligent ablation host computer that combines nerve monitoring, including ablating needle interface 100, nerve monitoring interface 200, host system 300, signal switching module 400, ablation module 500 and nerve monitoring module 600, ablation module 500 includes radio frequency output circuit 510, nerve monitoring module 600 includes stimulation circuit 610, radio frequency output circuit 510 is connected to ablation needle interface 200 through signal switching module 400 with stimulation circuit 610's output, signal switching module 400, ablation module 500 and nerve monitoring module 600 are connected respectively to host system 300, signal switching module 400 includes relay 410, ablation module 500 and nerve monitoring module 600 are connected respectively to the switching signal end of relay 410, the control signal of relay 410 connects host system 300.
The nerve monitoring module 600 comprises a stimulation circuit 610 and a signal receiving and conditioning circuit 620, the stimulation circuit 610 is connected with the ablation needle interface 100 through the signal switching module 400, the ablation needle interface 100 is connected with the ablation needle ablation electrode loop, and the signal receiving and conditioning circuit 620 is connected with an external nerve monitoring and recording electrode 650 through the nerve monitoring and receiving interface 640.
The signal receiving and conditioning circuit 620 comprises a signal filtering and amplifying circuit 621, an AD conversion circuit 622 and an algorithm monitoring circuit 623 which are sequentially connected, the output of the algorithm monitoring circuit 623 is connected with the main control module 300, and the signal filtering and amplifying circuit 621, the AD conversion circuit 622 and the algorithm monitoring circuit 623 are respectively connected with the main control module 300.
The ablation module 500 comprises a radio frequency output circuit 510 and a temperature detection circuit 530, wherein the radio frequency output circuit 510 comprises an external DC power input 511, a DC-DC voltage regulation and conversion circuit 512 and a DC-AC radio frequency output circuit 513 which are sequentially connected, the DC-AC radio frequency output circuit 513 is connected with an ablation needle interface 100 through a signal switching module 400, the ablation needle interface 100 is connected with an ablation electrode loop of an ablation needle, the temperature detection circuit 530 is directly connected with a thermocouple interface 110 of the ablation needle interface 100 without signal switching, an ablation needle thermocouple is arranged at the thermocouple interface 110, and the ablation needle thermocouple is arranged at a position close to a needle point.
The ablation module 500 further comprises an impedance monitoring circuit 540, the output of the impedance monitoring circuit 540 is connected with the main control module 300, the impedance monitoring circuit 540 prevents overheating carbonization during ablation, and the resistance is large during carbonization, so that once the impedance is increased, the ablation power is reduced to prevent carbonization.
The main control module 300 is further connected with an alarm circuit 700.
Whether the stimulation circuit 610 works or not is determined according to the control signal of the main control module 300, the signal of the nerve monitoring receiving electrode is received when the ablation module 500 does not work, nerve monitoring is carried out by an algorithm, and if the nerve monitoring receiving electrode is abnormal, the nerve monitoring receiving electrode stops working immediately and gives an alarm to prompt, so that the nerve is not damaged.
The following is the procedure for use of the ablation system of the invention:
before a doctor punctures and reaches a focus, the doctor uses a stimulation circuit to trigger a nerve stimulation circuit (shared by an ablation electrode circuit of an ablation needle) to continuously and intermittently stimulate for 100us, the doctor has a rest for 1 second, whether nerves are damaged or not is monitored by the continuous monitoring work mode of other parts of the nerve monitoring module 600, and when the nerves are ablated after the puncture is in place, the master control module 300 switches an ablation mode through the signal switching module 400, the doctor uses the ablation electrode circuit of the ablation needle to work for 200ms, then the nerve stimulation circuit works for 50us, and the other parts of the nerve monitoring module 600 continuously monitor for 10ms to alternately work. Therefore, nerve monitoring can be realized before puncture and during ablation, and the whole operation process is included in the nerve monitoring range.
By combining the structure of the invention, the ablation electrode of the radio frequency ablation needle is used as the stimulating electrode for nerve monitoring, the stimulation electrode does not need to be arranged additionally and the special ablation needle does not need to be produced independently, the intermittent work can be carried out by the radio frequency ablation and the nerve monitoring, the monitoring effect can be greatly improved, when the device is used for ablation, before the ablation needle punctures a focus, the ablation electrode on the needle point of the ablation needle is controlled by the stimulating circuit of the nerve monitoring module, the intermittent stimulating current is continuously sent out to stimulate a patient, the signal receiving electrode for nerve monitoring continuously receives a feedback signal of the patient to carry out nerve monitoring, and the nerve is ensured not to be damaged in the puncturing process. When the focus is ablated, the signal switching module continuously works in a time-sharing manner between the ablation module and the nerve monitoring module, so that whether nerves are damaged or not can be monitored in real time, and the safe and smooth operation is ensured.
Claims (6)
1. The utility model provides a combine neural monitoring's safe intelligence to melt host computer, its characterized in that, including melting needle interface, neural monitoring interface, host system, signal switching module, melting module and neural monitoring module, it includes radio frequency output circuit to melt the module, neural monitoring module includes amazing circuit, radio frequency output circuit is connected to melting needle interface through signal switching module with amazing circuit's output, host system connects signal switching module, melts module and neural monitoring module respectively, signal switching module includes the relay, melting module and neural monitoring module are connected respectively to the switching signal end of relay, the control signal connection host system of relay.
2. The safe intelligent ablation host machine combined with nerve monitoring as claimed in claim 1, wherein the nerve monitoring module comprises a stimulation circuit and a signal receiving and conditioning circuit, the stimulation circuit is connected with an ablation needle interface through a signal switching module, the ablation needle interface is connected with an ablation needle ablation electrode loop, and the signal receiving and conditioning circuit is connected with an external nerve monitoring and recording electrode through a nerve monitoring and receiving interface.
3. The safe intelligent ablation host machine with nerve monitoring combination according to claim 2, wherein the signal receiving and conditioning circuit comprises a signal filtering and amplifying circuit, an AD conversion circuit and an algorithm monitoring circuit which are connected in sequence, the output of the algorithm monitoring circuit is connected with the main control module, and the signal filtering and amplifying circuit, the AD conversion circuit and the algorithm monitoring circuit are respectively connected with the main control module.
4. The safety intelligent ablation host machine combined with nerve monitoring as claimed in claim 1, wherein the ablation module comprises a radio frequency output circuit and a temperature detection circuit, the radio frequency output circuit comprises an external DC power input, a DC-DC voltage regulation and conversion circuit and a DC-AC radio frequency output circuit which are connected in sequence, the DC-AC radio frequency output circuit is connected with an ablation needle interface through a signal switching module, the ablation needle interface is connected with an ablation electrode loop of an ablation needle, and the temperature detection circuit is directly connected with a thermocouple interface of the ablation needle interface without signal switching.
5. The safe intelligent ablation host computer with nerve monitoring of claim 4, wherein the ablation module further comprises an impedance monitoring circuit, the output of the impedance monitoring circuit is connected with the main control module.
6. The safe intelligent ablation host machine with nerve monitoring of claim 5, wherein the master control module is further connected with an alarm circuit.
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CN202011266116.1A CN112244995A (en) | 2020-11-13 | 2020-11-13 | Safe intelligent ablation host combined with nerve monitoring |
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CN202011266116.1A CN112244995A (en) | 2020-11-13 | 2020-11-13 | Safe intelligent ablation host combined with nerve monitoring |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN116019543A (en) * | 2023-02-13 | 2023-04-28 | 北京北琪医疗科技股份有限公司 | Integrated medical equipment combining radio frequency ablation with internal heating needle soft tissue heating |
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CN102985004A (en) * | 2010-04-30 | 2013-03-20 | 美敦力施美德公司 | Interface module for use with nerve monitoring and electrosurgery |
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CN109350222A (en) * | 2018-10-10 | 2019-02-19 | 郑州大学第附属医院 | A kind of thyroid tumors RF ablation device based on recurrent nerve detection |
CN109528297A (en) * | 2018-10-29 | 2019-03-29 | 四川大学华西医院 | A kind of ablation needle carrying out recurrent nerve monitoring and monitoring system |
CN111544109A (en) * | 2019-02-12 | 2020-08-18 | 四川锦江电子科技有限公司 | Multi-channel radio frequency output circuit and ablation equipment |
CN215384559U (en) * | 2020-11-13 | 2022-01-04 | 浙江伽奈维医疗科技有限公司 | Safe intelligent ablation host combined with nerve monitoring |
-
2020
- 2020-11-13 CN CN202011266116.1A patent/CN112244995A/en active Pending
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
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CN102985004A (en) * | 2010-04-30 | 2013-03-20 | 美敦力施美德公司 | Interface module for use with nerve monitoring and electrosurgery |
CN104287822A (en) * | 2013-07-16 | 2015-01-21 | 柯惠有限合伙公司 | Electrosurgical generator with continuously and arbitrarily variable crest factor |
US20180055557A1 (en) * | 2016-09-01 | 2018-03-01 | Rainbow Medical Ltd. | Ablation management |
CN109350222A (en) * | 2018-10-10 | 2019-02-19 | 郑州大学第附属医院 | A kind of thyroid tumors RF ablation device based on recurrent nerve detection |
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CN111544109A (en) * | 2019-02-12 | 2020-08-18 | 四川锦江电子科技有限公司 | Multi-channel radio frequency output circuit and ablation equipment |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN116019543A (en) * | 2023-02-13 | 2023-04-28 | 北京北琪医疗科技股份有限公司 | Integrated medical equipment combining radio frequency ablation with internal heating needle soft tissue heating |
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