WO2010110303A1 - 分注装置 - Google Patents
分注装置 Download PDFInfo
- Publication number
- WO2010110303A1 WO2010110303A1 PCT/JP2010/055061 JP2010055061W WO2010110303A1 WO 2010110303 A1 WO2010110303 A1 WO 2010110303A1 JP 2010055061 W JP2010055061 W JP 2010055061W WO 2010110303 A1 WO2010110303 A1 WO 2010110303A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- container
- dispensing
- patient
- nozzle
- supply unit
- Prior art date
Links
- 239000003814 drug Substances 0.000 claims abstract description 135
- 229940079593 drug Drugs 0.000 claims abstract description 43
- 238000003825 pressing Methods 0.000 claims abstract description 16
- 239000000243 solution Substances 0.000 claims description 99
- 239000000126 substance Substances 0.000 claims description 99
- 238000004140 cleaning Methods 0.000 claims description 63
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 54
- 238000010790 dilution Methods 0.000 claims description 47
- 239000012895 dilution Substances 0.000 claims description 47
- 238000000605 extraction Methods 0.000 claims description 20
- 238000005303 weighing Methods 0.000 claims description 19
- 238000003860 storage Methods 0.000 claims description 12
- 239000003085 diluting agent Substances 0.000 claims description 10
- 238000002156 mixing Methods 0.000 claims description 3
- 239000007788 liquid Substances 0.000 abstract description 62
- 238000000034 method Methods 0.000 description 21
- 238000005406 washing Methods 0.000 description 17
- 239000011550 stock solution Substances 0.000 description 15
- 238000001514 detection method Methods 0.000 description 13
- 239000008155 medical solution Substances 0.000 description 11
- 230000001954 sterilising effect Effects 0.000 description 9
- 239000003795 chemical substances by application Substances 0.000 description 8
- 238000011084 recovery Methods 0.000 description 8
- 238000004659 sterilization and disinfection Methods 0.000 description 5
- 230000002093 peripheral effect Effects 0.000 description 4
- 230000002265 prevention Effects 0.000 description 4
- 239000008399 tap water Substances 0.000 description 4
- 235000020679 tap water Nutrition 0.000 description 4
- 239000002351 wastewater Substances 0.000 description 4
- 239000000428 dust Substances 0.000 description 3
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 238000009434 installation Methods 0.000 description 3
- 230000009545 invasion Effects 0.000 description 3
- 230000033001 locomotion Effects 0.000 description 3
- 238000012545 processing Methods 0.000 description 3
- 244000052616 bacterial pathogen Species 0.000 description 2
- 235000019658 bitter taste Nutrition 0.000 description 2
- 238000004891 communication Methods 0.000 description 2
- 238000012790 confirmation Methods 0.000 description 2
- 238000011109 contamination Methods 0.000 description 2
- 238000007865 diluting Methods 0.000 description 2
- 238000007599 discharging Methods 0.000 description 2
- 238000012423 maintenance Methods 0.000 description 2
- 238000012856 packing Methods 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 241000894006 Bacteria Species 0.000 description 1
- 241000238631 Hexapoda Species 0.000 description 1
- 239000000654 additive Substances 0.000 description 1
- 238000012550 audit Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 230000035622 drinking Effects 0.000 description 1
- 238000001704 evaporation Methods 0.000 description 1
- 230000008020 evaporation Effects 0.000 description 1
- 239000004973 liquid crystal related substance Substances 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 238000007639 printing Methods 0.000 description 1
- 239000008213 purified water Substances 0.000 description 1
- 230000011218 segmentation Effects 0.000 description 1
- 238000003756 stirring Methods 0.000 description 1
- 229920003002 synthetic resin Polymers 0.000 description 1
- 239000000057 synthetic resin Substances 0.000 description 1
- 239000006188 syrup Substances 0.000 description 1
- 235000020357 syrup Nutrition 0.000 description 1
- 238000009423 ventilation Methods 0.000 description 1
- 239000002699 waste material Substances 0.000 description 1
Images
Classifications
-
- G—PHYSICS
- G07—CHECKING-DEVICES
- G07F—COIN-FREED OR LIKE APPARATUS
- G07F15/00—Coin-freed apparatus with meter-controlled dispensing of liquid, gas or electricity
-
- G—PHYSICS
- G07—CHECKING-DEVICES
- G07F—COIN-FREED OR LIKE APPARATUS
- G07F17/00—Coin-freed apparatus for hiring articles; Coin-freed facilities or services
- G07F17/0092—Coin-freed apparatus for hiring articles; Coin-freed facilities or services for assembling and dispensing of pharmaceutical articles
Definitions
- the present invention relates to a dispensing device for automatically dispensing a liquid agent.
- a liquid container tray mounting portion for mounting a liquid container tray that can accommodate a plurality of liquid containers containing a desired liquid agent, and a patient that can accommodate a plurality of patient containers
- a dispensing mechanism that includes a dispensing nozzle that selects any of the patient containers arranged in a tray and discharges and dispenses the inhaled liquid (for example, Patent Document 1).
- the dispensing nozzle is moved to discharge the liquid agent to each patient container. For this reason, it is necessary to accurately position each patient container at a predetermined position, and the installation work is troublesome and time consuming, and each requires a positioning structure. Moreover, there is a problem that the dispensed patient containers cannot be taken out sequentially.
- an object of the present invention is to provide a dispensing apparatus that can easily and quickly prepare a patient container and that can be sequentially taken out from the dispensed patient container.
- the present invention provides: Dispensing device, A chemical solution supply unit in which a plurality of drug bottles in which chemical solutions are stored by type are arranged; A container supply unit capable of arranging and arranging patient containers according to size; A dispensing unit having a nozzle that sucks a chemical solution from a drug bottle of the drug solution supply unit and dispenses it into a patient container of the container supply unit, and a rod that presses the patient container aligned with the guide member. And comprising The container supply unit A plurality of guide members for holding patient containers of the same size in an aligned state; And a positioning member for positioning the patient container pushed out from the guide member by the rod at a dispensing position.
- the patient container need only be aligned with the guide member. And it can dispense appropriately by pressing a patient container with the rod of a dispensing part, and positioning with a positioning member.
- the guide member is preferably exchangeable.
- This configuration makes it possible to arrange patient containers of frequently used sizes so that they can be freely aligned.
- This configuration makes it possible to easily take out the patient container while appropriately dispensing the patient container.
- the chemical solution supply unit includes a closing plate that opens and closes an upper opening of each drug bottle, It is preferable that the rod is configured such that the closed plate can be opened before the nozzle reaches the medicine bottle.
- the medicinal solution supply unit supports the medicinal bottle tilted with respect to the vertical direction so that the nozzle that has entered from the upper opening of the medicinal bottle can be arranged near the lowest position of the bottom of the medicinal bottle. Is preferred.
- the chemical solution supply unit includes an urging means for positioning the drug bottle in a tilted and supported state.
- the medicine bottle includes a closing plate that is rotatable about a support shaft,
- the closing plate is A closing portion extending from the support shaft to one side and capable of closing the upper opening of the medicine bottle;
- a pressure receiving portion that extends from the support shaft to the other side and is pressed by the rod to release the closing by the closing portion so as to open the upper opening of the medicine bottle, and allows the nozzle to enter the medicine bottle;
- it consists of.
- the lid with a simple configuration can keep the medicine bottle closed and prevent invasion of germs, dust, insects, etc., and further the evaporation of the chemical solution. Further, the lid can be automatically opened by a rod that moves together with the nozzle when sucking the chemical. For this reason, the installation of the lid and the installation of the medicine bottle can be completed simply by placing the medicine bottle on the medicine supply section.
- the container supply unit includes a weighing unit that supports and weighs the patient container positioned at the dispensing position,
- the weighing unit is A base that is movable below the dispensing position of each guide member;
- a support table provided on the base so as to be movable up and down, and supporting and weighing a patient container positioned at a dispensing position by moving up; Is preferably provided.
- Storage means for storing the amount of medicinal solution that can be stored in different patient containers of different sizes;
- a container selecting means for extracting a prescription amount of a certain chemical solution from the prescription data and selecting a patient container of an appropriate size from the capacity stored in the storage means; Further comprising The container selection means calculates the divided prescription amount by dividing the prescription amount when the prescription amount exceeds the maximum size of the container for a patient stored in the storage means, and calculates the divided prescription amount. It is preferred to select a properly sized patient container that can be accommodated.
- a storage means for storing the associated amount and the number of scales indicating one dose for the patient container; From the prescription data, the prescription amount of a certain medicinal solution is extracted, the volume per dose is compared with the capacity stored in the storage means and the capacity per scale calculated from the number of scales, and the mixing capacity of the diluent is determined.
- This configuration allows the dilution amount to be automatically set according to the number of scales on the patient container.
- the prescription data includes a specified number of days, It is preferable that the dilution amount calculating means calculates the mixture volume of the diluent only for the prescribed amount for the specified number of days.
- This configuration makes it possible to dilute only the chemical solution for the specified number of days and provide the subsequent chemical solution as a stock solution.
- the stock solution may be diluted at the time of use, and there is no possibility of contamination due to invasion of various bacteria when mixed with diluted water. Therefore, it can be used without any problem even when the time exceeds the specified number of days.
- the upper opening of the cleaning container is closed with an openable closing plate, and the closing plate is pressed by a rod that descends together with the nozzle and includes a pressure receiving portion that opens the upper opening.
- FIG. 2 It is a perspective view which shows the outline of the dispensing apparatus which concerns on this embodiment. It is a perspective view which shows the state which opened the upper door and lower door of FIG. (A) is a top view which shows the outline of the container supply part of FIG. 2, (b) is the side sectional drawing. It is a side view which shows the container holding part of FIG. (A) is a top view which shows the outline of the chemical
- FIG. 8 It is a schematic explanatory drawing which shows a series of operation
- FIG. 8 It is a front view which shows the outline of the dispensing apparatus which concerns on 2nd Embodiment.
- (A) is a top view which shows the container supply part of FIG. 8, (b) is the side view.
- (A) is a top view which shows the chemical
- (A) is a front view of a patient container, (b) is the side view.
- FIG. 1 It is a side view which shows the nozzle of a dispensing part.
- A) is a schematic front view which shows a washing
- (b) is a schematic sectional drawing which shows the washing
- A) is a top view which shows the positional relationship of the container supply part of FIG. 9, the washing
- (b) is an enlarged view of a sterilization part.
- FIG. 9 is a diagram showing a reissue screen pop-up displayed on the display panel of FIG. 8. It is a flowchart which shows the content of the dispensing process by the dispensing apparatus which concerns on 2nd Embodiment. It is a flowchart which shows the content of the dispensing process by the dispensing apparatus which concerns on 2nd Embodiment. It is a front view which shows the dispensing part which concerns on other embodiment. It is a figure which shows the other example of the liquid agent dispensing monitor screen displayed on the display panel of FIG.
- the dispensing apparatus includes a container supply unit 2, a chemical solution supply unit 3, a dispensing unit 4, and a cleaning unit 5 in the apparatus main body 1.
- the apparatus main body 1 has a substantially rectangular parallelepiped shape, and doors 6 and 8 that can be opened on the upper side and the lower side are provided on the front surface.
- a display panel 7 such as a liquid crystal display is provided on the front surface of the upper door 6.
- the display panel 7 displays the name, volume, etc. of the chemical solution to be dispensed.
- the container supply unit 2 is arranged in the left half, and the chemical solution supply unit 3 is arranged in the right half.
- cleaning part 5 is arrange
- a washing water supply tank 9 and a drainage recovery tank 10 are accommodated in the right half part so as to be able to be taken out.
- the cleaning water stored in the cleaning water supply tank 9 is supplied to a cleaning container 48 of the cleaning unit 5 described later by a pump (not shown).
- the water level in the cleaning water supply tank 9 is detected by a water level detection sensor (not shown). And if the water level of a wash water falls to a predetermined position, it will be possible to alert
- the waste water obtained by washing the nozzle 42 by the washing unit 5 is collected in the waste water collection tank 10.
- the drainage recovery tank 10 is also provided with a water level sensor (not shown), so that it can be notified when the waste liquid is full.
- a journal printer 11 and a label printer 12 are provided on the left side.
- a front surface of a container supply unit 2 to be described later is located, and further above the container An outlet 13 is formed.
- a pull-out (or overturning) shelf 14 and a recess 15 for accommodating a bar code reader (not shown).
- the bar code reader is used to read a bar code printed on a label attached to a medicine bottle 37 described later. By reading this barcode with a barcode reader, it is possible to call up information on the liquid medicine stored in the medicine bottle 37 from the database and display it on the display panel 7.
- the container supply unit 2 can accommodate patient containers 16 in a plurality of rows according to size, and is supported by guide rails (not shown) and can be pulled out forward.
- the patient container 16 is a lightweight container made of a synthetic resin material, has a substantially elliptical cross section, and has a mouth formed above.
- the patient containers 16 are arranged in each row so as to be aligned in the minor axis direction.
- a guide member 17 composed of a bottom surface and both side surfaces is detachably disposed.
- Elastic pieces 18 are respectively attached to the inner surfaces of both sides on one end side (front side) of the guide member 17.
- Each elastic piece 18 projects obliquely inward toward one end on the front side.
- a pressing piece 19 is disposed on the other end side (rear side) of the guide member 17.
- the pressing piece 19 is a metal plate bent in a substantially L-shaped cross section, and is colored black. The reason why it is colored black is to enable detection by a first detection sensor 25 described later, but it is also possible to adopt a configuration in which an opening is formed for the same purpose.
- the pressing piece 19 is pressed by a rod 43 provided in the dispensing unit 4 described later, and is used for alignment and movement of the patient container 16 disposed on the guide member 17. In a state where the patient containers 16 are aligned, the patient container 16 is not displaced rearward due to the weight of the pressing piece 19.
- a container holding portion 20 is disposed further forward of the elastic piece 18 of the guide member 17. As shown in FIG. 4, the container holding unit 20 is obtained by fixing a pair of holding plates 22 to the upper surface of the support plate 21 at a predetermined interval.
- the support plate 21 includes a central flat portion 23 and leg portions 24 extending obliquely downward from the flat portion 23 toward both sides (front and rear).
- a through-hole 23a is formed at the center of the flat portion 23, and the patient container 16 positioned at a predetermined position (dispensing position) above the first detection sensor 25 provided below the flat hole 23 and the pressing piece 19 described above. Can be detected.
- the first detection sensor 25 not only detects that the patient container 16 is positioned at the dispensing position, but also detects the pressing piece 19 so that the patient container 16 is missing in the row. Can be detected.
- the front end (lower end) of the leg portion 24 extends further to both sides in parallel with the flat portion 23.
- the holding plate 22 includes a plate main body 26 erected from both sides of the support plate 21, and an elastic guide 27 provided at a protruding portion on the upper edge of the plate main body 26.
- interval of the plate main body 26 is set to the dimension which can pass the container 16 for patients (long axis direction).
- the distal end of the elastic guide 27 is curved along the outer surface of the patient container 16, and the patient container 16 is positioned at the dispensing position by the elastic force.
- column can be changed freely according to the size of the patient container 16 to align. Normally, when the dispensing device is delivered, it can be freely selected and mounted according to the user's wishes. Further, all the dispensing positions are photographed by a camera (not shown) arranged on the upper side, and the patient container 16 is in an appropriate direction at that position (the major axis direction of the patient container 16 matches the left-right direction). It is used to determine whether or not it is positioned in the direction). Further, a first tray 17 a is provided below the guide member 17, and a second tray 17 b is provided below the container holding portion 20 at a position one level lower than the first tray 17 a.
- trays 17a and 17b prevent the electrical components and the like from reaching the lower side even if the chemical solution or the washing water is scattered.
- an auxiliary holding part 28 on which the patient container 16 can be placed is provided on the side of the container holding part 20.
- the auxiliary holding unit 28 is used when manually placing the patient container 16 that is large and is not frequently used.
- the auxiliary holding unit 28 can also be weighed by a weighing unit 29 described later.
- a weighing unit 29 is disposed below the container holding unit 20.
- a base 29b is provided on two rails 29a extending in the left-right direction so as to be reciprocally movable.
- a driving force from a motor (not shown) is transmitted to the base 29b via a belt 29c so as to reciprocate.
- Two shaft portions 29d are erected on the base 29b, and a support base 29e is provided along these shaft portions 29d so as to be moved up and down by driving another motor (not shown).
- the weighing unit 29 configured as described above stops on the lower side of the container holding unit 20 to be weighed and ascends to weigh the container holding unit 20 and the empty patient container 16 to be a reference value, and then descends once.
- the weighing unit 29 is configured to be reciprocally movable, and only one weighing unit 29 is required for the container holding units 20 at a plurality of locations. Therefore, it can be manufactured at low cost. Moreover, it waits on the lower side except at the time of weighing.
- a further front side of the container holding part 20 is an extraction part 30.
- the inner surface of the front wall that constitutes a part of the extraction portion 30 is an inclined surface 30a that gradually inclines obliquely forward as it goes upward.
- the patient container 16 discharged from the container holding unit 20 is supported on the inclined surface by the extraction unit 30, so that the upper side is positioned obliquely forward so that it can be easily extracted from the front side of the apparatus main body 1.
- Let A through hole 30b is formed in the front surface of the front wall, and the patient container 16 discharged to the extraction portion 30 by the second detection sensor 31 is detected through the through hole 30b.
- An LED 32 is disposed in the vicinity of the second detection sensor 31 and is visible from the front side through an opening provided on the front surface of the apparatus main body 1. The LED 32 is turned on when the patient container 16 is detected by the second detection sensor 31.
- a recess 20a is formed on the lower side of the LED 32. This recess is used for pulling out the entire container supply unit 2.
- the chemical solution supply unit 3 includes a supply unit main body 33 and a lid body 34 attached to be rotatable about a support shaft 34 a on the rear side of the supply unit main body 33.
- a holding container 36 having a top plate 35 in which a plurality of openings 35 a for holding the medicine bottle 37 is formed is accommodated in the supply unit main body 33.
- the opening 35 a is formed in a circular shape along the outer peripheral surface of the medicine bottle 37.
- An annular body 38 is attached to the upper opening of the medicine bottle 37.
- the annular body 38 is attached with a label printed with a barcode and has a built-in RFID (Radio Frequency IDentification).
- a label is originally attached to the medicine bottle 37 by a pharmaceutical company.
- the label is printed with a barcode as well as the name and content of the chemical.
- information corresponding to the chemical solution stored in the medicine bottle 37 to which the annular body 38 is attached is stored.
- the barcode barcode attached to the medicine bottle 37 and the barcode of the annular body 38 are read with a barcode reader to confirm whether or not they match.
- Data related to the chemical solution stored in the RFID is read by a reader described later.
- the lid 34 has an upper surface, a front surface, and both side surfaces, and a handle 39 is provided at the center of the front surface.
- cylindrical portions 34b are respectively provided at positions corresponding to the openings of the holding container 36 (specifically, positions corresponding to the upper end openings of the medicine bottles 37 held in the openings). Is formed.
- the center hole of each cylindrical portion 34b is closed by a closing plate 40 provided so as to be rotatable about the shaft portion 40a.
- the closing plate 40 includes a lid portion 40b that covers the center hole and a pressure receiving portion 40c that extends on the opposite side across the shaft portion 40a.
- the closing plate 40 normally closes the center hole by its own weight (or the urging force of the coil spring provided on the shaft portion 40a) of the lid portion 40b, and intrusion of dust or the like into the medicine bottle 37 with the upper opening portion opened. To prevent. Further, the closing plate 40 is rotated to the open position by being pushed down by the rod 43 of the dispensing unit 4 described later.
- 3a is a fan for ventilation.
- the dispensing unit 4 includes a nozzle 42 and a rod 43 supported by the support unit 41.
- a pump (not shown) is connected to the nozzle 42 via a tube (not shown) so that cleaning water can be sucked and discharged.
- the movement of the nozzle 42 and the control of the discharge of the suction water of the cleaning water can be performed by a conventionally known method (for example, see Japanese Patent Application Laid-Open No. 2004-245715).
- the support portion 41 includes a first rail 44 that extends in the front-rear direction provided on the inner surfaces of both sides of the apparatus main body 1, and a first rail 44 that is movably provided in the front-rear direction along the first rail 44.
- the internal space can be moved in the X-axis, Y-axis, and Z-axis directions by the two rails 45 and the third rail 46 of the frame body 4a provided so as to be movable in the left-right direction along the second rail 45.
- the support portion 41 moves up and down along the third rail 46, the third rail 46 moves left and right along the second rail 45, and the second rail 45 moves back and forth along the first rail 44.
- the liquid dripping prevention part 47 in which the recessed part 47a curved in the upper surface is formed in the downward side of the support part 41 is provided.
- the liquid dripping prevention unit 47 is driven by a motor 47b, and a receiving position located below the nozzle 42 around a support shaft 47e provided on the side of the third rail 46 via a pulley 47c and a belt 47d. Each can turn to a retracted position located on the side.
- a reader (not shown) for reading information written in the RFID built in the annular body 38 of the medicine bottle 37 is provided below the support portion 41.
- the nozzle 42 is connected to a cylinder (not shown), draws in the chemical solution from the medicine bottle 37 by retreating the piston in the cylinder, and temporarily stores it. And the chemical
- the cylinder it is preferable that a certain amount of air is sealed in advance so that the chemical liquid does not directly touch the piston when the chemical liquid is sucked.
- the rod 43 is disposed in front of the nozzle 42 and supported so as to be movable up and down with respect to the support portion 41.
- the lower end position of the rod 43 is located below the lower end position of the nozzle 42.
- the cleaning unit 5 includes a cleaning container 48 and an air supply cylinder 49 disposed on the upper side.
- the cleaning container 48 includes an outer container 50 and an inner container 51.
- the inner container 51 is connected to the cleaning water supply tank 9 through a tube 51a, and cleaning water is appropriately supplied by driving a pump (not shown).
- the washing water overflowing from the inner container 51 is stored in an outer region between the outer container 50 and is recovered into the recovery tank 10 via a tube 50a connected to the side wall of the outer container 50.
- the air supply tube 49 air is blown from the blower 42b to the nozzle 42 passing through the inside through an opening 42a formed in the side wall. Thereby, the water droplets adhering to the ridge and the outer peripheral surface remaining at the tip of the nozzle 42 can be dropped.
- the container supply unit 2 aligns the patient containers 16 in the short axis direction with the guide members 17 in each row according to size. And the press piece 19 is arrange
- the medicine bottle 37 is set according to the set position information of the medicine bottle 37 displayed on the display panel 7 by reading the barcode of the medicine bottle 37 with a barcode reader. Therefore, the user opens the lid 34 with the handle 39 and places the medicine bottle 37 at a position displayed on the display panel 7 (an opening 35 a formed in the top plate 35 of the chemical solution supply unit 3). That's fine.
- the dispensing unit 4 is moved to the origin position (the position at the far left corner of the apparatus body 1) only once when the power supply of the dispensing apparatus is turned on, and the origin taking is performed with the position as the reference position.
- the support unit 41 When prescription data is input from a server or the like (not shown), the support unit 41 is moved, and the rod 43 is positioned in a row where the patient containers 16 to be dispensed are arranged. And the container 16 for patients located in the back side of an applicable row
- the support part 41 is moved to an upper position of the medicine bottle 37 in which the corresponding medicine is accommodated according to the prescription data.
- the information written in the RFID is read by the reader, and the chemical solution stored in the medicine bottle 37 is collated. Thereby, it can be confirmed whether the chemical
- the support part 41 will be dropped.
- the rod 43 comes into contact with the pressure receiving portion 40c of the closing plate 40 as shown in FIG.
- the closing plate 40 is rotated by its own weight of the rod 43 to open the central hole of the cylindrical portion 34b.
- the closing plate 40 is opened and the tip of the pressure receiving portion 40c abuts against the lid body 34, further rotation is prevented.
- the rod 43 slides with respect to the support portion 41 and only the nozzle 42 is lowered. Subsequently, as shown in FIG.
- the nozzle 42 passes through the center hole and reaches the inside of the medicine bottle 37.
- the nozzle 42 reaches the liquid level of the chemical solution, as described above, the nozzle 42 is gradually lowered according to the decrease in the liquid level while sucking the chemical solution by a conventionally known method. Thereby, the chemical liquid can be sucked into the cylinder and temporarily stored without the outer peripheral surface of the nozzle 42 being immersed in the chemical liquid.
- the support portion 41 (nozzle 42 and rod 43) is raised.
- the rod 43 moves to the original position by its own weight.
- the closing plate 40 is released from the pressed state by the rod 43 and closes the central hole of the cylindrical portion 34b of the lid 34. If the support part 41 raises to a predetermined position, it will move to the container 16 for patients applicable to a dispensing position.
- the nozzle 42 When the nozzle 42 reaches the dispensing position, the nozzle 42 is lowered and the tip portion is positioned in the patient container 16. Then, the chemical liquid sucked into the cylinder by advancing the piston is supplied into the patient container 16. When the supply of the chemical solution in the cylinder is completed, the nozzle 42 is raised again, and this nozzle 42 is moved to the cleaning unit 5 this time. At this time, the weighing unit 29 is raised, the patient container 16 and the support plate 21 to which the medicinal solution is supplied are weighed, and the result is stored. Then, the weight of the dispensed drug solution is calculated by subtracting the weight of the patient container 16 from the weighing result.
- the nozzle 42 When the nozzle 42 reaches the cleaning unit 5, the nozzle 42 is lowered to enter the inner container 51 of the cleaning container 48 (here, approximately 1 cm is submerged from the tip of the nozzle 42). Then, the piston is moved backward to suck the cleaning water into the cylinder. When the cleaning water is sucked, the nozzle 42 is once lifted and moved to the outer region formed between the inner container 49 and the outer container 50, and the cleaning process is performed by discharging the sucked cleaning water. The discharged washing water is collected into the waste water collection tank 10. This cleaning process may be performed a plurality of times, or once if it can be cleaned. When the cleaning process is completed, the nozzle 42 is raised. At this time, air is blown toward the nozzle 42 by the air supply tube 49, and the cleaning water and the chemical solution adhering to the nozzle 42 are removed.
- the suction of the chemical solution from the drug bottle 37 by the nozzle 42, the dispensing of the sucked chemical solution into the patient container 16 and the cleaning of the nozzle 42 are repeated, and it corresponds to the patient container 16 based on the prescription data. Dispense a predetermined amount of each chemical solution. And every time it dispenses, the container 16 for patients and the support plate 21 are weighed in the weighing
- the support portion 41 is moved, and the rods 43 are used to push forward the pressing pieces 19 in the row in which the dispensed patient containers 16 are arranged.
- the patient container 16 at the top of the front where the dispensing of the drug solution has been completed is pushed out to the take-out portion 30 while being held by the elastic guide 27.
- the upper part of the container 16 for patient pushed out to the extraction part 30 protrudes diagonally forward by the inclination of the front inner surface. And this state is detected by the 2nd detection sensor 31, and LED32 lights. As a result, the user can see that the patient container 16 that has been dispensed has been dispensed.
- the journal printer 11 is activated, and the chemical information is printed.
- the printed chemical information is used for auditing.
- the label printer 12 is activated, and the label on which the patient name and the barcode are printed is discharged. This label is attached to the patient container 16 for use.
- the patient container 16 is associated with information on the dispensed liquid medicine (name of the liquid medicine, dosage, etc.).
- the upper doors 106a and 106b that can be opened are provided with a locking mechanism such as a solenoid. And the locked state by this locking mechanism can be unlocked by inserting and rotating a key in a key hole 106c provided in the right door 106a.
- a main body power supply (not shown) is in an on state, both doors 106a and 106b are electrically unlocked simultaneously by a key operation.
- the main body power is off, only the locked state of the right door is mechanically unlocked by key operation, and the left door 106b maintains the locked state.
- the left door 106b can be unlocked manually by opening the right door 106a.
- these doors 106a and 106b are provided with packing at the periphery so that they are in a sealed state in a closed state.
- the packing can be provided on the apparatus main body side.
- a window 107 having a vertically long rectangular shape and translucency is formed at the center of the right door 106a. The user can visually recognize the state of the chemical solution supply unit 103 through the window 107.
- a HEPA filter 108 and a fan 109 are provided on the upper surface of the apparatus main body 101 so that purified air can be supplied to the internal space of the apparatus main body 101.
- the air supplied into the apparatus main body 101 is discharged to the outside from the container supply unit 102, the chemical solution supply unit 103, the dispensing unit 104, the cleaning unit 105, and the like through gaps between components arranged on the lower side. Thereby, the area
- the container outlet 113 formed on the lower side of the left door 106b can be closed by an openable shutter 114.
- a drawer-type shelf 115 for placing the patient container 120 and a cap storage box 116 for storing the cap of the medicine bottle 137 are juxtaposed below the container outlet 113.
- a journal printer 118a, a label printer 118b, and a barcode reader 119 are disposed in these right regions (recesses 117 formed on the lower side of the right door 106a).
- the position of the extraction unit 130 is adjusted for each row in which the patient containers 120 are accommodated by size.
- the side walls constituting the extraction part 130 are formed low. Thereby, it becomes easy for a user to hold
- the extraction part 130 is adjusted in the front-rear and top-bottom positions according to the size of the patient container 120. As the patient container 120 becomes larger, the position of the extraction portion 130 is adjusted forward and downward (in FIG.
- the position is adjusted as the extraction portion 130 is positioned on the right side. Yes.)
- the gripping positions of all the patient containers 120 discharged to the extraction portion 130 substantially the same position so as to facilitate extraction.
- the patient container 120 is discharged to any of the extraction units 130 of each container supply unit 102, it can be detected by a sensor (not shown) through the sensor hole 130a formed in the extraction unit 130. Therefore, it is not necessary to provide a plurality of sensors.
- the chemical solution supply unit 103 does not include the lid 34 as in the first embodiment.
- the supply unit main body 133 is provided with a medicine bottle holding unit 135 including a pair of holding guides 134 so as to be substantially U-shaped instead of the opening 35a.
- the bottom surface 135a of the medicine bottle holding part 135 is inclined so as to be gradually lowered toward the front, and the medicine bottle 137 to be placed is inclined, that is, the outer peripheral surface of the medicine bottle 137 contacts the holding guide 134. Support the state held in contact.
- the inclination angle of the medicine bottle 137 at this time is such that when the nozzle 142 is inserted vertically downward from the upper end opening of the medicine bottle 137, the tip portion of the nozzle 142 can reach the deepest position of the inclined medicine bottle 137. It is set to become. Thereby, when extracting a chemical
- a closing plate 140 is attached to the upper end opening of each medicine bottle 137.
- the closing plate 140 includes a closing portion 140a that closes the upper end opening of the medicine bottle 137, and a pressure receiving portion 140b that extends obliquely from the closing portion 140a.
- the closing plate 140 is provided so as to be rotatable about the support shaft 141 and is supported in an inclined state by a spring 141a provided on the support shaft 141. It is biased in the closing direction. Thereby, the closed state by the closing plate 140 can be ensured.
- the closing plate 140 is rotated to the open position against the urging force of the spring 141a by pressing the pressing receiving portion 140b with a rod (not shown) that moves up and down together with the nozzle 142. Move.
- the rod is supported by the support portion 145 so as to be lifted and lowered, and the pressure receiving portion 140b is pushed down by its own weight to rotate the closing plate 140 to the open position. Then, after opening the closing plate 140, the support portion 145 is slid, and only the nozzle 142 continues to descend. As a result, it is possible to allow the nozzle 142 to enter from the upper end opening of the medicine bottle 137 while keeping the closing plate 140 open.
- a single medicine bottle 137 at the left end arranged in the foremost row of the medicine supply unit 103 contains dilution water for diluting the chemical solution.
- tap water or purified water is used as dilution water.
- the cleaning water supplied from the cleaning water supply tank 110 can be used as the dilution water as it is.
- the chemical solution stored in the medicine bottle 137 is periodically stirred using the nozzle 142. That is, the nozzle 142 is inserted into the medicine bottle 137, and the suction and discharge of the medicine liquid are repeated. Thereby, stirring of the chemical
- the used nozzle 142 may be washed.
- a nozzle 142 is detachable. That is, when the main body power supply is turned off, the dispensing unit 104 is lowered, and the screwing state of the nozzle holding unit 143 from the support unit 145 is released. And the nozzle 142 hold
- the nozzle 142 can be easily attached and detached in this way, if it is periodically replaced with a new one, problems such as contamination are not likely to occur, and the nozzle 142 is clean.
- the rod which is not shown in figure is attached to the dispensing part 104 so that raising / lowering is possible similarly to the said 1st Embodiment.
- a water supply pipe 150 that protrudes upward from the bottom surface and communicates with the cleaning water supply tank 110 is provided in the cleaning container 148, and communicates with the recovery tank 111 on the bottom surface.
- the drainage port 151 is opened and is disposed on the side of the container supply unit 102 as shown in FIG.
- the upper end opening of the water supply pipe 150 is closed by a rotatable closing plate 152.
- the closing plate 152 includes a closing portion 152 a that closes the upper end opening of the water supply pipe 150 and a pressure receiving portion 152 b that extends obliquely therefrom.
- the closing plate 152 rotates so as to close the upper end opening of the water supply pipe 150 by the closing portion 152a by the biasing force of the spring 152c.
- the closing plate 152 rotates when the pressure receiving portion 152b is pressed by the rod 143 provided in the dispensing unit 104 moved into the cleaning unit 105, and opens the upper end opening.
- the cleaning water in the water supply pipe 150 can be sucked by the nozzle 142.
- the cleaning container 148 itself can be removed with a single touch by rotating the lever 153. Thereby, the cleaning container 148 can be easily cleaned.
- the cleaning unit 105 configured as described above, when the nozzle 142 is cleaned, the nozzle 142 and the rod 143 are moved into the cleaning container 148. Then, the rod 143 presses the pressing receiving portion 152b of the closing plate 152, and the closing plate 152 is rotated to open the upper end opening of the water supply pipe 150. Then, the nozzle 142 is moved down to suck the cleaning water and then lifted. Thereby, the closing plate 152 is rotated by its own weight, and the upper end opening of the water supply pipe 150 is closed. Here, the washing water sucked from the nozzle 142 is discharged.
- the discharged cleaning water flows down from the closing plate 152 to the lower side of the cleaning container 148 and is recovered to the recovery tank 111 through the drain port 151.
- the nozzle 142 is dried by air blown from the blower 144. As described above, when cleaning the nozzle 142, it is only necessary to move it up and down, and it is not necessary to move it in the horizontal direction as in the first embodiment. .
- the water supply pipe 150 that communicates with the cleaning water supply tank 109 may be directly connected to a general water supply (not shown), and the drainage port 151 that communicates with the recovery tank 110 may communicate with a general water supply drainage (not shown). By doing so, it is not necessary to carry and install heavy washing water supply tank 109 and recovery tank 110.
- the sterilizing unit 160 has a pair of sterilizing lamps 162 arranged inside a casing 161 made of a metal material, and a nozzle 142 is provided between the sterilizing lamps 162 at the center of the upper surface. An insertion hole 161a that can be inserted is formed. The sterilizing unit 160 is disposed in front of the cleaning unit 105, and sterilizes the nozzle 142 inserted from the insertion hole 161a.
- Various settings can be made before the dispensing process. That is, setting whether to perform automatic dilution (setting 1), setting whether to use or dilute the stock solution (setting 2), setting whether to dilute based on a single dose (setting 3), number of days
- the setting of dilution (setting 4), the setting of the diluted drug depending on the age of the patient (setting 5), and the setting of the scale display on the patient container 120 (setting 6) can be performed.
- setting 1 set (1-1) automatic dilution on or (1-2) automatic dilution off.
- setting 2 either (2-1) undiluted solution dispensing, (2-2) drug bottle dispensing, fractional undiluted solution dispensing, (2-3) diluted dispensing within the specified number of days, or undiluted solution dispensing after the specified number of days To do.
- setting 3 (3-1) dilution is performed when the single dose includes a decimal, or (3-2) dilution is not performed when the single dose includes a decimal.
- setting 4 the number of days for dilution (specified number of days) is set.
- setting 5 an appropriate diluent is set according to the age of the patient.
- setting 6 a method of providing a scale to be printed on a label attached to the patient container 120 is set.
- the login dialog screen shown in FIG. On the login dialog screen, input fields for a user ID and a password are displayed. When both are input and the login button is operated, the collation is performed, and if it is registered data, the liquid medicine dispensing monitor screen shown in FIG. 17 or the liquid medicine dispensing detail monitor shown in FIG. Display one of the screens. All screens have the same display contents, but display forms are different. That is, the former highlights the column displaying patient names, while the latter highlights the column displaying drug names. In the initial setting, any screen can be selected, and the screen can be displayed based on the screen information at the end of the previous time.
- the liquid medicine dispensing detail monitor screen includes a patient button 172, a division field 173, a days field 174, an application container field 175, a usage field 176, a medicine name 177, a sequential reading mode button 178, an automatic dispensing mode button 179, A device connection field 180, a stop button 181, a hold button 182, an unprocessed list button 183, and a reissue button 184 are included.
- a patient details dialog screen is popped up so that the patient's name, height, ID, etc. can be confirmed.
- a division dialog screen is popped up as shown in FIG. 20, and the capacity of the applied container relative to the total dispensed volume, the dispensed volume after the division, the capacity of the applied container, etc. can be confirmed. ing.
- a days dialog screen including a date for selecting the number of prescription days is popped up as shown in FIG.
- the application container column 175 is touch-operated, as shown in FIG.
- a dosing container selection dialog screen which is a list of applicable patient containers 120 and their capacities, is popped up.
- a usage selection dialog screen including the timing of taking is displayed as shown in FIG.
- a medicine selection dialog screen is popped up as shown in FIG. In this medicine selection dialog screen, any one or all of medicines (chemical solutions), additives, and diluted water can be selected and displayed.
- a reception mode change screen is popped up as shown in FIG. 25 so that a prescription data reception mode can be set.
- a dispensing mode selection screen for selecting either automatic dispensing or manual dispensing is popped up as shown in FIG.
- the button display is automatic dispensing when manual dispensing is selected, and manual dispensing when automatic dispensing is selected.
- a communication information screen including a list of devices connected to the dispensing device such as a barcode reader and a printer is popped up as shown in FIG.
- the stop button 181 is touch-operated, as shown in FIG. 28, the dispensing apparatus is stopped.
- a medicine collection confirmation dialog screen that is a warning display for stopping the dispensing process is displayed in a pop-up manner.
- a hold list screen that is a list of patients whose dispensing process is held is popped up.
- an unprocessed list screen is popped up as shown in FIG.
- the unprocessed list screen displays a list of patients that have not been subjected to the dispensing process, and by selecting each patient, prescription data is displayed for that patient.
- a reissue screen pops up as shown in FIG. 31 so that the prescription data can be reissued while confirming its contents.
- step S1 it is first determined whether or not dispensing can be performed based on prescription data input from a server that is a host system. For example, when a certain drug solution A is to be taken in multiple doses, the prescription amount is only given for the whole, and if the dose for each dose is not included, it cannot be dispensed to decide.
- the prescription data is returned to the server, and vertical division processing is performed (step S2).
- the entire prescription amount (dispensed total amount) is decomposed into a plurality of prescription data obtained by decomposing each dose.
- prescription 1 is medicinal solution A
- 2 is medicinal solution A
- prescription 3 is medicinal solution A, 3 ml in the evening
- the prescription form of the chemical solution is confirmed based on the prescription data (step S3). That is, it is determined whether the chemical solution is supplied as an undiluted solution or diluted. In addition, about a certain chemical
- step S4 When it is determined that the prescription form is a stock solution, it is determined which of the dispensing methods is selected based on the setting 2 (step S4).
- step S5 it is determined whether the single dose contains a decimal number and no dilution is performed.
- the dilution amount is determined so that the single dose becomes an integer larger than that value and closest (step S6).
- the dilution amount is 0.5 ml
- the single dose is an integer of 5 ml.
- the daily dose may be calculated, and if the obtained value does not include a decimal, it may not be diluted. Further, when the daily amount includes decimal numbers, the dilution amount may be determined so as to be an integer larger than that value and closest.
- step S7 the patient containers 120 and the number are calculated according to the prescription data.
- the dispensing method is set to (2-2) medicine bottle dispensing and fraction is set to the stock solution dispensing bottle dispensing, the dispensing method is determined for each medicine contained in the prescription data (step S8).
- the volume is 500 ml
- the fraction of 20 ml is dispensed into the patient container 120 and dispensed.
- the capacity of the medicine bottle containing the medicine B is 300 ml
- the fraction of 90 ml is dispensed into the patient container 120 and dispensed.
- the specified number of days set is the same as when the prescription form described later is dilution.
- a dilution amount is calculated, and a value obtained by adding the dilution amounts is set as a dispensing amount (step S9).
- the size and number of patient containers 120 are determined in the same manner as described above (step S10).
- Step S3 Dilution
- the number of days is equally divided, or (4-2) the specified number of days is diluted dispensing
- the preparation is a stock solution
- the dilution amount is calculated as follows to perform dilution dispensing (step S12).
- the total amount of prescriptions for all chemicals included in the prescription data is calculated.
- the patient container 120 Based on the obtained calculated value, the patient container 120 having the same capacity as this calculated value, or if there is no such patient container 120, a patient container 120 having a size larger and closest thereto Select.
- the single dose of each chemical solution is calculated, and the total value of the single dose of all the chemical solutions is obtained.
- the dose per division of each patient container 120 is calculated.
- the total value calculated in (3) is subtracted from the dose value calculated in (4), and the obtained value is multiplied by the number of fractions (number of doses per day) and the number of days. Calculate the dilution amount per bottle.
- FIG. 12 shows the patient container 120 with the 100 ml scale shown in the table.
- the total prescription amount is 462 ml, so 500 ml is selected.
- the dilution amount per one container 120 for patients is obtained by subtracting 22 ml calculated in (3) from 23.8 ml obtained in (5), and adding 3 fractions and 7 days to 1.8 ml obtained. To obtain 37.8 ml.
- the volume can be exactly 500 ml, and one scale corresponds to one dose.
- step S13 the dilute dispensing (step S13) and the undiluted solution dispensing (step S14) are performed as follows.
- 157.5 ml which is a value obtained by subtracting the total amount for 7 days from the total amount for 14 days of the chemical solutions A and B, is stored in a 200 ml patient container 120. And when a patient actually uses, it dilutes with a diluent (generally tap water), and uses it as 200 ml. Thereby, until it is actually used, it is possible to prevent invasion of germs and the like, and it is clean.
- a diluent generally tap water
- the diluent is selected based on the age information included in the prescription data (step S15).
- it is selected whether it corresponds to the dilution liquid for infants, the dilution liquid for adults, or the dilution liquid for elderly people.
- a syrup is selected for a dilute solution for infants, and tap water is selected for a dilute solution for adults. If the age cannot be specified, select an adult diluent.
- journal printer is driven to print a label (step S16).
- the unit of dose according to setting 6 is used.
- the ml representation or the scale representation is printed.
- the drug bottle 37 is placed on a flat surface by the chemical solution supply unit 3, but the surface to be placed may be inclined.
- the inclination angle needs to be such that the tip of the nozzle 42 that has entered from the upper opening of the drug vial 37 can reach the vicinity of a deep position on the bottom surface of the tilted drug vial 37. According to this, the amount of the chemical solution remaining in the medicine bottle 37 sucked by the nozzle 42 can be reduced as compared with a flat case. That is, it is possible to suppress the amount of the chemical liquid that is wasted.
- the chemical solution in the drug bottle 37 may be agitated by repeatedly sucking and discharging the chemical solution in the drug bottle 37. According to this, even if it is a type of chemical solution that tends to precipitate, the chemical solution to be sucked can be homogenized without adding a special configuration.
- the air is blown by the air supply cylinder 49 to remove the cleaning water or chemical liquid adhering to the nozzle 42.
- the nozzle 42 is repeatedly moved up and down.
- the adhering liquid may be dropped in advance by vibrating. Thereby, the time for removing the adhering liquid in the air supply tube 49 can be shortened or eliminated.
- an image at the time of dispensing each drug solution may be stored together with patient data and prescription data, and may be viewed as an audit or history.
- the nozzle 142 and the pump 146 are connected by a tube.
- the tube may be loosened, and the cleaning liquid may remain.
- the nozzle 142 and the pump 146 may be directly connected, and both may be raised / lowered integrally. Further, even when the nozzle 142 and the pump are not directly connected and are connected by a tube (not shown), it is possible to raise and lower the tube so that the tube does not loosen.
- the concentration of the chemical solution is not considered in the dilution, but it is preferable to consider the concentration of the diluted chemical solution.
- the volume of the stock solution may be diluted within a range of 1.5 to 2 times.
- Table 7 shows the case where A medicine and B medicine are prescribed 12 times in the same patient container 16.
- the patient container 16 to be used needs to satisfy 99 to 132 ml. Therefore, the patient container 16 is searched from the smaller size according to Table 2, and the 100 ml patient container 16 which is the minimum size satisfying 99 ml to 132 ml is selected. In addition, from Table 5, the “number 4” scale that satisfies 12 times, that is, the scale number 12 is selected from the 100 ml patient container 16.
- the concentration of the drug solution after dilution is taken into account within a certain range, so that when taking the patient, it is close to the stock solution, causing bitterness such as bitterness and difficulty in drinking. There is nothing.
- FIG. 186 in addition to the content displayed on the liquid medicine dispensing monitor screen shown in FIG. 15, as shown in FIG. 186 may be displayed.
- the “priority medicine form” button 185 dispensing can be performed in a medicine form registered in advance by the user according to the internal regulations of each pharmacy. Examples of the drug form include drug A being dispensed as a stock solution, drug B being dispensed after predetermined dilution, and the like.
- the “stock solution dispensing” button 186 dispensing with the stock solution can be performed. In this case, as described above, when the patient actually uses it, it is diluted with a diluent (generally, tap water).
- a diluent generally, tap water
- dilution dispensing can be performed. The amount of the diluted solution in this case can be performed by any of the methods already described (any method may be selected).
- Container outlet 114 ... Shutter 115 ... Shelf 116 ... Cap storage box 117 ... Recess 118a ... Journal printer 118b ... Label printer 119 ... Bar code Reader 120 ...
- Patient container 130 Extraction part 130a ... Sensor hole 133 ... Supply part main body 134 ... Holding gas 135 ... Medicine bottle holding part 135a ... Bottom 137 ... Medicine bottle 140 ... Closure plate 141 ... Shaft part 141a ... Spring 142 ... Nozzle 143 ... Nozzle holding part 144 ... Blower 145 ... Supporting part 146 ... Pump 148 ... Cleaning container 150 ... Water supply Pipe 151 ... Drainage port 152 ... Closure plate 152a ... Closure part 152b ...
Landscapes
- Physics & Mathematics (AREA)
- General Physics & Mathematics (AREA)
- Medical Preparation Storing Or Oral Administration Devices (AREA)
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JP2011506077A JPWO2010110303A1 (ja) | 2009-03-24 | 2010-03-24 | 分注装置 |
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JP2012080956A (ja) * | 2010-10-07 | 2012-04-26 | Takazono Technology Inc | 水剤供給装置 |
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JP2013132482A (ja) * | 2011-12-27 | 2013-07-08 | Takazono Technology Inc | 水剤供給装置 |
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US9150119B2 (en) | 2013-03-15 | 2015-10-06 | Aesynt Incorporated | Apparatuses, systems, and methods for anticipating and delivering medications from a central pharmacy to a patient using a track based transport system |
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JP2017070862A (ja) * | 2017-01-30 | 2017-04-13 | 株式会社タカゾノテクノロジー | 水剤供給装置 |
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CN111329758A (zh) * | 2020-03-03 | 2020-06-26 | 江苏省肿瘤防治研究所(江苏省肿瘤医院) | 一种肿瘤科静脉注射混合配药装置 |
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JP6314229B2 (ja) * | 2014-07-18 | 2018-04-18 | 株式会社安川電機 | 薬液調製システム、洗浄装置、洗浄装置システム |
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JP2022107159A (ja) * | 2021-01-08 | 2022-07-21 | 株式会社湯山製作所 | 調製支援システム及び調製支援プログラム |
JP7594181B2 (ja) | 2021-01-08 | 2024-12-04 | 株式会社湯山製作所 | 調製支援システム及び調製支援プログラム |
WO2025034743A1 (en) * | 2023-08-07 | 2025-02-13 | Biocut, Llc | Filling and finishing system for cell/gene therapy product |
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JP5533711B2 (ja) | 2014-06-25 |
JP2012101028A (ja) | 2012-05-31 |
JP2012016569A (ja) | 2012-01-26 |
JP2012016570A (ja) | 2012-01-26 |
JPWO2010110303A1 (ja) | 2012-09-27 |
JP2014217785A (ja) | 2014-11-20 |
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